Written by Zita Sham, Fairuuz Saleh and Shiv Mohan Banka, Principal Physiotherapists at Phoenix Rehab.Clinically reviewed by Louise Yow, Principal Physiotherapist and Director, AHPC A1300363H.Last reviewed 2 October 2026.
Hip replacement surgery, also known as total hip replacement, is a major surgical procedure that replaces the worn-out joint surfaces of your hip with prosthetic components. Hip replacements are often solutions for patients suffering from chronic hip pain and limitations caused by osteoarthritis, a degenerative joint disease that damages the cartilage cushioning the hip joint.
The ball and socket joint of the hips comprises two bones, namely:
- Femur (thighbone)
- Pelvis (made up of three bones – ilium, ischium, and pubis)
During the hip replacement procedure, your orthopedic surgeon will remove the damaged ball (femoral head) and socket joint (acetabulum) of your hip and implant artificial components made of metal, ceramic, or plastic.
While hip replacement surgery offers significant pain relief and improved mobility, physical therapy after hip replacement is not optional. Just like physiotherapy for osteoarthritis of the hip, it is necessary for the recovery process and rehabilitation after hip joint replacement surgery.
Physiotherapy after surgery
Hip Replacement Recovery Program
The hip stops hurting long before the muscles around it are strong again. That gap is where the limp comes from.
For total hip replacement and hip resurfacing, by any surgical approach. A staged physiotherapy program run to your surgeon’s plan and precautions, at five Singapore clinics, from the week you come home.
No referral needed to start. Bring your operation note, discharge summary or scan report.
Start here
Where are you right now?
A replaced hip is a different problem depending on the week you are reading this. Pick the one that matches.
How the program runs
4-Stage Structured Recovery
You move up a stage when you meet the criteria for it, not when a number of weeks has passed. That is Criteria Before Clearance, and it is why the last appointment is a graduation rather than a discharge.
The shape of it
What happens, week by week
The weeks below are the usual shape after a total hip replacement. The precautions you are given depend on the surgical approach, and your surgeon’s list is the one to follow. Your surgeon’s protocol takes precedence over anything on this page, every time.
- Weeks 0 to 2Stage 1 · Calm & ProtectHome with a frame or crutches. Swelling controlled. Getting in and out of bed, the car and the shower safely, inside your precautions. Hip muscle work from the first days.
- Weeks 2 to 6Stage 2 · Move & MobilizeDown to one stick, then none. Walking further each week, and walking without the lurch to the side.
- Weeks 6 to 12Stage 3 · Rebuild & StrengthenStrength in the buttock and thigh muscles, standing on one leg, and stairs leg over leg.
- Month 3 onwardStage 4 · Return & PerformDistance, uneven ground, travel, swimming and golf. Strength often keeps improving for a year.
After the operation
Is this normal?
Usually expected
- Swelling and bruising down the thigh, sometimes to the knee.
- A feeling that the leg is a different length, which often settles as the muscles relax.
- Clicking from the joint.
- Tiredness that outlasts the pain.
- Numbness around the scar.
- An ache in the thigh after walking further than usual.
Contact your doctor
- Call 995 or go to the emergency department now: sudden shortness of breath, chest pain, or coughing up blood. After leg surgery these can mean a clot that has traveled to the lungs.
- Doctor the same day: a calf that becomes painful, swollen, warm or tender, which can mean a clot in the leg.
- Doctor the same day: fever, or a wound that is red, hot, opening or leaking.
- Emergency department now: sudden severe hip pain with the leg turned in or out and shorter, especially after a twist or a fall, which can mean a dislocation.
- Surgeon soon: a new limp or groin pain that comes on after you were walking well.
- Review soon: no change in walking or strength over 3 to 4 weeks of therapy.
We would rather send you back to your surgeon early than be the reason you went late.
If it is not going to plan
Months in, and you still lurch to one side when you walk
The hip does not hurt. The X-ray is fine. And when you walk past a shop window, you can see yourself tip to one side with every step on that leg.
You still take the stairs one at a time. You plan your route around the escalators. Getting out of the car takes a hand on the door frame and a push.
That lurch is the buttock muscles on the operated side not yet strong enough to hold the pelvis level, and the body leans over to make up for it. It is measured, standing on one leg and in strength, and trained out. Waiting does not train it.
The Stalled Recovery Review is three appointments, one a week for three weeks, with the same physiotherapist. The first finds what is holding you back. The next two measure how it responds, because what a joint does under load cannot be read in one visit. $690, nett, no GST.
More on what the three appointments cover: the Stalled Recovery Review.
