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Total Hip Replacement Exercise Guide: After the first follow-up visit
Hospital  >  Care Programs  >  Holland Bone and Joint Program  >  Patient education  >  Hip  >  Total Hip Replacement Exercise Guide  >  Progression exercises
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Strengthening and progression exercises

  • 3-4 times per week (every other day)
  • Start with 1 set of 10-15 repetitions
  • Progress gradually to 3 sets of 10-15 repetitions, take a 1-2 minute break between sets
  • Think slow and controlled movements, no need to hold the position
  • Move on to an exercise labeled “progression” when you can easily complete 3 sets of 10-15 repetitions
  • Repeat exercises on your other leg

Tips:

  • It is normal for muscles to feel sore or even shaky when starting a new exercise
  • Joint pain is not normal. Pain, unlike soreness, is an indicator that you may be overdoing it with your exercises. Rest for 1-2 days and then start exercising again slowly
  • Gradually increase your activity level
  • Walking DOES NOT take the place of your exercises
  • Continue with these strengthening exercises for at least the first year after your surgery

7. Bridge progression

  • Lying on back, knees bent
  • Squeeze buttocks
  • Lift buttocks off bed
Bridge

Progression level 1

  • Lift buttocks off the bed with both feet on bed
  • Once you are up, lift non-operated slightly off the bed
  • Keep non-operated leg up as you lower buttocks back to the bed

Progression level 2

  • Raise and lower buttocks with operated leg only on bed
  • Try straightening your non-operated leg while keeping it off the bed slightly

8. Clam shell

  • Lie on your non-operated side with your hips and knees slightly bent
  • Keep your feet together
  • Open your knees as much as you can without letting your top hip roll backwards
Clam shell exercise

Note: If you are having difficulty opening your knees or preventing your hip from rolling then push your feet against a wall or headboard as you lift your top knee


Clam shell progression

Progression: Tie a TheraBand® around your lower thighs, just above your knees. You may want to start off with a light resistance TheraBand®

9. Hip flexor strengthening

  • In sitting, lift your operated leg up so that your foot is off the floor
  • Try to avoid leaning back
  • Do not let your knee turn out to the side

Progression: push down with your hands to apply resistances

Hip flexor strengthening

10. Standing hip abduction progression

  • Hold onto a counter for balance
  • Lift your operated leg out to the side while standing tall
  • Keep your hips level and upper body straight
  • Do not hike your hip. Try to keep your foot slightly off the floor
  • Keep your toes pointing forward
  • Alternate legs

Progression: Tie a TheraBand® around your lower thighs

Standing hip abduction

11. Squat progression

  • Stand in front of a chair/sink and keep equal weight through both feet
  • Keep your toes pointing forwards
  • Bend your knees and stick your buttocks out
  • Lower your buttocks down slowly and with control, using hand support if needed
  • If using a chair, lower all the way down into sitting
  • Do not allow your knees to go ahead of your toes
Squat

Progression level 1: Tie a TheraBand® just above your knees. Press thighs apart against tension of TheraBand® while doing the chair squat exercise

Squat: Progression level 1

Progression level 2: Alternate single leg squat between operated and non-operated leg, using hand support if needed

Squat: Progression level 2

12. Crab walk

  • Bring your feet together and tie a TheraBand® just above your knees
  • Stand with feet shoulder distance apart
  • Stick your buttocks out as if you are about to sit in a chair
  • Do not allow your knees to go ahead of your toes
  • Maintain this squat position and take a few steps in one direction, then side step back in the other direction
  • When stepping feet back together, don’t bring feet closer than hip distance apart
  • Repeat in opposite direction until you are back to your starting position

Crab walk

13. Standing abduction against wall

  • Stand on operated leg
  • Bend non-operated leg and push your knee against the wall and return to standing on both legs
  • Your hip should not be touching the counter
  • Make sure to keep your hips level and thighs in line

Progression: Try to take your hand off the counter so that your lower leg is the only part of your body touching the wall.

Standing abduction against wall

14. Marching in standing

  • Hold onto a counter for support if needed
  • Bend your operated hip and lift your knee up towards your chest
  • Keep your back straight and ensure that you are not rocking from side to side
  • Alternate legs

Helpful Tip: perform this exercise in front of a mirror.

Progression:

  • level 1: Once you are able to stand without holding on, progress to marching at a slower pace
  • level 2: Standing on an uneven surface such as a flat pillow, wobble board or Bosu® ball
Marching in standing

Stretches

  • Warm up for 5-10 minutes before stretching (e.g walking, warm shower)
  • Hold stretches 45 seconds (or 5 slow deep breaths), repeat 3 times
  • Can be done everyday or several times a day if your muscles are tight
  • Repeat with the other leg

Exercise instructions

15. Hip bending stretch

  • Bend your knee and bring your operated leg toward your chest
  • When you cannot go any further on your own, use your hands/towel to pull your thigh towards your chest until you feel a gentle stretch

Hip bending stretch

16. Hip flexor stretch 

  • Lie with operated leg hanging over the end of the bed
  • Bend the non-operated leg toward your chest using your hands or a towel
  • You should feel the stretch at the front of your thigh/groin

Note: to increase the stretch, let more of your thigh hang off the bed and bend your knee.

Hip flexor stretch

17. Seated hamstring stretch

  • Sit on the edge of a chair
  • Keep non-operated foot flat on floor. Straighten your operated leg with heel on floor and toes pointing up to the ceiling
  • Ensure that you are sitting up straight with an arch in your low back
  • Slowly lean forward at hips while maintaining a straight back with chest up
Seated hamstring stretch

18. Adductor stretch

  • Stand with your feet wider than hip distance apart
  • Lunge away from the side that you are stretching
  • You should feel the stretch in your groin or the inside of your thigh
Adductor stretch

19. Side stretch

  • In sitting or standing
  • Raise the arm on your operated side above your head
  • Lean away from your operated side
  • Take 4 deep breaths to increase the stretch
Side stretch