Hip Replacement Gym Programme: How to Progress From Rehab to Strength Training
- Tom Morgan, Chartered Physiotherapist
- Aug 9
- 3 min read
If you already have a separate article answering when you can return to the gym after hip replacement, the next useful search target is what to do once you get there.
A good hip replacement gym programme should not be a random collection of machines. It should progress the same movement patterns used during rehabilitation: squatting, stepping, hip extension, hip abduction, balance and controlled single-leg loading.
When is gym-based rehabilitation appropriate?
For many suitable patients, light gym-based strengthening begins around six to eight weeks, once walking is controlled and any relevant precautions allow it. The exact timing should reflect your surgery, symptoms and physiotherapy advice.
Warm up with low-impact cardiovascular work
A stationary bike is a useful option because it warms the hip and knee through repeated movement. A treadmill may be suitable once unaided walking is comfortable, while a cross-trainer may follow when balance and single-leg control are reasonable.
Leg press
The guide introduces leg press from around six to eight weeks. Start with light resistance and a comfortable range. The aim is controlled loading of the quadriceps and gluteals rather than chasing a heavy number on the machine.
Squat progression
A squat can progress from a shallow bodyweight movement to a box squat and later to a lightly loaded squat once technique and comfort are good. Depth should increase gradually rather than being forced.
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Hip extension strength
Bridges can progress towards hip thrusts and Romanian deadlifts. The handbook places light hip thrust and RDL work around the later six-to-twelve-week phase for suitable patients, with loading progressing over the following months.
Hip abductor strength
Standing hip abduction and band walks can progress to cable or machine hip abduction. These exercises are especially relevant if you have residual pelvic drop or a limp.
Step-ups and step-downs
Step-ups build the strength needed for stairs and kerbs. Step-downs are introduced once you can control the upward phase well, because lowering your body requires good eccentric control.
How often should you train?
Two to three structured strength sessions per week is a useful long-term pattern for many patients. The sessions should become gradually more challenging while leaving enough recovery between harder workouts.
How do you know the programme is working?
Look beyond pain. Useful signs include a more level walking pattern, better single-leg balance, easier stairs, increased load tolerance and a closing strength gap between the operated and non-operated side.
When should you seek further advice?
Recovery is rarely a perfectly straight line, but new or rapidly worsening symptoms should not simply be pushed through. Contact your surgical team, GP or physiotherapist if pain, swelling, movement or function is moving in the wrong direction rather than gradually improving. Seek urgent medical attention for symptoms such as sudden breathlessness or chest pain, marked one-sided calf swelling, a hot increasingly red joint with fever, sudden loss of function, or other symptoms your surgical team has told you require urgent review.
Want the full hip replacement recovery plan?
This article provides general information and does not replace advice from your own surgeon, physiotherapist or medical team. Recovery varies between individuals and any specific restrictions or weight-bearing instructions from your surgical team should take priority.
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