Logistics
When can I…
Your surgeon decides, based on healing and what your job demands. These are typical points, not permissions.
| Activity | Typical point | What has to be true first |
|---|---|---|
| Walking without an aid | 2 to 6 weeks | A steady walk without a lurch, and your physiotherapist and surgeon agree. |
| Driving | 4 to 6 weeks | Off strong painkillers, able to get in and out inside your precautions, and able to do an emergency stop. Your surgeon agrees, and check your insurer. |
| Sleeping on that side | 6 weeks or later | Your surgeon agrees. A pillow between the knees often helps. |
| Desk work | 2 to 6 weeks | You can sit for an hour within your precautions. |
| Flying | Ask your surgeon | Long flights raise clot risk in the early months. Your surgeon advises on timing and precautions. |
| Golf, swimming, long walks | 3 months or later | Stage 4 criteria met, and the wound fully healed for swimming. |
| Medical certificate | Your doctor issues it | Physiotherapists do not issue MCs. We can write a report on your functional limits for your doctor or employer. |
The program
What it costs and what is in it
Hip Replacement Recovery Program, Stages 1 to 4
Per 45-minute appointment, nett, no GST. The Hip Replacement Recovery Program is 12 appointments, $2,760 in all. You pay for each appointment as you attend it. If you need more, your physiotherapist shows you which stage criteria are still open, and each extra appointment is $230.
- An Assessment & Treatment first, at $230: which stage you are in, what is limiting you, and a written plan you walk out holding
- Precaution coaching for the home, the car and the shower
- Staged range and strength work, progressed on criteria
- Single-leg standing time and hip strength measured against the other side
- A home program, written down
- A one-page report to your surgeon at weeks 2, 6 and 12 if you were referred
- Your next stage review dated into the diary, with the same physiotherapist
Graduation, Not Discharge. The program ends when you meet the Stage 4 criteria for the walking, stairs and activities you named at the start.
Who you will see
Managed by our physiotherapy team
Hip replacements sit with the physiotherapy team. You stay with the same physiotherapist through the program, and every appointment is one to one for the whole 45 minutes.
Ching Yee
Principal Physiotherapist at Tanjong Pagar, and at Jurong East from 20 October 2026. Recovery after total knee and hip replacement, and knee and spine degenerative conditions.
This program runs Stages 1 to 4 of the Phoenix Recovery Protocol. It sits under physiotherapy after surgery, alongside the other recovery programs.
Timings on this page are typical ranges, not predictions for any individual recovery, and your surgeon’s protocol takes precedence. Physiotherapists assess, treat, exercise, educate and refer; doctors diagnose, inject, prescribe and order imaging. If we find something that needs medical review we refer you back to your doctor.
Why Physiotherapy is Required After Hip Replacement Surgery
Physical therapy after hip surgery is both clinical- and cost-effective, especially for total hip replacement (THR) cases. The research found physiotherapy improved functional performance, hip muscle strength, pain management, and range of motion specifically in flexion (bending the hip).
Additionally, the study suggests physiotherapy provides a cost-effective solution from the UK’s perspective. From the Singaporean perspective, a systematic review has shown promise for the cost-effectiveness of physiotherapy interventions following total knee and hip replacements.
Physical therapy providers in Singapore such as Phoenix Rehab offer similar benefits with physiotherapy after total hip replacement. Our qualified physiotherapists create a personalised treatment plan based on your specific needs and recovery goals, vital for the rehabilitation process. We also focus on joint surgery such as hip fracture physiotherapy and hip impingement physiotherapy.
Let’s dive deeper into why physiotherapy is crucial for recovery after hip replacement surgery.
Reduce Pain and Inflammation
Pain and inflammation are natural after surgery, but they shouldn’t hinder your progress. Physiotherapists utilise manual therapy techniques like massage, joint mobilization, and soft tissue mobilization. These techniques target the surgical area and surrounding muscles, promoting pain relief and reducing stiffness.
Physiotherapists will also design a personalised exercise program that complements manual therapy. These exercises focus on gentle movement and increasing circulation, allowing you to move more comfortably and participate in daily activities sooner.
Rebuild Muscle Strength and Joint Motion
The surgical procedure can weaken the muscles that support and stabilise your hip joint. Physiotherapy addresses this by incorporating targeted strengthening exercises for your hip muscles, extensors, abductors, and adductors (buttock and thigh muscles). A strong foundation of musculature is essential for proper joint motion and stability.
The program will gradually progress, allowing you to regain your full range of motion in the hip joint. This newfound flexibility allows you to perform everyday activities with greater ease and confidence.
Improve Gait and Balance
Walking is a complex activity that requires precise coordination between multiple muscle groups. After surgery, your walking pattern (gait) may be altered due to pain or stiffness. Physiotherapists will guide you through gait re-education, ensuring proper weight distribution on your new hip. This not only improves walking efficiency but also reduces stress on the joint.
Additionally, physiotherapy incorporates balance training exercises. Improved balance helps prevent falls, a significant concern after hip replacement surgery.
Prevent Blood Clots
Following surgery, there’s an increased risk of blood clots forming in the legs. Early mobilization is key to preventing this complication. Physiotherapists will introduce safe and gentle exercises soon after surgery to promote good circulation in your legs. Early movement, proper positioning and compression stockings are the standard measures used after hip replacement to manage clot risk. Your surgical team sets which of them apply to you.
