What are the best exercises to do after hip replacement surgery?

Best Exercises After Hip Replacement Surgery

The best exercises after hip replacement surgery should include a progressive rehabilitation program that starts with gentle range of motion exercises and gradually advances to strengthening and functional exercises over a 9-12 month period, supervised by a physical therapist. 1

Initial Phase (0-4 weeks post-surgery)

Range of Motion Exercises

• Ankle pumps: Flex and extend your ankles to promote circulation
• Gentle hip and knee flexion: While lying on your back, slide your heel toward your buttocks
• Isometric quadriceps exercises: Contract thigh muscles without moving the joint 1
• Gluteal sets: Squeeze buttock muscles while lying down

Weight Bearing

• Begin immediate weight bearing as tolerated with proper gait pattern using assistive devices as needed 1
• Use cryotherapy in the first week to reduce pain 1

Intermediate Phase (4-8 weeks)

Strengthening Exercises

• Closed Kinetic Chain (CKC) exercises: Can begin from week 2 post-surgery 1
• Open Kinetic Chain (OKC) exercises: Can start from week 4 in a restricted range of motion (90-45°) 1
• Progressive resistance training: Begin with lower resistance and gradually increase

Functional Exercises

• Sit-to-stand practice: Focus on proper technique without using hands if possible
• Step-ups: Start with low steps and progress to higher steps
• Walking program: Begin with short distances and gradually increase duration

Advanced Phase (8-12 weeks)

Progressive Strengthening

• Hip abduction/adduction exercises: Using resistance bands or weights
• Quadriceps and hamstring strengthening: Increase resistance progressively
• Balance exercises: Single leg stance, tandem stance, and other balance activities 1

Functional Training

• Stair climbing: Practice proper technique ascending and descending stairs
• Gait training: Focus on normalizing gait pattern without assistive devices when appropriate

Long-term Phase (3-12 months)

Advanced Exercises

• Low-impact aerobic activities: Walking, stationary cycling, or aquatic exercises 1
• Neuromuscular training: Exercises that improve coordination and stability 1
• Functional task-specific training: Activities related to daily living and personal goals

Important Considerations

1. Exercise Progression: Follow the principle of "small amounts often" and gradually build up the "dose" over several months 1

2. Exercise Supervision: Programs are more effective when supervised by physical therapists rather than performed alone at home 1

3. Exercise Duration: Rehabilitation should continue for 9-12 months, depending on your return-to-work or play goals 1

4. Quality of Movement: Pay attention to correct movement patterns to prevent reinjury 1

5. Pain Management: Some discomfort during exercise is normal, but exercises should not cause severe pain or increased swelling

Precautions and Contraindications

• Avoid high-impact activities and exercises that place excessive stress on the hip joint
• Avoid extreme hip flexion beyond 90° and internal rotation during early recovery
• Do not perform exercises that cause sharp pain or significant increase in swelling
• Consult with your surgeon regarding specific movement restrictions based on your surgical approach

Monitoring Progress

Use objective measures to track progress:

• Range of motion measurements
• Strength assessments
• Functional tests (e.g., timed up and go, 6-minute walk test)
• Limb Symmetry Index (LSI) of >90% as a goal for strength and functional tests 1

By following this structured exercise progression after hip replacement surgery, you can optimize your recovery, improve function, reduce pain, and enhance your quality of life. Always consult with your healthcare provider before beginning any exercise program after surgery.