Rehabilitation after hip replacement — stages and exercises

Rehabilitation after hip replacement takes place in 4 stages: getting upright and learning to walk in hospital, early rehabilitation at home with crutches, rebuilding strength and walking unaided, and returning to full activity. Throughout, the surgeon’s recommendations on weight-bearing and movements to avoid apply. The pace of each stage is set by the doctor in charge together with the physiotherapist.

Below we describe the stages of rehabilitation without a rigid timetable, the symptoms that need urgent contact with a doctor, typical movement restrictions, 5 exercises with dosage and what home physiotherapy looks like in the Rydułtowy area.

Contents

What does rehabilitation after hip replacement look like?

Rehabilitation usually starts in hospital, in the first days after the operation, with exercises in bed, getting upright and learning to walk with crutches. After discharge, the aim is independence at home, reducing swelling and improving range of movement. Later you rebuild hip muscle strength, walking without crutches and balance, and finally return to work and leisure.

Stage	Main goals	Who decides on moving on
1. Hospital	getting upright, walking with crutches, sitting down and standing up safely	hospital team
2. Early stage at home	independence, controlling swelling, exercises in bed and on a chair	surgeon and physiotherapist
3. Rehabilitation	buttock and thigh strength, walking unaided, stairs	surgeon and physiotherapist
4. Return to activity	work, walks, cycling, swimming	surgeon and physiotherapist

Each patient goes through these stages at a different pace, depending on age, fitness before the operation, other conditions and the type of procedure.

Which movements should be avoided after hip replacement?

The restrictions depend on the approach through which the prosthesis was implanted, so the ones given by the surgeon apply. After a posterior approach, avoiding bending the hip beyond 90°, crossing your legs and turning the knee inwards is often recommended. After an anterior approach, the restrictions may be fewer or different. Some teams no longer use routine restrictions.

In practice, this means for example sitting on a higher chair with armrests, not bending down deeply to the floor and sleeping with a pillow between your knees, if this was recommended. If you do not know which restrictions apply to you, ask in hospital or at your follow-up visit with the surgeon.

Which exercises can you do after hip replacement?

In the early stage, exercises lying down are usually safe: foot movements to improve circulation, tightening the thigh and buttock muscles and carefully bending the knee within the permitted range. Do the 5 exercises below only if the surgeon or hospital physiotherapist has not advised otherwise, and always within the movement restrictions you were given.

1. Ankle pumps. Lying down, bend and straighten your feet at the ankles. 15–20 repetitions, every 1–2 hours during the day.
2. Thigh tightening. Lying with your legs straight, press your knee down into the bed and hold. 10 contractions of 5 seconds, 3 times a day.
3. Buttock squeezes. Lying down, squeeze your buttocks and hold. 10 contractions of 5 seconds, 3 times a day.
4. Knee bending with heel slides. Lying down, slide the heel of the operated leg towards your buttock, without exceeding the permitted hip bend. 10 repetitions, 2 sets, 2 times a day.
5. Leg slides out to the side lying down. Lying on your back, slide the operated leg out to the side along the bed and back, toes pointing at the ceiling. 10 repetitions, 2 sets, 2 times a day, if the surgeon allows it.

If the pain gets worse or spreads, stop the exercise and consult a physiotherapist.

How should you prepare your home for coming back from hospital?

Before coming home, it is worth removing rugs and cables you could trip over, preparing a stable chair with armrests, raising the toilet seat with a riser, placing the things you use most often at waist height and getting a reacher (grabber) and a long-handled shoehorn. Good night-time lighting reduces the risk of falling on the way to the toilet.

We give a detailed list in our post how to prepare your home for home physiotherapy. Help from someone close in the first period after discharge is also useful, especially with bathing and shopping.

What does rehabilitation at home and at the clinic look like?

In the early stage, when travelling is difficult, the physiotherapist can come to your home: they teach you to walk safely with crutches, stand up, manage stairs and do the exercises. Once the patient moves more easily, therapy can continue at the clinic in Rydułtowy. Home physiotherapy costs approx. PLN 200 for up to 5 km, then PLN 2/km, and the exact price is agreed when booking.

When choosing physical therapy treatments, the physiotherapist takes the metal implant into account, as some heat treatments and electrotherapy are contraindicated near it. The number and frequency of visits are set individually, in line with the surgeon’s recommendations. We write about choosing where to have therapy in our post rehabilitation at the clinic or at home.

Home physiotherapyafter hospital discharge, when travelling to the clinic is difficult; up to 15 km from Rydułtowyapprox. PLN 200 for up to 5 km, then + PLN 2/km; the exact price is agreed when booking Manual lymphatic drainagefor limb swelling after surgery, after agreeing it with your doctorPLN 110

Prices valid from 08.2026.

Which mistakes make recovery harder?

The most common mistakes are giving up crutches too early without the approval of a doctor or physiotherapist, ignoring the recommendations on movements to avoid, stopping the exercises once the pain eases, and lying or sitting still for long periods. It is also risky to ignore calf swelling and fever, and to leave rugs, thresholds and cables at home that make falls more likely.

You will find general information about joint problems in our guide joint pain and injuries.

Summary

Rehabilitation after hip replacement has 4 stages, and their pace is set by the surgeon together with the physiotherapist. The basis is regular exercise within the movement restrictions and watching for signs of thrombosis, infection and dislocation. Home physiotherapy within 15 km of Rydułtowy costs approx. PLN 200 for up to 5 km, then PLN 2/km.

Frequently asked questions

When can I stop using crutches after hip replacement?

The decision to stop using crutches is made by the surgeon or physiotherapist, as it depends on the type of prosthesis, how it is fixed and the patient’s progress. Usually you first move from two crutches to one, held on the side opposite the operated hip. The criterion is walking without limping and without pain, not the number of days since the operation.

When can I drive after hip replacement?

When you can return to driving is decided by the surgeon. They take into account the side of the operation, the type of gearbox, the strength and reaction speed of the leg and any painkillers you are taking. It is also worth checking your insurance conditions. As a passenger, you usually get into the car backwards, sitting on the seat first and then bringing your legs in.

Can I sleep on my side after hip replacement?

Sleeping on your side may be possible, but when and how depend on the surgeon’s recommendations. At first, lying on your back is often recommended, and later on your side with a pillow between your knees, which limits an unfavourable hip position. You usually only lie on the operated side once the wound and tissues have healed.

Can I do sport after hip replacement?

Many people return to walking, Nordic walking, cycling and swimming. Sports involving running, jumping and physical contact are usually not recommended, as they increase the risk of the prosthesis loosening and of injury. It is worth deciding on a specific activity together with the surgeon and physiotherapist, taking into account the type of prosthesis.

Do I need a referral for rehabilitation after a joint replacement?

A referral is usually not required for private rehabilitation at the “W zdrowym ciele” clinic or at home. The clinic has no contract with the NFZ, so visits are paid. You do, however, need your hospital discharge summary with the surgeon’s recommendations, as the physiotherapist plans the exercises and weight-bearing on that basis.

Which towns does the physiotherapist travel to?

The physiotherapist travels to patients within 15 km of Rydułtowy, including Rybnik, Wodzisław Śląski, Radlin and Pszów. A visit costs approx. PLN 200 for up to 5 km, then PLN 2 for each additional kilometre. The exact price is agreed when booking, by phone on 505 417 624.

Sources

• NICE, Joint replacement (primary): hip, knee and shoulder (NG157), 2020.
• Smith T.O. et al., Hip precautions following primary total hip arthroplasty: a systematic review,.
• Guidelines and recommendations of the centre where the operation was performed (given to the patient on discharge).