The First Few Weeks: Pain, Swelling, and Limited Movement

After hip replacement surgery, you will spend the first night or two in the hospital. Pain and swelling are normal and expected — your surgeon has cut through muscle and bone, and your body is beginning to heal. You will receive pain medication on a schedule, not just when you ask for it, because staying ahead of pain helps you move and recover faster than waiting until it becomes severe.

You will not be able to bend your hip more than 90 degrees for the first 6 to 12 weeks. This means no bending to pick things up, no crossing your legs, no sitting in low chairs, and no leaning forward past your waist. Your surgeon or physical therapist will give you a list of movements to avoid — follow it exactly, because dislocating the new joint is possible if you move it the wrong way during this window.

Swelling peaks around day three or four and then slowly decreases over weeks. Ice, elevation, and compression help. You will likely wear compression stockings to prevent blood clots, a real risk after hip surgery. Some people develop a blood clot anyway — if you notice sudden calf pain, warmth, or swelling in one leg, tell your doctor when ready.

Key Takeaways

  • Pain and swelling are normal for the first several weeks, and staying on a regular pain medication schedule helps you move and heal faster than waiting until pain is severe.
  • You must avoid bending your hip past 90 degrees and follow all movement restrictions your surgeon gives you, because the new joint can dislocate if you move it the wrong way during early recovery.
  • Physical therapy starts within days of surgery and continues for months — doing the exercises at home between sessions is what determines how well you recover, not the therapy sessions alone.
  • Most people go home within one to three days and use a walker or crutches for 4 to 6 weeks, then transition to a cane as strength and balance improve.
  • Returning to normal activities takes 3 to 6 months for most people, though some take longer depending on age, fitness before surgery, and how well they follow their recovery plan.

Getting Around: Walkers, Crutches, and When You Can Drive

You will leave the hospital with a walker or crutches. Most people use these for 4 to 6 weeks, though some need them longer. The goal is not to look independent — it is to protect your new hip while it heals and to prevent falls, which can damage the joint or break bone around it.

Driving depends on which hip was replaced and whether you are taking narcotic pain medication. If your right hip was replaced, you cannot drive until you can press the brake pedal without pain and have full control of your leg — usually 4 to 6 weeks. If your left hip was replaced, you may be able to drive sooner if your surgeon agrees and you are not on narcotics. Do not guess — ask your surgeon before you get behind the wheel.

Stairs are possible early on, but go slowly. Most people can manage one flight by week two or three if they use a rail and take one step at a time (up with the good leg first, down with the surgical leg first). Avoid stairs when you are tired or when pain is high, because a fall is more likely then.

Physical Therapy: What Happens and Why It Matters

Physical therapy starts in the hospital, often the day after surgery. A therapist will show you exercises to do — usually straightforward movements like lying on your back and tightening your thigh muscle, or lying on your side and lifting your leg. These look straightforward and feel pointless, but they prevent blood clots, reduce swelling, and rebuild the muscle that surgery weakened.

After you go home, you will have therapy sessions two to three times per week for 6 to 12 weeks, depending on your progress and your insurance. Between sessions, you will do exercises at home — usually 20 to 30 minutes a day. The home exercises matter more than the sessions themselves. People who skip them recover slower and regain less strength and range of motion.

Therapy progresses in stages. Early on, the focus is gentle movement and preventing stiffness. By week four or five, you will start weight-bearing exercises — standing, walking, and light resistance work. By week eight or ten, you will work on stairs, balance, and movements closer to normal daily life. Your therapist will tell you when you are ready to move to the next stage.

Pain, Medication, and When to Call Your Surgeon

Pain decreases steadily over the first 6 to 8 weeks if you are doing your exercises and following your movement restrictions. By week six, most people are off narcotic pain medication and using over-the-counter options like acetaminophen or ibuprofen. Some pain and stiffness can linger for months, especially first thing in the morning or after sitting for a long time.

Call your surgeon if you develop sudden severe pain that does not improve with medication and rest, because this can signal a complication like infection or dislocation. Also call if you have fever above 101 degrees, increasing redness or warmth around the incision, drainage from the wound, calf swelling or pain, chest pain, or shortness of breath. These are rare, but they need attention quickly.

