Hip Replacement Recovery: Week by Week Guide | Physiotherapy
Updated: Oct 4
Hip Replacement Recovery: A Week-by-Week Guide
Recovering from a total hip replacement follows a fairly predictable pattern, but it's normal to feel unsure about what's expected of you at each stage. As a physiotherapist who works with hip replacement patients across Greenwich and South East London, here's a realistic, week-by-week breakdown of what recovery usually looks like, and where physiotherapy support makes the biggest difference.
Week 1: Getting moving safely
Most patients are up and walking with a frame or crutches within a day of surgery. The priority this week is protecting the new joint: following your surgeon's hip precautions (usually avoiding bending past 90 degrees, crossing your legs, or twisting the hip inward), managing swelling and pain, and doing gentle ankle pumps and short walks little and often. This is also when a physiotherapist's home visit is most valuable, since getting in and out of bed, using stairs, and getting on and off the toilet safely at home is different from doing it in hospital.
Weeks 2-3: Building tolerance
Walking distance should be steadily increasing, and many people begin reducing reliance on crutches or a frame, moving to one crutch or a stick as strength and confidence allow. Swelling is often still present and worse by the end of the day. This is the stage where a structured exercise programme, rather than just walking, starts to matter: gentle strengthening for the muscles around the hip and knee, and controlled range-of-motion work within your precautions.
Weeks 4-6: The hardest stretch
This is often the stage patients describe as the most frustrating: the initial excitement of early progress has worn off, but full recovery still feels a long way away. Fatigue is common. Precautions are usually reviewed by your surgeon around 6 weeks, and physiotherapy at this stage typically focuses on normalising your walking pattern (many people compensate without realising it), progressing strength work, and starting balance training to reduce fall risk.
Weeks 6-12: Returning to normal activity
Once cleared by your surgeon, most hip precautions can be relaxed and rehabilitation shifts toward the specific things you want to get back to, whether that's gardening, golf, or simply walking further without discomfort. Most people can drive again somewhere in this window if cleared to do so, though this varies by surgeon and which hip was operated on. Full muscle strength and confidence, however, often takes considerably longer than most people expect.
3-12 months: The long tail of recovery
It's common for some swelling, mild stiffness, or muscle fatigue to persist for six months to a year, particularly with activity. This doesn't mean something has gone wrong; the tissues and muscles around a new hip joint continue adapting well beyond the point most people consider themselves 'recovered'. Continuing targeted strength and balance work through this period, rather than stopping once walking feels normal, is usually what determines long-term outcomes.
The most common mistakes I see
Doing too much, too soon in weeks 1-3 (leading to flare-ups and setbacks), or the opposite: becoming overly cautious out of fear of dislocation and under-loading the joint, which slows strength recovery. Both are understandable, and both are where individualised physiotherapy guidance, rather than generic advice, tends to matter most.
If you'd like a full stage-by-stage rehabilitation programme with exercise demonstrations to work through at home, I've put together a complete Hip Replacement Recovery & Rehabilitation Guide covering every stage in more detail, written specifically for this recovery.
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