You have a date for hip replacement surgery, or you have just come home from the hospital with a new hip. Either way, the same question is on your mind: what happens now, and how long until I can walk, climb stairs, and get my life back?

The surgery replaces the damaged joint. Rehabilitation is what makes the new joint work. The first three months after a total hip replacement are when most of the recovery happens, and physiotherapy is the main driver of that recovery. The exercises are simple, but they need to be done every day, and a few movements must be avoided completely in the early weeks.

This guide explains hip replacement rehabilitation in Surrey in plain language: what happens before surgery, what the first days at home look like, the week-by-week recovery timeline, the hip precautions, the exercises that help, the things to avoid, and when to call your surgeon. It is written for people who have had, or are booked for, a total hip replacement, where both the ball and the socket of the hip joint are replaced.

One honest note. This guide is about total hip replacement, not partial hip replacement, also called hemiarthroplasty, where only the ball of the joint is replaced. A partial replacement is usually done after a hip fracture, and the recovery is different. If you are having a partial replacement, your surgeon and physiotherapist will give you a different plan. This guide is for the total replacement that most people in Surrey receive for arthritis.

What Is a Total Hip Replacement?

In a total hip replacement, the surgeon removes the damaged ball at the top of the thigh bone and the worn socket in the pelvis, and fits a metal or ceramic ball and a plastic or ceramic socket in their place. The new joint is designed to move smoothly and without the bone-on-bone pain of arthritis. Most hip replacements in British Columbia are done because of osteoarthritis, the wear-and-tear arthritis that grinds the cartilage away over years. If arthritis is the reason for your surgery, our guide to arthritis treatment in Surrey explains how the condition develops and why the joint eventually needs replacing.
Not all hip pain needs a replacement. Many people with hip pain improve with physiotherapy, strengthening, and activity changes, and never need surgery. If your hip pain comes from something other than worn-out cartilage, such as a muscle strain, bursitis, or a pinched nerve, the treatment is different. Our guide to hip pain treatment in Surrey explains the common causes.

The operation usually takes one to two hours. Most people stay in hospital for one to three days, although some go home the same day. You will be up and walking with a walker on the day of surgery or the day after. Early movement is one of the most important parts of recovery: the longer you stay in bed, the weaker the muscles get and the higher the risk of blood clots.

A new hip does not feel like your old hip. It will feel stiff, tight, and strange for the first weeks, and the leg may feel longer or shorter than before. That is usually because the muscles are tight and the pelvis is tilted, and it settles as you recover. The hip is not meant to feel normal yet. It is meant to get better week by week, and that is what rehabilitation is for.

Before Surgery: Prehab Makes Recovery Easier

Prehab means physiotherapy before your operation. It is one of the best things you can do for your recovery, and it is often overlooked. The stronger your leg is going in, the faster it comes back after surgery.

A prehab program usually starts four to six weeks before surgery. Your physiotherapist will test your hip movement, leg strength, and walking. Then you will work on three things. First, strengthening the muscles around the hip, especially the gluteal muscles, because they keep you steady when you walk and weaken quickly after surgery. Second, keeping the hip as flexible as possible, because a hip that moves well before surgery moves better afterwards. Third, practising with walking aids, so you are not learning to use a walker or crutches for the first time while you are in pain.

Prehab is also the time to prepare your home. Move a bed or a chair to the ground floor if your bedroom is upstairs. Clear the hallways of rugs, cords, and clutter. Put a chair with arms in the bathroom and the kitchen, raise the toilet seat, and get a shower chair. Stock the freezer and the pantry. Arrange for someone to be with you for the first week, especially at night. If falls are a worry, our guide to falls prevention for seniors in Surrey covers home safety in detail.

One more thing to ask about before surgery: in British Columbia, some patients qualify for free post-surgical rehabilitation through Vancouver Coastal Health's OASIS program, which covers physiotherapy after hip and knee replacement for patients who had surgery at certain hospitals and live in Surrey, when referred through the program. Ask your surgeon or your physiotherapist whether you qualify.

