Hip Replacement Recovery: When Should Physiotherapy Begin?

Why so early

Early movement reduces the risk of blood clots and chest infections, keeps muscles from switching off and speeds recovery. Getting out of bed and taking a few steps with a walker, supported by a physiotherapist, is usually the first session.

It feels ambitious. It's safe because modern hip replacements are designed to take weight almost immediately in most cases.

Before surgery

The best time to start is actually before the operation. Strengthening the hip and thigh muscles, practising with crutches and learning the exercises in advance tends to make the first weeks after surgery smoother. If your surgery date is set, ask about prehab.

In hospital

Early goals are getting in and out of bed safely, walking short distances with a walker and managing the toilet and stairs if needed at home. Ankle pumps, buttock squeezes and quad sets start right away.

The first six weeks at home

This phase builds walking and basic strength. Typical exercises include hip abduction and hip extension in standing, mini squats holding on and walking practice with an aid. Many people progress from a walker to crutches to a stick over these weeks.

Precautions matter here. Depending on the surgical approach, you may be asked to avoid bending the hip past 90 degrees, crossing your legs or twisting. These are usually lifted around six weeks, but follow your surgeon's specific advice.

Six weeks to three months

Precautions ease and the programme expands: bridges, step ups, balance work and longer walks. Most people drive again and return to most daily activities during this window.

Three months and beyond

Strength keeps improving, walking becomes more natural and many return to low-impact activities like swimming, cycling and brisk walking. Recovery continues gently up to a year.

Home or clinic?

The early weeks are often easier at home, when car travel is awkward and precautions limit how you sit. Our guide to home physiotherapy after hip replacement covers what that involves, and our post hip replacement exercises page lays out the full programme.

Sleeping after hip replacement

Sleep can be difficult in the first weeks after hip replacement. Many surgeons advise sleeping on your back initially, with a pillow between the legs to stop them crossing. Some allow sleeping on the operated side once it's comfortable, or on the non-operated side with pillows between the knees.

Getting in and out of bed safely matters. Sit on the edge of the bed, then slide back and bring the legs in together, keeping them apart and avoiding twisting. Reverse to get out.

Follow your surgeon's specific advice, as precautions depend on the surgical approach. Your physiotherapist will practise bed transfers with you.

Warning signs

Seek urgent help for sudden severe hip pain, a clunk with the leg looking shorter or turned, wound redness or discharge, fever, or calf pain and swelling. These are uncommon but need attention.