The Definitive Guide to Exercising After Hip Surgery

Hip surgery, whether for replacement, repair, or other interventions, marks a pivotal moment on your journey to recovery and renewed mobility. While the surgery itself addresses the underlying issue, your active participation in rehabilitation through carefully structured exercise is the cornerstone of a successful outcome. This guide cuts through the noise, offering a clear, actionable roadmap to exercising safely and effectively after hip surgery. We’ll focus on the how-to, providing concrete examples and practical advice to empower you at every stage of your recovery.

Understanding Your Post-Surgical Landscape

Before diving into specific exercises, it’s crucial to understand the immediate post-surgical period. Your body is healing, and the tissues around your hip are vulnerable. Adhering strictly to your surgeon’s and physical therapist’s initial instructions is non-negotiable. This often includes weight-bearing restrictions, limitations on range of motion, and precautions against certain movements (e.g., extreme hip flexion, adduction, or rotation, depending on the type of surgery and approach). Your initial exercises will be gentle, focusing on circulation, muscle activation without strain, and preventing complications like blood clots.

The Immediate Post-Operative Phase (Days 1-7, approximately)

This phase is about gentle awakening of your muscles and ensuring good blood flow. Pain management is key here; take your prescribed medication as directed to allow for comfortable movement within your limitations.

1. Ankle Pumps:

How to do it: While lying in bed or sitting in a chair, gently pump your ankles up and down, as if pressing an imaginary gas pedal and then lifting your toes towards your shins.
Concrete Example: Perform 10-15 repetitions every hour while awake. This seemingly simple exercise significantly helps prevent deep vein thrombosis (DVT) by promoting blood circulation in your lower legs.

2. Quad Sets (Quadriceps Setting):

How to do it: Lie on your back with your leg straight. Tighten the muscle on the top of your thigh (quadriceps) by pushing the back of your knee down into the bed. You should feel your kneecap pull slightly upwards. Hold the contraction.
Concrete Example: Hold for 5 seconds, then relax. Repeat 10 times, 3-4 times a day. Imagine trying to flatten a towel rolled under your knee.

3. Gluteal Sets (Gluteal Squeeze):

How to do it: Lie on your back. Gently squeeze your buttocks together, holding the contraction.
Concrete Example: Hold for 5 seconds, then relax. Repeat 10 times, 3-4 times a day. This helps activate your gluteal muscles without putting stress on the hip joint.

4. Heel Slides (Assisted, if necessary):

How to do it: Lie on your back with your knee straight. Slowly slide your heel towards your buttocks, bending your knee, while keeping your heel on the bed. Only go as far as your pain and surgical precautions allow. Do not lift your heel or force the movement.
Concrete Example: Perform 5-10 repetitions, 3-4 times a day. If you find it difficult, use a strap or towel looped around your foot to gently assist the movement. Stop if you feel any sharp pain.

5. Deep Breathing Exercises:

How to do it: Lie on your back or sit comfortably. Place one hand on your chest and the other on your abdomen. Inhale slowly and deeply through your nose, feeling your abdomen rise. Exhale slowly through pursed lips.
Concrete Example: Take 5-10 deep breaths every hour. This is crucial for lung expansion after surgery and helps prevent respiratory complications.

The Early Rehabilitation Phase (Weeks 2-6, approximately)

As your pain subsides and initial healing progresses, your physical therapist will introduce more challenging exercises aimed at improving range of motion, strength, and controlled movement. Always defer to your physical therapist’s specific instructions, as recovery timelines vary.

Strengthening Exercises: Building Foundational Stability

1. Standing Hip Abduction (Assisted):

How to do it: Stand with your hands on a stable surface (countertop, back of a sturdy chair) for support. Keeping your affected leg straight, slowly move it out to the side, away from your body. Do not lean your torso to compensate.
Concrete Example: Perform 10-15 repetitions on each leg (even the unaffected leg benefits from strengthening), 2-3 sets per day. Focus on slow, controlled movement. Initially, your range of motion will be limited.

2. Standing Hip Extension (Assisted):

How to do it: Stand with support. Keeping your affected leg straight, slowly move it backward, behind your body, without arching your lower back.
Concrete Example: Perform 10-15 repetitions, 2-3 sets per day. This targets your glutes and hamstrings. Keep your core engaged to prevent back strain.

3. Mini Squats (Partial Knee Bends):

How to do it: Stand facing a stable surface or wall. Place your feet shoulder-width apart. Slowly bend your knees as if you are about to sit in a chair, but only go down a few inches. Keep your back straight and your weight over your heels.
Concrete Example: Perform 10-15 repetitions, 2-3 sets per day. Imagine you are lowering yourself just enough to tap your buttocks on a low stool. Do not let your knees go past your toes.

