Total Hip Replacement Rehab: What to Expect

If you have hip osteoarthritis, you may benefit from physical therapy to help manage the pain and improve your range of motion (ROM), strength, and overall function. Sometimes, hip pain from arthritis persists in spite of your best efforts with conservative treatments. If that occurs, your physician may recommend a total hip replacement to definitively treat your hip arthritis.





Many patient benefit from physical therapy total hip replacement. Physical therapy after total hip surgery can help you safely regain ROM and strength and can help you return to full functional mobility.


Total Hip Surgery


Total joint replacement surgery is a complex process, but in general, the surgery involves your physician making an incision in the front or side of your hip. Muscles will then be resected and your hip joint will be exposed. Specialized tools will be used to cut away the joint that is arthritic and damaged. Then, a metal prosthesis will be installed on the end of your femur (thigh bone) and in the socket of your hip. A small plastic piece will also be placed in between the ball and socket to allow the metal pieces to glide and slide normally. Once the new hip is implanted, the muscles will be repaired and your incision will be closed.


Starting PT after Total Hip Surgery


Most patients start outpatient PT with us about two to three days after total hip replacement surgery. Your first session will be an initial evaluation. Your physical therapist will meet with you to discuss your condition, how you are feeling, and your past medical history. Your PT will also ask about your home situation and your previous level of work and recreational activities.


After the brief interview, your therapist will take various measurements that give an idea of how you are moving after your surgery. Common impairments measured after total hip replacement include:


  • Range of motion

  • Strength

  • Pain

  • Functional mobility

  • Balance

  • Bed and chair mobility


After your therapist gathers information about your impairments and functional mobility, he or she will work with you to develop a plan of care and goals for rehab. Most goals are functional: returning to normal walking is a common one. Your PT will also prescribe a home exercise program for you to be doing. Exercises at home are an important component of your rehab.


Physical therapy treatment after total hip replacement may involve various components. Your PT will work with you to improve gait (the way you walk), your hip mobility, and strength in the muscles around your hip and legs. Heat or ice may be used for pain and inflammation, and exercises will be done to ensure you can quickly regain mobility.


Patient education after total hip replacement is paramount. If you have had a surgical procedure with a posterior approach, there are total hip precautions that you must follow to prevent your hip from dislocating.


Total hip precautions include:


  • Avoid flexing your hip up more than 90 degrees

  • Avoid crossing your legs

  • Avoid turning your hip and toes inward

Your PT will likely remind you of these precautions often. Don't worry, your hip precautions aren't forever. They are just followed in the weeks after your surgery.


If you have had an anterior approach total hip replacement, there are a couple precautions you must follow in the immediate post-operative period. These include:


  • Avoid excessive extension of your hip

  • Avoid excessive rotation of your hip

Again, these precautions are only temporary. You must speak to your physician to understand your personal total hip precautions.


Exercises after Total Hip Replacement


One of the most important components of your rehab program after total hip replacement is exercise. Exercise has been proven to help improve mobility and strength and improve overall function after surgery. Your PT can show you which exercises are best.


Common exercises that are prescribed after total hip replacement may include:


  • Heel slides

  • Quad and glute sets

  • Straight leg raises

  • Bridges

  • Balance exercises

  • Gait training exercises

  • Stationary bike

  • Treadmill walking

Do not start any exercise program after total hip replacement surgery until you are told to by your physician or physical therapist.


Getting Back to Normal


Most patients spend about four to six weeks in physical therapy after total hip replacement. Your course of rehab may be quicker or slower, depending on your personal situation. You can expect to be walking normally within a month of surgery and back to most normal work and recreational activities within two months of your total hip replacement. Your PT will work directly with you to help you recover fully and to ensure you understand your prognosis during rehab.


Total hip replacement surgery can be extremely effective in helping to decrease hip pain and limited mobility due to hip osteoarthritis. Finding the right PT, like the ones at Capital Region Physical Therapy, can help you have a successful outcome after surgery. Call us today at (518) 439-5006 to set up an appointment and get started.


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Call 518.439.5006

Fax: 518.478.6474

1873 Western Ave. Albany, NY 12003