Whether you’ve had a hip replacement (total hip arthroplasty) or a hip fracture repair (ORIF), rehabilitation is the most important factor determining how quickly — and how fully — you recover. Here’s what to expect at each stage.
Day 1–2: Hospital Recovery
Physical therapy typically begins within 24 hours of surgery. This is not a mistake — early mobilization reduces the risk of blood clots, pneumonia, and deconditioning. On day 1, you’ll likely:
- Sit on the edge of the bed with PT assistance
- Stand and take a few steps with a walker
- Learn your hip precautions (depending on surgical approach — anterior vs. posterior)
- Begin deep breathing exercises to prevent pneumonia
Week 1 (Hospital or SNF)
- Walking progressively longer distances with a walker
- Practicing transfers: bed to chair, chair to standing, toilet
- OT training for dressing, bathing with hip precautions
- Pain management — medication scheduled around therapy
- Wound care monitoring
- Blood thinner medication (typically 2–6 weeks post-op)
Week 2
- Progressive strengthening: hip abductors, glutes, quadriceps
- Balance training
- Stair training (step-to-step gait)
- Increased walking endurance — target 150–300 feet independently
- Home assessment planning begins
Weeks 3–4
Most patients who went to an SNF discharge home in weeks 3–4, depending on their progress and home environment. Before discharge:
- Must demonstrate safe independence with walker on all surfaces you’ll encounter at home
- Must safely manage stair negotiation if home has stairs
- Home equipment arranged: raised toilet seat, shower chair, grab bars, walker
- Outpatient PT scheduled to continue strengthening
Months 2–3
- Transition from walker to cane (hip replacement, typically 4–6 weeks; hip fracture, 6–12 weeks)
- Progress toward cane-free walking if strength and balance allow
- Hip precautions often released at 6-week surgical follow-up (confirm with surgeon)
- Return to driving typically at 4–6 weeks
Months 3–6
- Full return to most daily activities
- Low-impact exercise encouraged: swimming, stationary bike, walking
- High-impact activities (running, jumping) generally not recommended with hip replacement
Tips for a Successful Recovery
- Do your exercises every day — the strengthening exercises your PT gives you are medicine
- Don’t push through sharp pain — discomfort is normal, sharp pain is a signal to stop and communicate
- Follow your hip precautions exactly — dislocation is a serious complication that sets recovery back significantly
- Attend all scheduled PT appointments — skipping sessions prolongs recovery
