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7 best exercises after hip replacement surgery

7 best exercises after hip replacement surgery

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Dr Nidhi
August 10, 2026 8:58 am
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The 7 best exercises after hip replacement surgery are: ankle pumps, quad sets, glute squeezes, heel slides, seated marching, short arc quads, and standing hip abduction. These exercises should begin within 24 hours of surgery under physiotherapist supervision. They rebuild muscle strength, restore range of motion, prevent blood clots, and speed up return to normal daily activities. Most patients regain full mobility within 6–12 weeks with consistent exercise and guided physiotherapy.

If you just had a hip replacement — or you’re about to — you probably have one big question on your mind: When can I get back to normal?

The honest answer? That depends almost entirely on how consistently you do your post hip replacement exercises in those first critical weeks. The surgery fixes the joint, but the exercises rebuild your life around it.

At Resolve360, our certified physiotherapists have guided thousands of hip replacement patients through recovery. In this guide, we break down the 7 most effective exercises after hip replacement surgery — what they are, exactly how to do them, and why each one matters for your long-term recovery.

Why Exercises After Hip Replacement Matter So Much


Hip replacement surgery in the US is one of the most common orthopedic procedures — over 450,000 procedures are performed annually, according to the American Academy of Orthopaedic Surgeons (AAOS). Most patients are walking with assistance within the first 24 hours. But walking alone isn’t enough.

After a total hip replacement, the muscles surrounding your new joint are weakened, tight, and confused. Without targeted exercises for hip replacement recovery, several serious problems can develop:

  • Blood clots (deep vein thrombosis) due to poor circulation
  • Muscle atrophy leading to instability and falls
  • Reduced range of motion that becomes permanent
  • Hip joint dislocation from muscle imbalance
  • Chronic pain patterns that outlast the surgery itself

Structured exercises after hip surgery activate the right muscle groups, restore joint mechanics, and — crucially — rebuild your confidence in movement. Guided physical therapy has been shown to significantly reduce recovery time compared to unassisted home recovery.

The 7 Best Exercises After Hip Replacement Surgery

These exercises are safe to begin in the first few days after surgery. Always perform them in the sequence listed — they progress from the gentlest to the most demanding. If any movement causes sharp, shooting pain, stop and consult your care team immediately.

1. Ankle Pumps

This is the very first exercise you’ll do — often within hours of coming out of surgery. It looks simple, but it’s doing critical work inside your body.

How to do it

  1. Lie flat on your back in bed with your legs straight.
  2. Slowly flex both feet — pull your toes toward your nose.
  3. Hold for 2–3 seconds, then point your toes away.
  4. Repeat 10–20 times, 3–4 times per day.
Why it worksAnkle pumps activate the calf muscle pump, which pushes blood back toward the heart. After hip surgery, blood clot risk (DVT) is highest. This simple movement is your first line of defense. It also reduces swelling in the lower leg and foot.

⏱ Start: Day 1 after surgery

2.  Quad Sets (Thigh Tightening)

Your quadriceps — the four muscles at the front of your thigh — are the main engine for walking, standing up from a chair, and climbing stairs. This exercise wakes them up safely, without any joint movement.

How to do it

  1. Lie on your back with your operated leg straight.
  2. Tighten the thigh muscle by pressing the back of your knee firmly down into the bed.
  3. Hold the contraction for 5 seconds. Breathe normally.
  4. Release and relax for 5 seconds. Repeat 10–15 times.
Why it worksQuad sets re-establish neuromuscular connection between your brain and the quads — which often “switch off” after surgery due to pain inhibition. Rebuilding this connection is essential before you attempt standing or walking exercises.

⏱ Start: Day 1–2 after surgery

3. Glute Squeezes (Gluteal Sets)

Your glutes are the primary stabilizers of your new hip joint. Weak glutes are one of the most overlooked causes of slow hip replacement recovery — and one of the most fixable.

How to do it

  1. Lie on your back with legs slightly apart.
  2. Squeeze your buttocks together as firmly as you can.
  3. Hold for 5 seconds, then slowly release.
  4. Repeat 10–15 times, 3 times daily.
Why it worksStrong glutes protect your hip implant by absorbing load during every step you take. This exercise also targets the gluteus medius — the muscle most responsible for sideways hip stability and preventing the “Trendelenburg limp” seen in some post-surgical patients.

⏱ Start: Day 1–2 after surgery

4. Heel Slides

This is the first exercise that introduces gentle movement through the hip joint itself. It improves flexibility in both the hip and knee — two joints that work in constant partnership.

How to do it

  1. Lie flat on your back with legs straight.
  2. Slowly slide the heel of your operated leg toward your body, bending the knee.
  3. Slide until you feel a comfortable stretch — do not bend the hip past 90 degrees.
  4. Hold for 3–5 seconds, then slowly slide back to the starting position.
  5. Repeat 10 times per session, 3 sessions daily.
Why it worksHeel slides improve hip and knee flexion range of motion — the fundamental motion required for sitting, getting in a car, walking up stairs, and rising from a chair. Without this flexibility, everyday activities remain difficult long after surgery.

