Rehabilitation after hip surgery involves distinct phases of recovery. The goal is to allow the best environment for tissue healing while maximizing long-term function. The guidance of a physical therapist, in consultation with your physician, is essential to an effective recovery.

Typical Recovery Process

This is an example of a typical recovery process, and should not be used to direct your rehabilitation after surgery. Each procedure and patient presents a unique set of circumstances, and progressions should be based on your individual responses, exam findings, and progress.

Patients will begin formal outpatient physical therapy approximately two weeks after surgery. Patients are instructed to follow post-operative range-of-motion precautions for six weeks including:

  • No hip hyperextension
  • No excessive external rotation


Patient will be WBAT (weight bearing as tolerated) with walker or appropriate assistive device per surgeon’s or physical therapist’s recommendation. Patient may progress from walker to straight cane when able to demonstrate equal weight bearing, minimal pain, and limited compensatory strategies. Patients should limit overall ambulation distance initially and progression should be based on soreness and pain response. Patients should be instructed to avoid walking for exercise until cleared by MD or PT and only when able to ambulate without assistive device or limp.

Phase One (1-6 Weeks)

  • Decrease pain and inflammation
  • Gradual Restoration of functional range of motion and flexibility
  • Normalize gait pattern with least restrictive device
Range of Motion/Flexibility
  • Gentle/active Prone knee flexion/quad stretch (initially with pillow under pelvis)
  • Stationary Bike: Very low resistance with an elevated seat height. Avoid use of recumbent bike. Emphasize pain free range of motion.
Soft Tissue Mobilization
  • Scar Mobilization: To begin once incision is well healed. Encourage patient to perform daily.
Recommended Strengthening Exercises
  • Glute & Quad and Transverse abdominis activation/ setting exercises
  • Hooklying Adduction & Abduction Isometrics (pain free amount of pressure)
  • Clamshells (within protected ROM)
  • Short Arc Knee extension progressing to Long Arc Knee extension exercises
  • Single Leg Balance (initially with UE assist)
  • Standing Terminal knee extension
  • Mini Wall Squats or Leg Press ( < 90 deg flexion)
Criteria to advance to Phase Two
  • Subjective reports of < 3/10 pain with all ADLs and PT
  • Non reactive pain with low level ADLs
  • 4+/5 strength throughout all hip musculature
  • 10 seconds of single leg stance without loss of pelvic height or increased effort
  • Minimal deviations with ambulation

Phase Two (6 Weeks)

  • Increase lower-extremity strength progressing toward that of uninvolved lower extremity
  • Restore normal gait pattern without assistance or deviations
  • Regain independence with all ADLs/IADLs
Range of Motion/Flexibility
  • Stationary Bike: Low to moderate resistance
  • Add gentle hip extension and external rotation ROM per tolerance once restrictions are lifted
Recommended Strengthening Exercises
  • Continue appropriate exercises from Phase One
  • Steamboats
  • Side-lying hip abduction
  • Side stepping with band
  • Step ups
    • Delayed until patient able to ambulate w/out AD or limp and denies pain with ADLs and short bouts of community ambulation
  • Sit to Stands
  • Assisted single-leg mini-squats
    • Delayed until patient able to ambulate w/out AD or limp and denies pain with ADLs and short bouts of community ambulation
Criteria to advance to Phase Three
  • Non-reactive pain with all exercise and IADLs
  • Unassisted community ambulation without reactive pain or symptoms
  • 5/5 strength throughout hip musculature
  • Full/functional pain free ROM at involved hip
  • Ability to demonstrate 10 step ups without significant compensation

Phase Three (To Begin Once Phase Two Criteria Are Met)

  • Return to functional activities without reactive pain or compensations
  • Begin light recreational activities
  • Symmetrical lower-extremity strength
Range of Motion/Flexibility
  • Continue previous exercises as appropriate
  • Stationary Bike – continue to progress resistance and duration as able
Recommended Strengthening/ Functional Exercise
  • Continue exercises from previous phases with progressive resistance
  • Bridge Progressions
  • Sport Cord resisted walking (forward, backwards, lateral)
  • Initiate structured walking program
    • No treadmill until patient demonstrates functional hip extension ROM ( > 10 deg)
  • Elliptical Trainer – low incline and tolerable resistance

Phase Four (12+ Weeks)

  • Return to recreational activities
  • Demonstrate independence with home exercise program
Exercise/Activity Recommendations
  • Continue to progress exercises from previous phases as appropriate
  • Continue to progress walking program
  • Gradual return to appropriate/recommended recreational activities with structured guidance from physical therapist and clearance from surgeon
    • Golf, walking, biking, doubles tennis, swimming

Discharge Criteria

Below are basic discharge recommendations. Readiness for discharge varies between patients and criteria should be tailored to each individual and based on their prior level of function and goals.

  • Independent non-antalgic ambulation
  • Timed 10-meter walk test: ≤ 7 seconds
  • Symmetrical lower-extremity strength
  • Independent stair ascent and descent with step-overstep pattern
  • Independent with home-exercise program