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After total hip replacement

Hip & knee · After a total hip replacement

Count the weeks from the day of your operation. The date is on your discharge card.

If your doctor wrote a different plan on your prescription, follow that instead of this page.

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Weeks 0–2

Get out of bed and walk from the day after the operation, with help and a walker. Short walks, often. Follow the hip precautions we gave you at all times, for as long as we tell you. Sit on a firm, high chair with arms, and use a raised toilet seat or a commode chair. Keep the ankles moving to protect against clots, and take every dose of the blood-thinning tablets we prescribe.

Weight bearing Full, as comfortable, with a walker, unless we have told you otherwise.

Hip precautions

Hip precautions

Do NOT bend the hip past 90 degrees, cross your legs, or twist the leg inwards.

  • All day
  • Ask us when to stop

Should feel: Safe movement Should not feel: Any of the four positions shown

Ankle pumps

Ankle pumps

Pump the feet up and down to keep the blood moving.

  • 20 times
  • Every hour while awake

Should feel: The calf working Should not feel: Calf pain or swelling — tell us

Terminal knee extension

Terminal knee extension

Heel on a rolled towel, knee hanging free. Press it straight.

  • Hold 5 seconds
  • 10 times
  • 3 times a day

Should feel: The back of the knee stretching Should not feel: —

Buttock squeeze

Buttock squeeze

Lie on your back with the legs straight. Squeeze the buttocks together, hold, then relax.

  • Hold 5 seconds
  • 10 times
  • 3 times a day

Should feel: The buttocks tightening Should not feel: Back pain

Lying hip slide out

Lying hip slide out

Lie on your back, legs straight, toes pointing up. Slide the leg out to the side and back, keeping the knee straight.

  • 10 times
  • 3 times a day

Should feel: The side of the hip working Should not feel: The toes rolling outwards

Short-arc quads

Short-arc quads

Lie with a rolled towel under the knee. Lift the heel until the knee is straight, hold, then lower slowly. Take the towel away afterwards.

  • 10 times
  • 3 times a day

Should feel: The front of the thigh working Should not feel: Sharp pain at the wound

Not yet A pillow under the knee. Breaking the hip precautions: bending the hip past a right angle, crossing the legs or twisting the leg inwards. Low chairs. Squatting, sitting on the floor or using an Indian toilet — until we have told you it is safe.

Move to the next stage only after we have seen you, and the X-ray if one was planned.

Weeks 2–6

Stitches out. Walk a little further each day and stand up straight. Keep following the hip precautions. Carry on with the earlier exercises.

Weight bearing Full. Move from the walker to a stick when you feel steady.

Standing hip abduction

Standing hip abduction

Hold a chair. Lift the leg out to the side, keeping the body upright.

  • 10 times
  • Daily each side

Should feel: The side of the hip working Should not feel: Leaning over

Standing hip extension

Standing hip extension

Hold a chair. Take the leg backwards, keeping it straight.

  • 10 times
  • Daily each side

Should feel: The buttock working Should not feel: Arching the back

Sitting knee bend

Sitting knee bend

Sit on a firm chair. Slide the foot back under the chair to bend the knee, hold, then bring it forward.

  • 10 times
  • 3 times a day

Should feel: A stretch as the knee bends Should not feel: Sharp pain

Sitting heel and toe raises

Sitting heel and toe raises

Sit with both feet flat on the floor. Lift the heels, lower them, then lift the toes.

  • 10 times
  • 3 times a day

Should feel: The calf and the front of the shin working Should not feel: Sharp pain

Not yet A pillow under the knee. Breaking the hip precautions: bending the hip past a right angle, crossing the legs or twisting the leg inwards. Low chairs. Squatting, sitting on the floor or using an Indian toilet — until we have told you it is safe. Driving.

Move to the next stage only after we have seen you, and the X-ray if one was planned.

Weeks 6–12

Walk without a limp and improve your balance. Carry on with the earlier exercises.

Weight bearing Full. Use the stick outdoors until you are steady without it.

Mini squat

Mini squat

Hold a support. Bend the knees a little way, then straighten.

  • 10 times
  • Daily

Should feel: The thighs working Should not feel: Deep groin pain

Calf raises

Calf raises

Rise onto both toes and lower under control.

  • 15 times
  • Daily

Should feel: The calf working Should not feel: Sharp pain

Single-leg balance

Single-leg balance

Stand on one leg beside a worktop.

  • 30 seconds
  • 3 times a day

Should feel: Working to stay steady Should not feel: Losing balance — hold on

Step-up

Step-up

Hold a rail. Step up onto a low step with the operated leg, then step down with the other leg.

  • 10 times
  • Daily

Should feel: The thigh working Should not feel: The knee falling inwards

Not yet Bending the hip past a right angle, crossing the legs or twisting the leg inwards — until we tell you these precautions can stop. Heavy lifting. Squatting, sitting on the floor or using an Indian toilet — until we have told you it is safe.

Move to the next stage only after we have seen you, and the X-ray if one was planned.

Month 3 onwards

Back to your usual activities. Keep walking, and keep the hip muscles strong. Tell any dentist or doctor that you have a hip replacement.

Weight bearing Full.

Heel-to-toe walking

Heel-to-toe walking

Walk heel to toe along a line, beside a support.

  • 10 steps
  • Daily

Should feel: Steadier walking Should not feel: Wobbling — use the wall

Static cycling

Static cycling

Set the seat high, so the knee is almost straight at the bottom. Pedal gently with little resistance.

  • 10 minutes
  • Daily

Should feel: The knee moving freely Should not feel: Pain in the knee or hip

Walking

Walking

Walk daily, building distance slowly.

  • 20–30 minutes
  • Most days

Should feel: Easier walking Should not feel: Limping heavily — use a stick

Not yet Squatting, sitting on the floor or using an Indian toilet — until we have told you it is safe.

Stop and telephone us if

  • Sudden severe hip pain, the leg suddenly looks shorter or turned, or you cannot stand on it: the joint may have come out — go to the nearest hospital
  • Sudden breathlessness or chest pain — go to the nearest hospital
  • The calf becomes swollen, tight or painful — go to the nearest hospital
  • The wound keeps leaking, or you have a fever — come the same day
  • Hip pain that gets worse after it had been getting better — come the same day
  • A fall

Ready when you are.

Call either clinic during consulting hours, or send a WhatsApp message any time.

Nallasopara West Virar East