⏱ Start: Day 2–3 after surgery

5. Seated Marching

Once you can safely sit in a firm chair, this exercise is a game-changer. It begins rebuilding hip flexor strength and prepares you for normal walking mechanics — all while supported by the chair.

How to do it

  1. Sit upright in a firm chair with feet flat on the floor, hip-width apart.
  2. Sit tall — do not slouch or lean forward past 90 degrees.
  3. Slowly lift one knee up toward your chest a few inches, then lower it.
  4. Alternate legs in a slow, controlled marching motion.
  5. Perform 10–15 repetitions per leg, 2–3 times daily.
Why it worksSeated marching strengthens the hip flexors (the muscles that lift your leg when walking) while minimizing load on the new joint. Research shows that hip flexor weakness is present in nearly all hip replacement patients and is directly linked to a slower return to independent walking.

⏱ Start: Day 3–5 after surgery

6. Short Arc Quads

This exercise targets the terminal range of quad strength — the “last 30 degrees” of knee extension that is critical for locking the knee during walking and going up stairs.

How to do it

  1. Lie on your back and place a rolled towel or small pillow under your knee to elevate it slightly.
  2. Keeping the thigh still, slowly straighten your knee by lifting your foot toward the ceiling.
  3. Hold at the top for 5 seconds, squeezing the quad firmly.
  4. Slowly lower back down. Repeat 10–15 times per set.
Why it worksShort arc quads strengthen the VMO (vastus medialis oblique) — the teardrop-shaped muscle just above the inner knee that acts as a shock absorber. Importantly, this exercise challenges the quad without putting bending force on the hip, making it safe in early recovery.

⏱ Start: Week 1–2 after surgery

7. Standing Hip Abduction

This is the most advanced exercise in the early-stage list — and one of the most important for long-term hip stability. It directly targets the outer hip muscles responsible for balance.

How to do it

  1. Stand facing a countertop, sturdy chair, or wall. Hold it lightly for balance.
  2. Keep your body upright and your operated leg straight.
  3. Slowly lift the operated leg out to the side — about 12–18 inches — without tilting your body.
  4. Hold for 3 seconds, then slowly lower back to center.
  5. Perform 10 repetitions. Rest. Repeat 2–3 times daily.

WHY IT WORKS
Hip abduction strengthens the gluteus medius — the critical muscle that keeps your pelvis level with every step. Without it, patients develop a compensatory "Trendelenburg gait" (hip dropping to the opposite side), which leads to back pain and puts excess stress on the knee and opposite hip.
⚠ IMPORTANT
  • Do not lift the leg behind you (hip extension) without clearance from your surgeon — especially with posterior approach surgery.
  • Stop if you feel groin pain, clicking, or instability.
⏱ Start: Week 2–3 after surgery (standing cleared)

Hip Replacement Recovery Timeline: What to Expect Week by Week

Recovery from hip replacement surgery doesn’t follow a single path — but understanding the general timeline helps you set realistic expectations and track your progress.

Phase
When
Key Exercises & Goals
Phase 1
Days 1–3
(Hospital)
Ankle pumps, quad sets, glute squeezes.
Goal: prevent blood clots, activate core muscles, begin standing with assist.
Phase 2
Weeks 1–2
(Home)
All Phase 1 + heel slides, seated marching, short arc quads. Goal: walk with walker indoors, manage swelling, regain basic daily function.
Phase 3
Weeks 3–6
Standing hip abduction, progressing to cane. Goal: improve balance, increase walking distance, reduce reliance on assistive devices.
Phase 4
Weeks 6–12
Stationary bike, mini squats (controlled), stair climbing. Goal: return to driving, light household tasks, 30+ min walks.
Phase 5
3–6 Months
Progressive resistance exercises, swimming, light sports (golf, hiking). Goal: full functional return, no pain limitations.
⚠ HIP PRECAUTIONS AFTER SURGERY — DO NOT IGNORE THESE
  • Do not bend your hip more than 90 degrees (especially for posterior approach surgery)
  • Do not cross your operated leg over the other leg
  • Do not rotate your foot inward on the operated side
  • Do not sit on low, soft surfaces for the first 6 weeks
  • Stop any exercise immediately if you feel sudden groin pain or a "pop" sensation

5 Common Mistakes That Slow Down Hip Replacement Recovery

In our experience at Resolve360 working with post-surgical patients, these are the mistakes we see most often — and they’re all avoidable:

  • Doing too much too soon. Sharp pain means stop. Mild discomfort during exercise is expected — sharp or shooting pain is not.
  • Skipping exercises because “it hurts.” Icing before and after exercise manages pain far better than avoiding movement.
  • Sitting for hours without movement. Get up and move for at least 5 minutes every hour. Stiffness is your enemy.
  • Neglecting the “boring” early exercises. Ankle pumps and glute squeezes seem minor — but skipping them creates bigger problems later.
  • Stopping physiotherapy the moment you feel better. Muscle weakness around the hip can persist for up to 2 years. Guided exercise keeps you on track.