Functional Restoration
The ultimate goal of physiotherapy is to empower you to regain your independence in performing everyday activities (daily living activities) such as:
- Walking
- Climbing stairs
- Getting dressed
- Bathing
- Preparing meals
Manual therapy, targeted exercises, gait training and balance work are what the program is built from. What you can do at the end of it is measured against where you started.
What to Expect During Physiotherapy Rehabilitation
Physiotherapy isn’t something that starts after you’ve fully recovered from hip replacement surgery. Similar to physiotherapy for labral tear hip, this process is necessary for the healing process from the very beginning.
Physical therapy rehabilitation typically begins in the hospital shortly after surgery. Bed exercises like ankle pumps and leg slides will be introduced to improve circulation and prevent stiffness.
In some cases, your orthopedic surgeon may recommend pre-operative physiotherapy exercises. Prehabilitation focuses on strengthening the muscles around your hip joint in the weeks leading up to surgery. What you build before the operation is what the first weeks after it draw on.
As you progress, your physiotherapist will gradually introduce more challenging exercises, including:
Straight Leg Raises
Straight leg raises directly target the quadriceps muscles on the front of your thigh, which are essential for extending your hip joint. Strong quadriceps are key for activities like walking, climbing stairs, and standing from a seated position. To perform this exercise:
- Lie on your back.
- Slowly raise your operated leg.
- Keep that leg straight.
- Hold for a few seconds and lower back down.
Hip Abduction
This exercise targets the gluteus medius muscles, located on the outer side of your hip. These muscles play a role in stabilising your hip joint and preventing unwanted inward rolling during movement. Weakness in the gluteus medius can contribute to limping and gait abnormalities. Strengthening these muscles through hip abduction exercises enhances hip stability and proper mechanics, leading to a smoother and more efficient walking pattern. To do this:
- Lie on your side
- Lift your operated leg upwards away from your other leg with your toes pointing forward.
- Hold for a few seconds and lower back down.
Short Leg Stands
This might seem like a simple exercise, but they pack a powerful punch when it comes to regaining balance and confidence after surgery. Balancing on your operated leg challenges your core muscles and proprioception (your body’s awareness of its position in space). As you progress in these exercises, gradually increasing the standing time and reducing support, you’ll retrain your body for balance and stability. You can do this exercise with support or something to hold for balance.
These are just a few examples of the exercises you might encounter during physiotherapy rehabilitation. Your physiotherapist will design a personalised program that incorporates a variety of exercises tailored to your specific needs and recovery goals.
Tips for When You Get Home
Following discharge from the hospital, physiotherapy continues at home. Here are some tips to ensure a smooth recovery:
- Use a walking aid: Your physiotherapist may recommend a walker or crutches for support during the first few weeks.
- Practice safe exercises: Perform your prescribed exercises regularly on a firm surface, initially under the supervision of a physiotherapist or caregiver.
- Maintain good posture: Stand tall with your shoulders back and avoid slouching. This promotes proper alignment and protects your new hip.
- Use a raised toilet seat: This can make sitting and standing from a seated position easier.
- Apply ice packs: Ice therapy can help reduce pain and swelling after exercises.
- Listen to your body: Don’t push yourself too hard. Rest when you feel tired and seek advice from your physiotherapist if you experience any pain or discomfort.
What Not to Do After Hip Replacement
Here are some activities to avoid during your initial recovery:
- Crossing your legs: This can put undue stress on your new hip joint.
- Bending at the waist: Bend from your knees and hips when picking up objects.
- Twisting: Avoid twisting motions that can strain your hip joint.
- Climbing stairs without a handrail: Use the handrail for support when navigating stairs.
- Operating a vehicle: Wait for your doctor’s approval before getting behind the wheel again.
Conclusion
Hip replacement surgery is done to reduce pain and improve mobility. What happens in the months afterwards decides how much of that you use. The work after a hip replacement is strength and walking pattern, trained back rather than waited for. Your therapist measures both and tells you where you are against the criteria for your stage.
For impingement or a labral repair at the hip, the gluteal muscles were switched down long before the operation. See the Hip Arthroscopy and FAI Recovery Program, which sets out the four stages and what moves you up.
Where are you with this right now?
1. It is settling on its own
Hip pain from a specific overload often settles over six to twelve weeks with load management and graded strengthening. If you can walk further this month than last and sleeping on that side is getting easier, it is settling. You do not need us for this, and we would rather say so.
2. It has stopped improving
You put your socks on sitting down. You have stopped sleeping on that side. You take the stairs one at a time without noticing.
The hip stops hurting long before the muscles around it are strong again. That gap is where the limp comes from. That is the gap worth measuring, and it is not measured by how you feel on the day.
The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.
3. You have had surgery, or you have a date
Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See the Hip Replacement Recovery Program, or hip physiotherapy if you are not sure which applies to you.
All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.
Next step
Find out which stage you are in
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Related reading
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