From Hospital to Home: The First Days

The hospital physiotherapist will get you walking before you go home. You will use a walker at first, and practise getting in and out of bed, sitting and standing from a chair, and walking to the bathroom. You will also start the first exercises: ankle pumps, gentle buttock squeezes, and heel slides.

Before you leave, the hospital team will check that you can walk a short distance, climb a few stairs with a rail, and get in and out of a car. You will go home with prescriptions for pain medicine and blood thinners, instructions for the incision, and a surgeon follow-up appointment, usually around two weeks after surgery.

The first days at home are the hardest. The hip will be sore and swollen, and you will be tired. That is normal. Take your pain medicine on schedule for the first week, rather than waiting until the pain is severe, and take it about 30 minutes before your exercises, so you can move the hip with less pain.

Ice the hip for 15 to 20 minutes at a time, several times a day, with a cloth between the ice and the skin. Keep the leg raised on pillows when resting. Sleep on your back for the first few weeks, with a pillow between your knees if you turn onto your side, so the operated leg cannot cross over the other leg.

The First 2 Weeks: Movement Comes First

The first two weeks are about three things: controlling pain and swelling, getting the hip moving, and walking safely. You will have physiotherapy, either at home or at a clinic, and you will have exercises to do several times a day.

The most important exercise in the first two weeks is the ankle pump. Move your ankle up and down, ten times every hour you are awake. It looks trivial and it is not: it keeps the blood moving in the leg and prevents blood clots, one of the main risks after hip replacement. Do it even when you do not feel like exercising.

The second exercise is the buttock squeeze. Lie on your back and tighten the muscles of your buttocks, hold for five seconds, then relax. Do this ten times, three times a day. It wakes up the gluteal muscles cut during surgery, the ones that hold you steady when you walk.

Walk every hour you are awake, even if it is only to the bathroom and back. Use the walker until your physiotherapist tells you it is safe to switch to a cane. Do not rush the walking aids: a fall in the first weeks can dislocate the new hip. Most people switch to a cane at around two to three weeks, and walk without an aid at around four to six weeks, but the timing depends on your strength and balance, not the calendar.

Weeks 2 to 6: Building Strength and Walking

By two weeks, the incision is usually healing well and the surgeon will check it at your follow-up appointment. The swelling is starting to come down, and you are walking more. This is the phase where the real work starts.

Your physiotherapist will add strengthening exercises. Standing hip abduction, lifting the operated leg out to the side while holding a counter, builds the muscles that keep your pelvis level when you walk. Without them, you limp, and a limp loads the lower back and the other hip. Heel slides keep the hip and knee moving, and seated marching builds the hip flexors that lift your leg when you walk.

Walking is the main exercise in this phase. Build up gradually, a few minutes more each day. By four to six weeks, most people are walking for 15 to 20 minutes at a time, several times a day, on flat, even ground at first. Uneven ground, slopes, and curbs come later, when your balance is better.

Stairs are a milestone in this phase. Going up is easier than going down. The rule is "up with the good leg, down with the bad leg": lead with your unoperated leg going up, and lead with your operated leg going down, always holding the rail. Your physiotherapist will practise stairs with you first.

Driving is another question that comes up often. You cannot drive until you can sit in the car without breaking your hip precautions, press the pedals, and react quickly in an emergency. For a right hip replacement, that is usually around six weeks. For a left hip, and an automatic car, it may be sooner, around four weeks. Your surgeon will clear you, and your insurance needs that clearance.

Weeks 6 to 12: Getting Your Life Back

By six weeks, most people are walking without an aid, the swelling is much less, and the hip moves well. Your surgeon will usually ease the hip precautions at the six-week check. This is when rehabilitation shifts from getting the joint moving to getting you back to your life.

Your physiotherapist will add harder strengthening exercises: mini squats holding onto a counter, step-ups on a low step, and walking on uneven ground. Balance exercises matter too, because your leg has been weak and your walking pattern has changed. If your lower back has been aching from months of limping, that often improves as your walking normalises, and our guide to lower back pain treatment explains how the back and the hip affect each other.
By eight to twelve weeks, most people are doing most of their normal activities: walking the dog, shopping, light housework, and gardening. Golf, swimming, and cycling are usually possible by three months. Recovery after a hip replacement is often faster than after a knee replacement, because the hip is a more stable joint and the muscles around it recover more quickly. If you have also had a knee replaced, or are considering one, our guide to knee replacement rehabilitation in Surrey explains how that recovery differs.

