Physiotherapy After Hip Replacement — What the First 6 Weeks Look Like
Written by Mamdouh Sarhan, MSc, MCSP, HCPC Reg.Hip replacement surgery is one of the most successful orthopaedic procedures performed in the UK — with the right rehabilitation, the vast majority of patients achieve excellent outcomes and return to full activity. But the surgery itself is only the beginning. What happens in the first 6 weeks of recovery has a significant impact on your long-term outcome. This guide explains what physiotherapy after hip replacement looks like, week by week, and why home visit physiotherapy is particularly valuable in this period.
Why Physiotherapy After Hip Replacement Is Essential
Hip replacement surgery replaces the damaged joint, but it does not automatically restore the strength, movement, and confidence in walking that you need for a full recovery. The muscles around the hip — particularly the gluteus medius and hip flexors — are weakened by the surgical approach and need to be progressively rehabilitated. Without proper physiotherapy, patients often develop a Trendelenburg gait (a hip drop when walking), compensatory movement patterns that stress other joints, and persistent weakness that limits their long-term function. Physiotherapy is not optional after hip replacement — it is essential.
Weeks 1–2: Early Recovery
In the first two weeks after hip replacement, the focus is on pain and swelling management, protecting the surgical repair, and beginning gentle movement to prevent stiffness and blood clots. You will be given hip precautions by your surgical team — specific movements to avoid to protect the new joint while the soft tissues heal. Physiotherapy in this phase includes gentle ankle pumps and foot exercises to improve circulation, bed exercises to begin activating the hip and thigh muscles, and supervised walking practice with your walking aid. Home visit physiotherapy is particularly valuable in this phase — you cannot drive, and travelling to a clinic is uncomfortable and difficult.
Weeks 3–4: Building Strength and Confidence
By weeks 3–4, most patients are walking more confidently with their walking aid and beginning to manage more of their daily activities independently. Physiotherapy in this phase progresses to standing exercises — mini squats, hip abduction, and step exercises — to begin rebuilding the hip and thigh strength needed for walking without a limp. Balance training begins, and walking distances are gradually increased. Many patients are able to reduce their walking aid from two crutches to one stick in this phase.
Weeks 5–6: Progressing to Function
In weeks 5–6, the focus shifts toward functional rehabilitation — preparing you for the activities of daily life. This includes stair climbing (if not already achieved), getting in and out of a car, and beginning to walk without a walking aid if your strength and balance allow. Physiotherapy exercises become more challenging, with progressive resistance training to rebuild full hip strength. By the end of week 6, most patients are walking independently and managing most daily activities, though full recovery continues for several months.
Common Mistakes in Hip Replacement Rehabilitation
The most common mistake is doing too little too soon — being overly cautious and not progressing exercises because of fear of damaging the new joint. Modern hip replacement implants are robust, and progressive exercise is safe and necessary. The second most common mistake is doing too much too soon — overdoing activity and causing pain and swelling that sets back recovery. A physiotherapist helps you navigate this balance, progressing your rehabilitation at the right pace for your individual recovery.
Why Home Visit Physiotherapy Is Ideal After Hip Replacement
For the first 4–6 weeks after hip replacement, home visit physiotherapy is the most practical and effective option. You cannot drive, travelling to a clinic is uncomfortable, and the exercises you need to do are best learned and practised in your own home. I can assess your actual environment — your furniture heights, your stairs, your bathroom setup — and give you practical advice that a clinic physiotherapist cannot provide. I work within your surgeon's post-operative precautions and progress your rehabilitation at the right pace to achieve the best possible outcome.
The first 6 weeks after hip replacement are the most important period for your long-term recovery. With the right physiotherapy support — delivered at home, at the right pace — the vast majority of patients achieve excellent outcomes and return to full activity. I provide post-hip replacement physiotherapy across Aylesbury and Buckinghamshire, with home visits available within 48 hours of discharge. No GP referral needed.
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Written By
Mamdouh Sarhan
HCPC Registered Physiotherapist · MSc · NHS Background
Private physiotherapist serving Buckinghamshire. Specialising in home visits, neurological rehab, and musculoskeletal conditions.