Physiotherapy after Hip Surgery

Physiotherapy after Hip Surgery: Know Everything!

Physiotherapy after hip surgery is a vital component of the rehabilitation process, promoting recovery and helping patients regain mobility and strength. Following hip surgery, such as a total hip replacement, structured physiotherapy protocols are essential to ensuring optimal outcomes. This content delves into the intricacies of physiotherapy after hip surgery, focusing on guidelines, exercises, and the overall importance of physiotherapy following hip replacement.

The Role of Physiotherapy After Hip Surgery

Physiotherapy plays a crucial role in post-operative care, aiding in pain management, enhancing joint function, and preventing complications. For patients who have undergone hip surgery, early and consistent physiotherapy is key to a successful recovery. The primary goals include:

  • Restoring the range of motion.
  • Strengthening muscles around the hip.
  • Enabling patients to return to their normal activities.

Total Hip Replacement Physiotherapy Protocol

The total hip replacement physiotherapy protocol typically follows a staged approach designed to cater to the different phases of recovery:

Phase 1: Immediate Post-Operative Phase

During this initial phase, the focus is on controlling pain and inflammation, preventing blood clots, and protecting the new hip joint. Patients may start with simple exercises, such as ankle pumps, isometric quadriceps contractions, and gentle hip movements, all within a few days of surgery.

Phase 2: Early Recovery Phase

This phase involves more active exercises aimed at improving the range of motion and increasing muscle strength. Walking aids are commonly used during this period to ensure safety. Physiotherapists will introduce exercises like seated knee extensions, hip abductions, and gentle stretching routines. It’s crucial to follow the specific total hip replacement physiotherapy protocol given by the healthcare provider to prevent any complications.

Phase 3: Intermediate Recovery Phase

Patients gradually progress to more challenging exercises, focusing on building hip strength and endurance. Activities such as stationary biking, controlled squats, and balance exercises become part of the regimen. Physiotherapy post-hip replacement at this stage helps transition patients from assisted movements to more independent mobility.

Phase 4: Advanced Recovery and Return to Function

In the advanced stages of rehabilitation, the goal shifts towards returning to normal activities and improving overall function. High-level strengthening exercises, agility drills, and advanced balance training are incorporated. Physiotherapy following hip replacement continues to play a pivotal role in refining movement patterns and ensuring the longevity of the hip joint.

When should Physical Therapy be started after Hip Replacement?

Starting physical therapy promptly after hip replacement is essential for optimizing recovery outcomes. According to the American Academy of Orthopaedic Surgeons (AAOS), physical therapy often begins as early as the day of or the day after surgery. Early mobilization is crucial to prevent complications such as blood clots and to promote the return of normal joint function. In their guidelines, the AAOS emphasizes that initiating gentle exercises within the first 24 hours significantly enhances patient outcomes by reducing post-operative pain and swelling (AAOS, 2021).

Furthermore, a study published in the Journal of Bone and Joint Surgery highlights that early physical rehabilitation within the first-week post-surgery accelerates functional recovery and improves long-term mobility (Citation: Journal of Bone and Joint Surgery, 2019). A tailored physiotherapy program focusing on range-of-motion exercises and gradual weight-bearing activities is critical during this initial phase. Starting physical therapy early aligns with modern post-operative care standards and plays a pivotal role in restoring independence and quality of life for hip replacement patients.

Benefits of Physiotherapy After Hip Replacement

Physiotherapy after hip replacement offers numerous benefits:

Pain Management

Effective pain control is vital for a smooth recovery. Physiotherapy techniques such as manual therapy, soft tissue mobilization, and specific exercises help alleviate pain and reduce dependency on medications.

Improved Mobility

Regular physiotherapy sessions enhance joint flexibility and overall mobility. Through targeted exercises, patients regain the ability to perform daily activities, like walking and climbing stairs, with greater ease.

Muscle Strengthening

Reinforcing the muscles around the hip joint is a key aspect of rehabilitation. Physiotherapy exercises, tailored to individual needs, help in rebuilding muscle strength and endurance, thus providing better support to the hip.