Running, jumping, and contact sports are not recommended with a hip replacement, because they wear the parts out faster and increase the risk of dislocation. Your surgeon will give you a list of safe activities and ones to avoid, and it is worth following. A hip replacement that is looked after can last 20 years or more.

Hip Precautions: The Three Rules That Protect Your New Hip

After a hip replacement, the new joint is held in place by muscles that have been cut and stretched, and by a capsule that needs time to heal. Until those tissues heal, the ball can pop out of the socket. That is called a dislocation, and it is painful and needs emergency treatment. Hip precautions are the rules that stop it happening.

The classic precautions apply mainly when the surgeon used the posterior approach, operating from the back of the hip. Most hip replacements in BC are done this way. The three rules are simple, and they apply for the first six weeks, or until your surgeon eases them:

  • Do not bend your hip past 90 degrees: do not bend forward to put on socks or shoes, sit in a low chair, or squat to pick something up. Use a raised toilet seat and a long-handled shoehorn and reacher.
  • Do not cross your legs. Do not cross your ankles either. When you sit, keep your knees apart. When you sleep on your side, put a pillow between your knees. When you get in and out of bed or a car, keep the operated leg slightly out to the side.
  • Do not twist the operated leg inward. When you turn, turn your whole body, feet and all, instead of twisting at the hip. Do not pivot on the operated leg.

If your surgeon used the anterior approach, operating from the front of the hip, the precautions are different and usually fewer, because the muscles at the back of the hip are not cut and the dislocation risk is lower. Your surgeon will tell you which approach was used and which rules apply to you. Always follow your own surgeon's instructions, not a generic list.

Safe Exercises After Hip Replacement

These are the core exercises of hip replacement rehabilitation in Surrey. They are safe for most people after a total hip replacement, but they are not a prescription. If your surgeon gave you different instructions, follow those. If an exercise causes sharp pain, or the swelling jumps up and stays up, stop and tell your physiotherapist.

Ankle Pumps and Circles

Move your ankle up and down, then in circles, ten times every hour you are awake for the first two weeks, and several times a day after that. It prevents blood clots and keeps the circulation going.

Buttock Squeezes

Lie on your back with your legs straight. Tighten the muscles of your buttocks, hold for five seconds, then relax. Do ten repetitions, three times a day. This wakes up the gluteal muscles cut during surgery and builds the strength that keeps your pelvis steady when you walk.

Heel Slides

Lie on your back and slowly slide your heel towards your bottom, bending the knee as far as you comfortably can, then slide it back out. Do ten repetitions, three times a day. This keeps the hip and knee moving. Do not bend the hip past 90 degrees while doing it.

Standing Hip Abduction

Hold onto a counter for balance. Keeping your knee straight, lift your operated leg out to the side, then lower it slowly. Do ten repetitions, once a day, from about week two. This is the most important strengthening exercise for walking without a limp.

Standing Hip Extension

Hold onto a counter for balance. Keeping your knee straight, move your operated leg slowly backwards, then return. Do ten repetitions, once a day, from about week two. This strengthens the muscles at the back of the hip that push you forward when you walk.

Seated Marching

Sit in a firm chair with your feet flat on the floor. Lift one knee up, as if marching, then lower it. Alternate legs. Do ten repetitions on each side, once a day, from about week three. This builds the hip flexors that lift your leg when you step forward.

What to Avoid After Hip Replacement

Most of the things to avoid are about protecting the new joint while it heals and not falling.