4. Bridging:

How to do it: Lie on your back with your knees bent and feet flat on the floor, hip-width apart. Gently lift your buttocks off the floor a few inches, creating a straight line from your shoulders to your knees. Hold briefly, then slowly lower.
Concrete Example: Perform 10-15 repetitions, 2-3 sets per day. Focus on squeezing your glutes as you lift. Avoid arching your lower back excessively.

5. Straight Leg Raises (SLR) – Supine:

How to do it: Lie on your back with your unaffected leg bent and foot flat on the floor. Keep your affected leg straight. Tighten your quadriceps on the affected leg, then slowly lift the entire leg a few inches off the bed, keeping it straight. Do not lift higher than the level of your bent knee.
Concrete Example: Hold for 3-5 seconds, then slowly lower. Perform 10-15 repetitions, 2-3 sets per day. Ensure your back remains flat on the surface.

Balance and Proprioception Exercises: Re-establishing Stability

1. Standing Weight Shifts:

How to do it: Stand with support, feet shoulder-width apart. Slowly shift your weight from one leg to the other, lifting one foot slightly off the ground, then the other.
Concrete Example: Perform 10-15 shifts per side, 2-3 sets per day. This helps your body relearn how to balance and distribute weight safely.

2. Single Leg Stance (Assisted):

How to do it: Stand with strong support (e.g., counter, sturdy chair). Gently lift your unaffected foot off the ground, balancing on your affected leg. Gradually reduce your reliance on support as you gain confidence.
Concrete Example: Hold for 10-30 seconds, 3-5 repetitions per day. Start with just a few seconds and build up. Only attempt this when your therapist gives you the green light.

Intermediate Rehabilitation Phase (Weeks 6-12, approximately)

As your strength and confidence grow, your exercise program will become more dynamic, incorporating movements that mimic daily activities and prepare you for a return to more functional tasks. This phase often includes light resistance and increased repetitions.

Functional Strength and Mobility

1. Step-Ups:

How to do it: Stand in front of a sturdy, low step (start with 2-4 inches, gradually increasing height as tolerated). Step up onto the step with your affected leg, then bring your unaffected leg up. Step down with your affected leg first, then the unaffected leg. Maintain good posture.
Concrete Example: Perform 10-15 repetitions, 2-3 sets per day. Focus on using your leg muscles to lift your body, not momentum.

2. Wall Slides:

How to do it: Stand with your back against a wall, feet shoulder-width apart and a few inches away from the wall. Slowly slide down the wall by bending your knees, as if sitting in an imaginary chair. Go down only as far as comfortable, typically to a 45-degree knee bend initially. Hold, then slide back up.
Concrete Example: Perform 10-15 repetitions, 2-3 sets per day. Keep your core engaged and your back flat against the wall.

3. Standing Hip Flexion:

How to do it: Stand with support. Slowly lift your knee on the affected side towards your chest, keeping your back straight. Only go as high as comfortable and as allowed by your surgical precautions.
Concrete Example: Perform 10-15 repetitions, 2-3 sets per day. This strengthens your hip flexors, crucial for walking and climbing stairs.

4. Leg Press (Machine, if available and approved):

How to do it: If using a leg press machine, adjust the seat so your knees are at a comfortable angle and your feet are flat on the platform. Slowly push the platform away from you using your legs, then control the return movement. Ensure you do not fully extend your knees or allow them to lock.
Concrete Example: Start with light weight, 10-15 repetitions, 2-3 sets. Your physical therapist will guide you on appropriate weight and range of motion.

Endurance and Light Cardiovascular Activity

1. Stationary Cycling (Low Resistance):

How to do it: Start with a recumbent stationary bike, as it provides more back support and is often easier to get on and off. Set the resistance to very low. Focus on smooth, continuous pedaling.
Concrete Example: Begin with 10-15 minutes, 1-2 times per day. Gradually increase duration and resistance as tolerated. Ensure your hip does not flex beyond the recommended limits for your surgery (adjust seat height as needed).

2. Walking Program (Progressive):

How to do it: Start with short, frequent walks on flat, even surfaces. Gradually increase the distance and duration. Focus on a normal heel-to-toe gait pattern. Use assistive devices (cane, crutches) as directed by your therapist, and gradually wean off them as your balance and strength improve.
Concrete Example: Begin with 5-10 minutes, 2-3 times per day. Add 5 minutes to each session per week, or as tolerated. Aim for a consistent walking rhythm.

