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Physiotherapy after a hip replacement: what to expect

Physiotherapy after a hip replacement: what to expect

Patients are usually asked to stand within a day of a hip replacement, and it surprises families every time. It is deliberate: early, controlled movement reduces the risk of clots and stiffness far more than rest does.

The first two weeks are about safety rather than strength — getting in and out of bed without twisting the new joint, walking with a frame or sticks, managing stairs, and respecting the movement restrictions the surgeon set. Most families find this the hardest phase, because the patient feels capable of more than they should attempt.

Weeks three to six shift to strength and range. The exercises are unremarkable and repetitive, and their whole value is in being done daily. This is the phase where a home physiotherapist earns their fee: not by doing something exotic, but by being there often enough that the programme is actually followed.

From six weeks onward the focus moves to walking normally again — retraining a gait that has been compensating for pain, often for years before the surgery. Skipping this is why some patients still limp long after the joint itself has healed perfectly well.

Two things to raise immediately with the physiotherapist or surgeon: calf pain or swelling, and any sudden increase in hip pain after a period of improvement. Neither is likely, and both are worth a phone call the same day.

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