Coming home after a hip replacement is a strange mix of relief and nerves. The surgery is behind you, but the part that decides how well you end up moving is only just starting.
The first four weeks after a hip replacement tend to be the busiest stretch of the whole recovery. Pain comes and goes, sleep gets broken, and jobs like putting your socks on turn into a proper operation. It is also when most of the visible progress happens, with plenty of people going from a walking frame to a single stick inside the month.
Here is what those weeks usually involve, from the day you leave the ward to the point where you start feeling a bit more like yourself.
Leaving the Ward and Getting Home
Most people go home one to three days after surgery, once they can get in and out of bed, walk a short distance with a frame or crutches, and manage a few steps safely. Hospital discharge normally comes with a folder: your exercises, how much weight to put through the leg, wound care instructions, painkillers, and blood-thinning medication to take for a few weeks.
Post-op physio starts on the ward, often the same day as your operation or first thing the next morning. Someone will get you standing, show you how to handle crutches, and run through the first exercises before you go anywhere. What you do at home carries that on rather than starting something new.
Ask for a copy of your surgeon’s protocol before you leave if it is not already in the folder. It sets out which movements to avoid and for how long, and it varies far more than people expect. Posterior approaches often come with instructions about not bending past 90 degrees, not crossing your legs and not turning the foot inwards. Plenty of surgeons using an anterior approach give hardly any restrictions at all. Yours is the one that applies, not the version your neighbour was given five years ago.
Week One: Getting Upright and Moving
The aim in week one is to get moving again in small, regular doses rather than one big effort. A short walk around the house every hour or two beats a single long one, and it keeps swelling and stiffness from settling in.
Early exercises are gentle and repetitive. Ankle pumps to keep the blood moving, buttock squeezes, heel slides, and standing knee lifts holding onto a worktop. Ice and elevation help with swelling, and taking your painkillers half an hour before you exercise makes the whole thing more manageable.
It helps to have someone watch you do them early on, because a small fault in how you are loading the leg gets reinforced hundreds of times over a fortnight. Clearcut Physiotherapy goes through the programme with you and adjusts it as the leg settles, which is more useful than working from a photocopied sheet alone.
Getting to a clinic in the first week or two is not realistic for everyone. Home rehab visits solve that, and they suit anyone who cannot drive yet, has stairs to negotiate before they even reach the front door, or lives a fair distance from the nearest practice. Some people arrange them before they leave hospital so there is no gap.
Week Two: Sore Days and Better Days
Week two rarely runs in a straight line. Swelling often peaks around now, some days feel like a step backwards, and sleep is still broken because finding a comfortable position takes trial and error. None of that means anything has gone wrong; it’s just that progress at this stage tends to zigzag.
Your wound gets checked somewhere around ten to fourteen days, and any clips or non-dissolving stitches usually come out then. Until it has fully closed, keep it dry and follow whatever the ward told you about showering.
Stairs come back into the picture this week for most people. The old rule still holds: good leg first going up, operated leg first coming down, crutch or stick moving with the operated side. Take one step at a time rather than trying to walk up normally.
Weeks Three and Four: Strength and Confidence
By now, walks get longer, and most people are moving off the frame onto crutches or a stick, though the timing depends on your age, how strong you were beforehand, and what your surgeon has said. Standing exercises get added, and everyday jobs like making a cup of tea or getting dressed start feeling less like an event.
Once the wound has fully closed and dried over, usually somewhere around two to three weeks, your physio may start gentle work on the scar tissue around the site. Tightness there can pull on how you move without you noticing, so easing it early keeps it from becoming a nuisance later.
If you know somebody who has been through recovery after knee replacement, try not to measure yourself against them. Knee rehab pushes hard on getting the joint fully straight and bending again, and the swelling tends to hang around longer. Hips generally settle more quickly in the early weeks, which surprises people who were braced for the same experience.
Driving usually comes back somewhere around six to eight weeks, and desk work around four to six, but both depend on your surgeon and which leg was done. Ask rather than assume, since insurers will not cover you if you drive before you have been cleared.
Signs That Need a Phone Call Rather Than a Wait
Most of the first month is uncomfortable but uneventful. A few things are not, and they are worth knowing so you are not talking yourself out of ringing anyone at two in the morning.
Pain, swelling, warmth or tenderness in your calf can mean a clot, and it needs contacting your surgical team or GP the same day. Sudden breathlessness, chest pain, or coughing up blood needs 999 straight away.
A wound that becomes hot, increasingly red, starts leaking, or smells, particularly alongside a temperature or feeling generally unwell, should be looked at promptly rather than left to see if it improves. Sudden severe pain with a leg that looks shorter or turned out, or that you cannot stand on at all, means A&E.
How Ongoing Physio Gets Paid For
If your surgery was private, check what rehab is insurance-covered and how many sessions your policy allows, ideally before you come home rather than after. Some policies fund a set block as part of aftercare, others need authorisation first, and finding out early avoids a gap in your programme at the point you most need it.
On the NHS, outpatient or community physio is usually arranged as part of your discharge plan, though how quickly it starts varies by area. If there is a wait, some people fund a few sessions themselves to bridge it and then pick the NHS programme up when it comes through.
Line Up Your Physio Before You Come Home
The first month sets the tone for everything after it. Move little and often, follow the restrictions you were given rather than the ones somebody else was given, keep on top of pain relief so you can actually do your exercises, and expect the odd bad day without reading too much into it.
The one thing worth sorting in advance is who is guiding you. Book your rehab before you are discharged, whether that means clinic appointments or visits at home, so you walk through your own front door with a plan already in place.
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