Prevention of Complications

Structured physiotherapy protocols help in preventing post-surgical complications such as blood clots, infections, and hip dislocations. Following the recommended physio program diligently minimizes the risk of these adverse events.

Enhanced Balance and Coordination

Rehabilitation after hip surgery includes balance and coordination exercises that are instrumental in preventing falls and ensuring safe mobility. Improved balance contributes significantly to the overall quality of life post-surgery.

Physiotherapy Exercises Specific to Hip Surgery

The following exercises are commonly included in a hip replacement physiotherapy routine:

Ankle Pumps

Ankle pumps are essential exercises to promote blood circulation and reduce the risk of blood clots. These can be done lying down, making them convenient for immediate post-operative care.

Heel Slides

Heel slides help maintain and improve the range of motion. The exercise involves sliding the heel towards the buttocks while lying on the back.

Hip Abductions

Hip abductions strengthen the muscles on the outside of the hip. They can be performed lying down or standing with support.

Seated Knee Extensions

Knee extensions target the quadriceps muscles and help in promoting knee and hip flexibility.

Gluteal Sets

Gluteal sets involve tightening the buttock muscles, an important exercise for strengthening the hip area post-surgery.

Incorporating Physiotherapy into Daily Routine

Consistency is key to achieving successful outcomes with physiotherapy. Patients should integrate prescribed exercises into their daily routines and adhere to the recommended physiotherapy program. Regular visits to a physiotherapist, as well as at-home exercises, will contribute significantly to the recovery process.

Selecting a Physiotherapist

Choosing a qualified physiotherapist experienced in post-hip replacement rehabilitation is essential. The physiotherapist should have a thorough understanding of the hip replacement protocol physiotherapy, ensuring that the exercises and treatments are tailored to the patient’s specific needs.

Long-Term Physiotherapy Goals

The long-term goals of physiotherapy after hip surgery include maintaining joint health, preventing future injuries, and sustaining an active lifestyle. Ongoing exercises, periodic physiotherapy sessions, and self-management techniques are crucial for long-term success.


Physiotherapy after hip surgery is indispensable for a speedy and effective recovery. By following a structured total hip replacement physiotherapy protocol, patients can achieve optimal mobility, strength, and joint function. The role of physiotherapy extends beyond immediate post-operative care, playing a crucial part in long-term health and well-being. Through consistent effort, proper guidance, and adherence to physiotherapy protocols, individuals can look forward to a promising recovery journey and an enhanced quality of life.


How long do you need PT after hip replacement surgery?

The duration of physical therapy (PT) after hip replacement surgery varies based on individual recovery rates, the complexity of the surgery, and the patient’s overall health and fitness level. Generally, patients can expect to engage in physiotherapy for approximately 6 to 12 weeks post-surgery, although this timeframe can be extended for some individuals who require additional support. The initial weeks focus on gentle exercises to enhance the range of motion and reduce swelling, gradually progressing to more intensive strength and endurance training.

What exercises should not be done after hip surgery?

Post-hip surgery recovery requires careful consideration of which exercises to avoid to prevent complications and ensure optimal healing. High-impact activities like running, jumping, and strenuous sports should be strictly avoided as they can place excessive stress on the new hip joint and surrounding tissues, potentially leading to dislocation or other damage. Additionally, exercises that involve twisting or pivoting on the operated leg, such as certain yoga poses or tennis, are not recommended due to the risk of causing hip joint instability. According to a study published in the Journal of Orthopaedic & Sports Physical Therapy, patients should also avoid deep squats and lunges that require significant hip flexion, as these movements can exacerbate post-operative pain and prolong recovery time (Journal of Orthopaedic & Sports Physical Therapy, 2020). Ensuring a safe and effective recovery involves adhering to the guidance of healthcare professionals and gradually reintroducing low-impact activities tailored to the individual’s progress.


"Hasan", I am a physiotherapy Doctor. I have completed my B.S.c course (4 years) under Rajshahi University, Faculty of Medicine, Rajshahi. Currently I am working as a clinical physiotherapist at a renowned physiotherapy center and I am continuing my MPT (Master's of physiotherapy) degree at CRP, Savar.

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