How Resolve360 Can Help Your Hip Replacement Recovery

Getting the right guidance at the right time makes a measurable difference in recovery outcomes. Resolve360 offers live 1-on-1 online physiotherapy sessions — meaning you get a certified physiotherapist guiding your exercises via video call, from the comfort of your own home.

This is especially valuable in the first few weeks after surgery when traveling to a clinic is difficult, painful, and unnecessary. Our physiotherapists specialize in post-joint-replacement rehabilitation and create customized recovery plans based on your surgery type (anterior vs. posterior approach), your fitness level before surgery, and your personal recovery goals.

🏆 Resolve360 has supported 50,000+ patients with post-surgical rehabilitation. Our dedicated care manager system means you always have someone to answer questions between sessions — because recovery doesn't follow a 9-to-5 schedule.

Also Read: Top 10 Best Online Physical Therapy Services in the USA

Start Your Recovery Today — From Home

Get a free consultation with a licensed physical therapist at Resolve360 — available within 15 minutes of booking, 7 days a week, across all conditions.

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Frequently Asked Questions

The single most recommended exercise to start immediately after hip replacement surgery is the ankle pump. It prevents life-threatening blood clots and is safe to perform within hours of surgery. For overall recovery, the combination of ankle pumps, quad sets, glute squeezes, heel slides, and standing hip abduction — done consistently — produces the best long-term outcomes.
Most patients begin gentle exercises (ankle pumps, quad sets) within the first 24 hours of surgery — often while still in the hospital. A physical therapist will typically visit you on Day 1 to begin your program. Standing and walking with assistance usually begins on Day 1 or 2, depending on your surgeon’s protocol.
Most patients walk with a walker within 1–2 days of surgery. By 4–6 weeks, many can walk short distances without a walker or cane. Full, normal walking — including longer distances and uneven terrain — typically returns between 6 and 12 weeks post-surgery. With consistent physiotherapy, this timeline can be significantly shortened.
Avoid any exercise that involves bending the hip past 90 degrees, crossing the legs, or rotating the foot inward — especially in the first 6–12 weeks. Specifically avoid: deep squats, yoga poses that cross the legs, high-impact activities like running and jumping, and any exercise that causes sharp groin or hip pain. Always confirm restrictions with your specific surgeon, as anterior and posterior approaches have different precautions.
Yes — and you should. All 7 exercises listed in this guide can be done at home with no equipment (except a firm chair and a wall or countertop for standing exercises). Working with an online physiotherapist through services like Resolve360 ensures you’re performing exercises correctly, safely, and progressing at the right pace for your body.
Most patients can safely navigate stairs with a railing and physiotherapist guidance within 1–2 weeks of surgery. The technique matters: lead with your non-operated leg going up, and lead with your operated leg going down. Practice this first with your physiotherapist before attempting stairs alone.
 
Yes — multiple clinical studies support the effectiveness of telehealth physiotherapy for post-surgical rehabilitation. Online sessions with a certified physiotherapist through Resolve360 allow real-time correction of exercise form, personalized progression, and immediate answers to questions — all from home. This is particularly valuable in the early weeks when mobility is limited.
Most patients report that the first 2 weeks — managing pain, fatigue, and limited independence — are the hardest. The psychological challenge of slow progress is also significant. Having structured exercises to do daily provides a sense of control and measurable progress, which is why working with a physiotherapist is so valuable during this period.
Mild discomfort during exercise is normal and expected. Sharp, shooting, or worsening pain is a signal to stop. Ice the area for 15–20 minutes after exercise to manage soreness. If pain is consistently getting worse rather than better over 2–3 days, contact your care team or physiotherapist immediately.
Most physiotherapists recommend completing your full exercise routine 2–3 times per day in the early weeks. Each session typically takes 20–30 minutes. Consistency beats intensity — doing your exercises every day at a manageable level produces better results than occasional long sessions.
Dr Nidhi Kumari

Dr. Nidhi Kumari

She has persuaded her bachelor’s from SGT University, Gurugram, she has done her internship at Dr. Ram Manohar Lohia Hospital, and persuade her Master in Physiotherapy from Chaudhary Charan Singh University, Meerut. She has previously worked with Orthocure clinic, Dr.Nasir physiotherapy rehabilitation, Quantum physiotherapy, and wellness center.

If you have more questions.

Book a Consultation
Dr Nidhi Kumari

Dr. Nidhi

She has persuaded her bachelor’s from SGT University, Gurugram, she has done her internship at Dr. Ram Manohar Lohia Hospital, and persuade her Master in Physiotherapy from Chaudhary Charan Singh University, Meerut. She has previously worked with Orthocure clinic, Dr.Nasir physiotherapy rehabilitation, Quantum physiotherapy, and wellness center.

If you have more questions.

Book a Consultation

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