Exercises After a Hip Replacement: Rebuilding Strength Safely

Exercise is the single most important thing you can do to recover well from a hip replacement. The new joint is only part of the picture. The muscles around your hip have often been weak for a long time because of the pain that led to surgery, and rebuilding them is what gives you a strong, stable, comfortable hip in the long run.

The encouraging part is that the exercises are gentle and simple. They are not about working hard or pushing through pain. They are about moving little and often, every day, so that strength returns steadily and safely. This guide walks you through the typical progression, always within the hip precautions your team has given you.

A word on precautions first

Before any exercise, make sure you understand your hip precautions. Depending on the surgical approach, and particularly with a posterior approach, you will usually be asked to avoid bending the hip past 90 degrees, not to cross your legs, and not to twist on the operated leg.

Every exercise below is designed to respect these limits, but it is worth reading our hip replacement precautions guide so you understand exactly why these movements are restricted. If any exercise causes sharp pain or feels like it pulls the hip into a forbidden position, stop and check with your physical therapist.

Early bed exercises (from day one)

These gentle movements can usually begin within a day of surgery. They get the blood flowing, which protects against clots, and they switch the muscles back on. Aim for little and often, several short sessions through the day.

Ankle pumps. Lying on your back, point your toes away from you and then pull them back toward you, slowly and repeatedly. This keeps blood moving in your legs and helps guard against clots and swelling.

Static quadriceps (thigh squeezes). With your leg straight, press the back of your knee down into the bed and tighten the muscle on the front of your thigh. Hold for a few seconds, then relax. This wakes up the muscles that straighten your knee and support your hip.

Glute squeezes. Squeeze your buttock muscles together, hold for a few seconds, then release. This strengthens the powerful muscles that drive your hip and help you stand and walk.

Heel slides. Lying on your back, slowly slide your heel up toward your bottom, bending the knee and hip a little, then slide it back down. Only bend within your allowed range and never past the point your team has set. Keep the movement small and controlled.

Knee bends in lying. Some teams add a gentle bend where you slide the heel a small way as above, always staying well within your allowed range. Never chase a deeper bend in these early days. The aim is gentle, frequent movement, not stretching to a limit.

These early exercises feel almost too easy, but they matter enormously. They are the foundation everything else is built on. Try to fit in a short set every couple of hours while you are awake rather than saving them all for one sitting, which is both more effective and far less tiring.

Standing exercises (once you are on your feet)

As you become steadier, your physical therapist will add standing exercises. Always hold onto something solid and stable, such as a kitchen worktop, for balance.

Hip abduction. Standing tall, slide your operated leg out to the side, keeping your toes pointing forwards and your body upright. Bring it gently back. Do not lean or twist. This strengthens the side hip muscles that keep you stable when walking.

Standing knee raises. Lift your operated knee up in front of you, but only to a height that keeps the hip below the 90 degree limit. Lower it slowly and with control. Keep the movement gentle and never force the leg higher than your precautions allow.

Hip extension. Standing tall and holding your support, move your operated leg gently backwards from the hip, keeping your knee straight and your body upright. Bring it back slowly. This works the muscles at the back of the hip.

Do each in slow, controlled sets as your physical therapist advises, resting between them. Quality of movement matters far more than speed or number.

Walking is exercise too

Walking is one of the best things you can do, and it counts as exercise in its own right.

In the early days you will use a frame or crutches, then progress to a single stick as your strength and balance improve. Focus on walking well rather than far: stand tall, take even steps, and try not to limp or rush. Short, frequent walks around the house are better than one long, exhausting outing.

As the weeks pass, gradually increase your distance, listening to your body and easing off if swelling or soreness flares. Our guide on swelling after hip replacement explains how to manage that. The hip replacement recovery timeline shows how walking typically progresses from a frame to a stick to unaided over the weeks.

A good way to build up is to add a little each day rather than making big jumps. If today’s walk felt comfortable, you might go slightly further tomorrow. If it left you sore or swollen, hold steady or ease back for a day before trying again. Walking on flat, even ground at first is kindest to the new hip, with slopes and rougher surfaces added once you feel steady and strong.

What to avoid

Some movements and activities should wait until your team gives the all clear.

Avoid any exercise that bends the hip past 90 degrees, crosses your legs, or twists the operated leg. Steer clear of high-impact activities like running, jumping, and contact sport, which put too much stress on the new joint, usually for good. Do not push into sharp pain. Mild aching and a gentle stretch during exercise are normal, but a sharp, stabbing pain is a signal to stop.

Skip deep squats, low chairs, and sitting on the floor in the early stages, as these all force the hip to bend too far. Build up gradually and only progress when your physical therapist agrees.

It also helps to balance exercise with rest. Doing too much in one go, then needing a day or two to recover, slows you down more than a steady daily routine. If an exercise leaves your hip sore and swollen for hours afterwards, you have likely overdone it, so ease back next time. Pain that settles quickly after exercise is fine, but pain that lingers is a sign to do a little less.

Consistency is everything

The secret to a strong recovery is not intensity but consistency. A few minutes of gentle exercise spread across the day, every day, achieves far more than an occasional hard session, and it is much kinder to your healing joint.

Follow the specific program your physical therapist gives you, as it is tailored to your surgery, your approach, and your progress. Build the exercises into your daily routine, perhaps tied to set points in the day such as after breakfast and before bed, so they become a habit you barely have to think about.

Some people find a few simple tools help them stay on track and motivated, from resistance bands to apps and pedometers. Our guide to the best recovery tech for hip replacement covers gadgets that can support your program.

Keep going even when you feel better. The hip continues to gain strength for many months, and the people who recover best are simply the ones who keep turning up for their exercises, gently and patiently, day after day.

This guide is part of our hip replacement recovery series.