Why These Exercises Help
Total hip replacement removes the damaged joint and replaces it with a prosthetic implant, but the surrounding muscles — weakened by both the arthritis and the surgery itself — require systematic rehabilitation to recover their strength and function. Without targeted rehabilitation, patients commonly develop a persistent limp, hip flexor contracture, and significantly reduced walking endurance even after a technically successful surgery. Post-operative exercises restore muscle strength, promote osseointegration of the implant, improve proprioception, and reduce the risk of dislocation by ensuring muscles provide adequate dynamic stability around the new joint. Following a structured rehabilitation programme at Realign Rehab Clinic Faridabad has been shown to reduce recovery time by 20–40% compared to self-managed recovery.
5 Best Hip Replacement Recovery Exercises
1. Ankle Pumps (Day 1 Post-Op)
Sets/Reps: 3 sets × 20 reps, hourly | Difficulty: Beginner
How to do it: Lie in bed with legs flat. Flex and extend both ankles briskly — pulling the toes upward, then pointing them downward in an alternating pumping motion. Perform this as frequently as possible in the first 24–48 hours post-surgery.
Physiotherapy tip from Dr. Vaishali Suri: Ankle pumps activate the calf muscle pump, driving venous blood return from the lower limb and significantly reducing the risk of deep vein thrombosis (DVT) — the most serious early complication after hip replacement. Begin within hours of waking from anaesthesia, or as soon as cleared by nursing staff.
2. Supine Heel Slides
Sets/Reps: 3 sets × 15 reps | Difficulty: Beginner
How to do it: Lie on your back. Slowly slide the heel of the operated leg toward your buttocks by bending the hip and knee. Slide back to the start position. Keep the movement smooth and within a comfortable range. Do not force hip flexion beyond 90 degrees in the early post-operative period.
Physiotherapy tip from Dr. Vaishali Suri: Heel slides restore early hip flexion mobility and maintain quadriceps and hip flexor length in the first week after surgery. The 90-degree hip flexion restriction is standard for posterior approach THR — confirm your restriction precautions with your surgeon and physiotherapist at Realign Rehab Clinic before progressing range.
3. Glute Sets (Isometric Gluteal Contraction)
Sets/Reps: 3 sets × 10 reps, 5-second hold | Difficulty: Beginner
How to do it: Lie on your back with legs straight. Squeeze the buttock muscles of the operated leg as firmly as comfortable, as if trying to hold a coin between your cheeks. Hold for 5 seconds, then fully relax. Ensure you are contracting the buttock and not the abdomen or thighs.
Physiotherapy tip from Dr. Vaishali Suri: Gluteal activation is often significantly impaired immediately post-operatively due to surgical trauma to the posterior capsule and short external rotators. Isometric glute sets are the safest starting point to re-establish neuromuscular connection with the gluteus maximus before progressing to weight-bearing exercises.
4. Standing Hip Abduction (Weeks 2–4)
Sets/Reps: 3 sets × 15 reps each side | Difficulty: Beginner to Intermediate
How to do it: Stand next to a wall or chair for balance. Keeping the pelvis level, lift the operated leg out to the side to approximately 30–40 degrees. Hold briefly at the top, then lower with control. Do not allow the pelvis to drop on the moving side.
Physiotherapy tip from Dr. Vaishali Suri: Restoring gluteus medius strength is the primary goal of Phase 2 hip replacement rehabilitation. Persistent gluteus medius weakness is the most common cause of the post-operative Trendelenburg limp. At our Faridabad clinic, we assess hip abduction strength at every follow-up and progression is tied directly to achieving symmetry with the opposite side.
5. Partial Weight-Bearing Mini Squat (Weeks 3–6)
Sets/Reps: 3 sets × 10–12 reps | Difficulty: Intermediate
How to do it: Stand with both hands lightly resting on a stable surface. Feet hip-width apart. Lower into a partial squat to approximately 30–40 degrees of knee bend, distributing weight evenly between both legs. Press through both heels to return to standing. Progress to equal weight-bearing without support as tolerated.
Physiotherapy tip from Dr. Vaishali Suri: The partial squat prepares the hip for the demands of stair climbing and rising from a chair — two key functional goals in hip replacement recovery. Ensure hip precautions (no flexion beyond 90 degrees, no crossing the midline) are respected during this exercise until your surgeon confirms full precaution lifting.
Safety Precautions
- Strictly follow your surgeon's hip precautions (posterior approach: no flexion >90°, no adduction, no internal rotation) until formally discharged from these restrictions.
- Stop any exercise that causes increased wound pain, swelling, warmth, or redness at the hip — these may indicate complications requiring medical review.
- Do not skip the walking aid until cleared by your physiotherapist — premature unsupported walking risks dislocation and adverse loading of the implant.
- These exercises complement professional physiotherapy; they do not replace a clinical assessment and hands-on treatment.
When to See a Physiotherapist
Post-operative physiotherapy should begin within 24 hours of surgery and continue systematically through all phases of recovery. Dr. Vaishali Suri at Realign Rehab Clinic, NIT-5 Faridabad provides dedicated THR rehabilitation including gait re-education, progressive strengthening, stair training, and return-to-activity planning. Early physiotherapy referral is strongly associated with faster discharge from walking aids. Call +91 9818185589 to arrange your post-operative rehabilitation.
FAQ
How often should I do these exercises?
In the first 2 weeks, perform exercises 2–3 times daily. From weeks 3 onwards, progress to once daily strengthening with daily walking. Your physiotherapist will set specific session targets based on your recovery trajectory.
Can I do these exercises if I had an anterior approach THR?
Yes, but with different precautions. Anterior approach patients typically have fewer flexion restrictions but may need to avoid hip extension and external rotation in the early weeks. Always confirm your specific precautions with your surgeon and Dr. Vaishali Suri before beginning any exercise programme after THR.
How long before results?
2-4 weeks with consistency. Combine with physio at Realign Rehab Clinic Faridabad — call +91 9818185589.