Three weeks after hip replacement, you should expect moderate pain that is noticeably better than the first week, increased ability to walk with your walker or crutches, and swelling that comes and goes depending on activity.

At this stage, you are past the acute post-operative phase but still in early recovery. Pain should be manageable with medication, though you may still need prescription painkillers or over-the-counter options. Swelling in your hip, thigh, and knee is normal and often peaks around day 10 to 14 before beginning to improve. You should be able to put weight on your surgical leg with information, though walking distances remain short—typically 50 to 100 feet with a walker or crutches.

The surgical incision should be mostly closed and no longer draining. Bruising around the hip and thigh may still be visible and can appear darker before it fades. You may notice warmth or mild redness around the incision, which is normal, but increasing redness, warmth, pus, or opening of the incision requires when ready contact with your surgeon.

Key Takeaways

  • Pain at three weeks should be significantly less than the first week and manageable with medication, though some discomfort during movement is expected.
  • Swelling typically peaks around two weeks and begins to improve by week three, but will increase again if you overdo activity.
  • You should be walking short distances with a walker or crutches and bearing weight on the surgical leg, but not yet walking without an assistive device.
  • Contact your surgeon when ready if you develop fever, increasing redness or warmth at the incision, drainage, or signs of blood clots such as calf pain or sudden shortness of breath.
  • Physical therapy exercises should be happening daily, and your range of motion should be gradually improving even though movement still feels stiff.

Pain and Swelling at This Stage

By week three, pain should be noticeably less intense than in the first two weeks, though it does not disappear. Most people report pain levels dropping from 7 or 8 out of 10 in the first week to 4 or 5 out of 10 by week three. Pain typically comes in two forms: a dull ache that is present most of the time, and sharper pain that occurs when you move the hip in certain directions or put weight on the leg.

Swelling is still present at three weeks but should be starting to decrease. You may notice the swelling is worse in the morning or after activity, and improves with elevation and ice. Compression socks or a compression wrap, if your surgeon recommended one, help reduce swelling. If swelling suddenly increases, becomes very hard or hot, or is accompanied by calf pain, contact your surgeon—these can be signs of a blood clot.

Walking and Weight-Bearing Progress

At three weeks, most people are walking with a walker or crutches and putting full weight on the surgical leg, though the gait is still slow and careful. Walking distances typically range from 50 to 150 feet before fatigue sets in. You should not yet be walking without an assistive device, even if you feel capable—using a walker or crutches protects the hip and prevents falls while your muscles are still weak.

Walking should feel easier than it did in week one, but your hip will still feel stiff and tight. You may notice a catching sensation or clicking in the hip, which is usually normal scar tissue forming. However, if you hear a loud pop or feel sudden sharp pain during walking, stop and contact your surgeon. Your physical therapist will guide you on when to progress to a cane and when to walk without information, which typically happens around week 6 to 8.

The Incision and Signs of Infection

The surgical incision should be mostly healed by three weeks, though it may still be slightly red and tender. Some people still have small amounts of clear or slightly bloody drainage, but this should be minimal. The incision should not be opening up or leaking fluid. You can usually shower by this point, though your surgeon will give you specific instructions—some prefer you to keep the incision dry for the full six weeks.

Watch for signs that something is wrong: increasing redness that spreads beyond the when ready incision area, warmth that feels hot to the touch, pus or thick drainage, the incision opening up, or fever above 101 degrees Fahrenheit. Any of these warrant a call to your surgeon the same day. Minor redness and mild tenderness around the stitches or staples are normal, but spreading redness is not.

Range of Motion and Stiffness

Your hip should have more range of motion at three weeks than it did at one week, though movement is still limited and stiff. Most people can bend the hip to about 60 to 80 degrees by this point, though bending past 90 degrees is still restricted to protect the new joint. Straightening the leg should be nearly full, though some people still have a slight bend. Rotating the hip inward and outward is usually still very limited and may feel uncomfortable.