Advanced Rehabilitation Phase (Months 3+, as directed by your surgeon/PT)

This phase focuses on returning to more complex activities, sports-specific training if applicable, and building higher levels of strength, power, and endurance. The exercises become more challenging and dynamic.

Dynamic Strength and Agility

1. Lunges (Controlled):

How to do it: Stand with your feet hip-width apart. Step forward with one leg, lowering your hips until both knees are bent at approximately a 90-degree angle. Ensure your front knee is directly over your ankle and your back knee hovers just above the floor. Push off with your front foot to return to the starting position.
Concrete Example: Start with 8-12 repetitions per leg, 2-3 sets. Initially, perform static lunges (step and hold) before progressing to walking lunges. Maintain good form and avoid letting your front knee track inward.

2. Glute Bridge with March:

How to do it: Start in the bridge position (feet flat, hips lifted). While maintaining the bridge, slowly lift one foot a few inches off the floor, as if marching. Lower it, then lift the other.
Concrete Example: Perform 10-12 repetitions (alternating legs counts as one), 2-3 sets. This adds an element of core stability and challenges your glutes and hamstrings further.

3. Single Leg Romanian Deadlifts (SLRDL) – Assisted:

How to do it: Stand on your affected leg, with a light weight (e.g., 2-5 lbs dumbbell) in the hand opposite your standing leg. Hinge at your hips, keeping your back straight, and slowly lower the weight towards the floor while simultaneously extending your non-standing leg straight back behind you. Focus on maintaining balance and feeling the stretch in your hamstring. Return to starting position.
Concrete Example: Perform 8-12 repetitions, 2-3 sets. Use a chair or wall for light support initially. This is excellent for hamstring and glute strength, as well as balance.

4. Plyometric Prep (Low Impact):

How to do it: (Only with therapist approval!) Start with very low-impact activities like double-leg hops in place or gentle skipping. Focus on soft landings.
Concrete Example: 10-15 gentle hops, 2-3 sets. This is a very gradual introduction to impact, essential for preparing for running or jumping activities if cleared.

Cardiovascular Endurance

1. Treadmill Walking/Light Jogging (if approved):

How to do it: Begin with power walking on the treadmill. If cleared for jogging, start with short intervals of jogging interspersed with walking. Gradually increase jogging duration and speed.
Concrete Example: Start with 20-30 minutes of brisk walking, gradually adding 1-minute jogging intervals. Progress to 5 minutes of jogging, then 10, and so on.

2. Elliptical Trainer:

How to do it: The elliptical provides a low-impact cardiovascular workout that mimics walking or running. Start with low resistance and a comfortable stride.
Concrete Example: 20-40 minutes, 3-4 times per week, gradually increasing resistance and speed.

3. Swimming/Water Aerobics:

How to do it: The buoyancy of water reduces stress on the hip joint, making it an excellent option for cardiovascular fitness and gentle range of motion. Focus on controlled movements, avoiding vigorous kicking initially.
Concrete Example: 30-45 minutes of continuous swimming or water walking/aerobics, 2-3 times per week. Begin with gentle leg movements like flutter kicks and gradually progress to more active kicking as tolerated.

Essential Considerations for Every Stage

Exercising after hip surgery is a marathon, not a sprint. Consistency, patience, and meticulous attention to detail are paramount.

Listen to Your Body

This is perhaps the most critical advice. Pain is your body’s alarm system. While some discomfort is normal during rehabilitation, sharp, sudden, or increasing pain is a red flag.

Concrete Example: If performing a lunge causes a sharp pain in your groin, stop immediately. Rest, apply ice, and consult your physical therapist before attempting it again. Pushing through significant pain can lead to setbacks or re-injury.

Proper Form Over Quantity

Sacrificing correct technique for more repetitions or heavier weights is counterproductive and dangerous. Incorrect form can put undue stress on your healing hip.

Concrete Example: When doing mini-squats, focus on keeping your back straight and knees tracking over your toes. If you find your knees collapsing inward or your back rounding, reduce the depth of your squat or use additional support until your form improves. It’s better to do 5 perfect squats than 10 sloppy ones.

Gradual Progression

Avoid the temptation to do too much, too soon. Your progress should be incremental and measured.

Concrete Example: If you’re walking, don’t suddenly decide to hike a steep hill after a week of flat ground. Increase distance, then speed, then incline, each in small, manageable steps. Similarly, with weights, increase by 1-2 lbs at a time, not 10 lbs.