  • Do not bend your hip past 90 degrees for the first six weeks, unless your surgeon used the anterior approach and told you otherwise.
  • Do not cross your legs or ankles, and do not sleep on your side without a pillow between your knees.
  • Do not twist on the operated leg. Turn your whole body instead.
  • Do not sit in a low chair, a low toilet, or a deep sofa for the first six weeks. A firm chair with arms makes sitting and standing much easier.
  • Do not drive until your surgeon clears you.
  • Do not run, jump, or play contact sports. These wear the replacement out faster and increase the risk of dislocation.
  • Do not lift heavy objects in the first six weeks, and do not carry anything while you are still using a walker or a cane.
  • Do not skip your exercises because the hip feels better. The exercises are what keep the muscles strong and the hip moving, and stopping early is the most common reason people limp months after surgery.

When to Call Your Surgeon or Physiotherapist

Most of the discomfort after hip replacement is normal. But some things are not, and they need a call the same day. Call your surgeon or your physiotherapist if any of these happen:

  • The incision opens, leaks fluid, or becomes increasingly red, hot, or swollen
  • You develop a fever above 38 degrees, or chills
  • The calf becomes very painful, swollen, or tender, which can be a sign of a blood clot
  • You have chest pain or sudden shortness of breath, which needs emergency care, call 911
  • The hip becomes suddenly much more painful, the leg looks shorter or turned out, or you cannot move the hip at all, which can be a sign the hip has dislocated, call 911 or go to the emergency department
  • You have a fall, even if the hip does not hurt much afterwards
  • The hip feels unstable, or gives way when you put weight on it
  • You develop new numbness or weakness in the leg or foot

Frequently Asked Questions

How long does hip replacement rehabilitation take?

Most of the recovery happens in the first three months. You will be walking with a walker in the first days, with a cane by two to three weeks, and without an aid by four to six weeks. Strength and walking keep improving for six to twelve months, although the biggest gains are in the first three months.

How much should my hip bend after replacement?

The goal is to bend the hip to 90 degrees and beyond by six weeks, once your surgeon eases the precautions. That is enough to sit comfortably, climb stairs, and get in and out of a car. In the first six weeks, the 90-degree limit is a safety rule, not a sign the hip cannot bend further. Your physiotherapist will measure your hip movement at each visit and tell you when it is safe to go further.

Is hip replacement rehabilitation painful?

Yes, especially in the first two weeks. The hip is sore and stiff, and the exercises are uncomfortable. That is normal, and it improves week by week. Take your pain medicine on schedule for the first week, and take it about 30 minutes before exercising. Some discomfort during exercises is expected. Sharp pain is not, and if the pain is sharp or the swelling jumps up and stays up, you have done too much and should tell your physiotherapist.

Can I climb stairs after hip replacement?

Yes. Most people practise stairs in the hospital before going home. The rule is "up with the good leg, down with the bad leg": lead with your unoperated leg going up, and lead with your operated leg going down, always holding the rail. By six weeks, most people climb stairs comfortably. If your home has stairs, your physiotherapist will check that you can manage them before you are discharged.

Will I need physiotherapy for the rest of my life?

No. Formal physiotherapy usually lasts six to twelve weeks after surgery, with visits becoming less frequent as you improve. After that, you keep doing the exercises on your own, and you keep walking, cycling, or swimming as part of your normal routine. A hip replacement needs lifelong sensible use, not lifelong physiotherapy.

Get Help with Your Hip Replacement Recovery in Surrey

A hip replacement is a big operation, and the recovery is a real project. But it is also one of the most successful operations in medicine. Most people who have it say the same thing a year later: they wish they had done it sooner. The difference between a good result and a great result is usually the rehabilitation: the daily exercises and the hip precautions in the first six weeks.

If you are booked for hip replacement surgery, or you have just had one and want a clear plan, book an assessment at Renew Physiotherapy for hip replacement rehabilitation in Surrey. We will measure your hip movement, test your strength and walking, and build a program around your surgery date and your goals. We will tell you honestly what to expect, week by week, and we will keep you on track through the first three months when it matters most.

Renew Physiotherapy

5722 176a Street, Surrey, BC V3S 4H2

Phone: (236) 450-0171

Email: Info@renewclinics.ca

Website: www.renewclinics.ca

Book your hip replacement rehabilitation assessment today and start your recovery with a clear plan.