Stiffness is worst in the morning or after sitting for a while. Gentle movement and physical therapy exercises help, but pushing too hard causes pain and swelling to increase. Your physical therapist will guide you through specific movements designed to gradually improve range of motion without damaging the new joint. Progress is slow—it typically takes 6 to 12 weeks to regain most normal range of motion.

Physical Therapy and Daily Activity

By three weeks, you should be doing physical therapy exercises at home daily, either with a therapist visiting your home or at an outpatient clinic. Exercises typically include straight-leg raises, hip abduction (moving the leg out to the side), gentle hip flexion, and walking. These exercises should not cause sharp pain, though mild discomfort is expected. If an exercise causes pain that lasts more than a few hours after you stop, you are doing too much.

Daily activities at three weeks typically include bathing with information, dressing with adaptive equipment (like a sock aid or reacher), and light household tasks. You should not be driving, climbing stairs without a railing, or doing heavy lifting. Sitting should be limited to short periods—most surgeons recommend getting up and walking every hour to prevent stiffness and blood clots. Sleeping may still be difficult; many people sleep in a recliner or with a pillow between the knees to keep the hip in a safe position.

Medication and Pain Management

At three weeks, many people are still taking prescription pain medication, though some have switched to over-the-counter options like acetaminophen or ibuprofen. Do not stop pain medication abruptly; talk to your surgeon about tapering it down as pain improves. Taking medication before physical therapy or walking helps you move more comfortably and get better results from therapy.

Constipation is a common side effect of pain medication, especially prescription opioids. Drinking plenty of water, eating fiber, and using a stool softener (ask your surgeon which one) helps prevent this. Some people also experience mild nausea or dizziness from pain medication; taking it with food or adjusting the timing can help. If side effects are severe, contact your surgeon about switching medications.

When to Contact Your Surgeon

Call your surgeon the same day if you develop fever above 101 degrees, increasing redness or warmth at the incision, drainage that is thick or foul-smelling, the incision opening up, calf pain or swelling in the lower leg, sudden shortness of breath, chest pain, or severe pain that is not controlled by medication. These can be signs of infection, blood clots, or other complications that need when ready attention.

Contact your surgeon within a few days if you notice decreased range of motion compared to the previous week, inability to bear weight on the surgical leg when you were able to before, or persistent swelling that is not improving with elevation and ice. These may indicate that something needs adjustment in your therapy or medication plan.

Frequently Asked Questions

Is it normal to still need pain medication at three weeks?

Yes. Most people still need pain medication at three weeks, though the type and amount usually decrease. Some people switch from prescription painkillers to over-the-counter options by this point, while others still need prescription medication. Talk to your surgeon about your specific pain level and whether your current medication plan is appropriate.

Why is my hip still so swollen?

Swelling peaks around 10 to 14 days after surgery and then gradually improves, but it does not disappear by three weeks. Swelling increases again if you overdo activity, so if yours suddenly got worse, you may have done too much. Elevation, ice, and compression help. Swelling can take 3 to 6 months to fully resolve.

Can I drive at three weeks?

No. You should not drive until you can walk without a walker or crutches, have good range of motion in the hip, and are off prescription pain medication—typically around 6 to 8 weeks. Driving requires quick reflexes and the ability to press the brake pedal, which your hip is not ready for yet.

What does a blood clot feel like after hip replacement?

A blood clot in the leg causes calf pain, swelling, warmth, or redness in the lower leg. A blood clot in the lungs causes sudden shortness of breath, chest pain, or rapid heartbeat. Contact your surgeon when ready if you notice any of these. Blood clots are serious and require urgent treatment.

Should I be walking without my walker by three weeks?

No. Most people still need a walker or crutches at three weeks. Your muscles are still weak, and walking without support risks falls and damage to the new joint. Your physical therapist will tell you when it is safe to progress to a cane or walking without information, which is usually around week 6 to 8.