Incorporate Warm-up and Cool-down

Every exercise session should begin with a gentle warm-up and end with a cool-down.

Warm-up Example: 5-10 minutes of light cardio like slow walking or stationary cycling, followed by gentle dynamic stretches (e.g., leg swings, controlled hip circles within your comfortable range of motion).
Cool-down Example: 5-10 minutes of light walking, followed by static stretches (holding a stretch for 20-30 seconds) for the muscles you just worked, ensuring they are not forced beyond their comfortable range.

Nutrition and Hydration

Fueling your body properly is vital for healing and energy for exercise.

Concrete Example: Focus on a diet rich in lean protein (for muscle repair), fruits, vegetables (for vitamins and minerals), and whole grains (for sustained energy). Stay well-hydrated by drinking plenty of water throughout the day, especially before and after exercise.

Consistency is Key

Short, frequent exercise sessions are often more effective than long, sporadic ones.

Concrete Example: Aim for 2-3 short exercise sessions (15-20 minutes) per day in the early stages, rather than one hour-long session once every few days. This promotes continuous muscle activation and blood flow.

Sleep and Rest

Your body does its most significant healing during sleep. Adequate rest is crucial for recovery.

Concrete Example: Aim for 7-9 hours of quality sleep per night. If you feel fatigued, take a short nap or allow yourself an extra rest day from intense exercise. Pushing through extreme fatigue can increase your risk of injury.

Use Assistive Devices as Directed

Don’t rush to abandon crutches, walkers, or canes if your physical therapist recommends them. They provide crucial support and protect your healing hip.

Concrete Example: Continue using your walker for outdoor walks until your therapist deems you stable enough to transition to a cane, and then fully unassisted walking. Trying to go without support too early can lead to falls or improper gait patterns.

Stay Positive and Patient

Recovery from hip surgery is a journey with ups and downs. Celebrate small victories and don’t get discouraged by temporary plateaus or minor setbacks.

Concrete Example: Keep a log of your exercises and progress. Seeing how far you’ve come can be incredibly motivating. If you have a day where you feel less energetic, acknowledge it and adjust your activity level without guilt.

Consult Your Professionals Regularly

Your surgeon and physical therapist are your primary guides. Attend all appointments and communicate openly about your progress, pain levels, and any concerns.

Concrete Example: Before attempting any new or more challenging exercise, always confirm with your physical therapist that it is appropriate for your current stage of recovery. They have the expertise to tailor your program to your specific needs and surgical details.

Beyond the Structured Program: Integrating Movement into Daily Life

Once you’ve progressed significantly through your rehabilitation, the goal shifts to seamlessly integrating safe, healthy movement into your everyday life.

Ergonomics and Posture

How to do it: Pay attention to how you sit, stand, and move during daily tasks. Maintain good posture to reduce strain on your hip. When sitting, use chairs that allow your hips to be higher than your knees.
Concrete Example: When bending down to pick something up, squat down by bending your knees and keeping your back straight, rather than bending forward at your waist. When standing for long periods, shift your weight occasionally.

Safe Lifting Techniques

How to do it: Always lift with your legs, not your back. Keep objects close to your body. Avoid twisting motions while lifting.
Concrete Example: If lifting a grocery bag, bend at your knees and hips, engage your core, and stand up smoothly, keeping the bag close to your torso. Do not twist your body as you lift or carry.

Adapting Hobbies and Sports

How to do it: Discuss your return to hobbies or sports with your surgeon and physical therapist. They can advise on modifications or alternative activities.
Concrete Example: If you were a runner, you might start with power walking, then elliptical, and gradually introduce short intervals of jogging on soft surfaces. A golfer might need to modify their swing to reduce hip rotation.

Long-Term Maintenance

Exercise after hip surgery isn’t a temporary fix; it’s a lifelong commitment to maintaining mobility, strength, and preventing future issues.

Concrete Example: Even after formal physical therapy ends, continue with a regular exercise routine that includes a mix of strength training, cardiovascular activity, and flexibility exercises. Consider joining a gym, taking a gentle exercise class, or continuing a walking program.

Final Thoughts on Your Journey

Your hip surgery is a new beginning, and thoughtful, consistent exercise is your compass on the path to full recovery. This guide has provided a comprehensive framework, but remember that your unique journey will be guided by your medical team. Embrace the process, celebrate each milestone, and empower yourself through informed, diligent action. Your commitment to exercise will not only heal your hip but also enhance your overall well-being, restoring your ability to move with freedom and confidence.