Mild swelling and bruising around the incision are normal and can last weeks. The incision itself usually closes within 2 to 3 weeks, and you can shower once it is closed — ask your surgeon when that is safe. Avoid soaking the incision in a bath until your surgeon says it is okay.

Returning to Daily Activities and Exercise

Most people can return to light daily tasks — cooking, laundry, light cleaning — by week four or five, as long as they do not involve bending past 90 degrees or carrying heavy loads. By week 8 to 12, you can usually resume most normal activities: grocery shopping, going to work, social outings. Heavy lifting and high-impact exercise take longer.

Walking is the best exercise during recovery. Start with short walks on flat ground — 5 to 10 minutes — and gradually increase distance and pace as your strength improves. By week 8 or 10, many people are walking 20 to 30 minutes without pain. Swimming and water aerobics are excellent once the incision is fully healed, usually by week 6 or 8.

High-impact activities like running, jumping, or contact sports are usually not recommended after hip replacement, even after full recovery. Your surgeon will tell you which activities are safe for your specific situation. Low-impact options like walking, cycling, golf, and tennis are generally fine once you have full strength and range of motion back.

Timeline: What to Expect Month by Month

Weeks 1 to 2: You are home, using a walker or crutches, doing basic exercises, managing pain with medication. Swelling is high. You cannot bend your hip past 90 degrees. Most people are not working.

Weeks 3 to 6: Pain is decreasing. You are walking longer distances with your walker or crutches. You may transition to a cane by week 5 or 6. You can do light daily tasks. Physical therapy continues. Some people return to desk work.

Weeks 7 to 12: You are off narcotics for most of the day. You can walk without a cane for short distances, though you may still use it for longer walks or when tired. Range of motion is improving. You can return to most normal activities, though not heavy lifting or high-impact exercise. Many people return to full-time work.

Months 4 to 6: Strength and endurance are nearly normal. You can do most activities without thinking about your hip. Swelling is minimal. Some stiffness may remain, especially in the morning. Most people are fully back to their normal routine, though full recovery can take up to a year.

Complications: What Can Go Wrong and How Often

Most hip replacements go smoothly, but complications do happen. Infection occurs in fewer than 1 in 100 cases and is usually caught early if you watch for fever, increasing redness, or drainage. Blood clots form in the leg or lungs in a small percentage of cases — compression stockings and blood thinners reduce this risk. Dislocation is possible if you move your hip the wrong way during the first weeks, which is why movement restrictions matter.

Nerve or blood vessel injury during surgery is rare but can cause numbness, weakness, or swelling. Most resolve on their own over weeks or months. Implant loosening or wear can happen years after surgery, but modern implants are designed to last 15 to 20 years or longer in most people.

If you develop symptoms that worry you — sudden pain, swelling, fever, drainage, calf pain, chest pain, or shortness of breath — contact your surgeon or go to an emergency room. Do not wait to see if it improves on its own.

Frequently Asked Questions

How long until I can sleep normally?

Most people can sleep on their back or non-surgical side within a few weeks. Sleeping on the surgical side takes longer — usually 6 to 8 weeks or more — because pressure on the new joint can cause pain. Use pillows between your knees to keep your hip in a safe position and reduce strain.

Can I take a bath or shower?

You can shower once your incision is closed and dry, usually within 2 to 3 weeks. Avoid soaking in a bath until your surgeon says it is safe, typically 4 to 6 weeks after surgery. Keep the incision clean and dry, and pat it gently rather than rubbing.

When can I go back to work?

If your job is desk work with no heavy lifting or standing for long periods, you may return in 4 to 6 weeks. If your job involves standing, walking, or physical demands, recovery takes 8 to 12 weeks or longer. Talk to your surgeon about your specific job before you return.

Will I need another surgery on this hip?

Modern hip implants last 15 to 20 years or longer in most people. You may need revision surgery if the implant loosens, wears out, or becomes infected — but this is not may provide. Taking care of your hip, avoiding high-impact activities, and maintaining a healthy weight can extend the life of your implant.

What if I am not improving as fast as expected?

Recovery speed varies based on age, fitness before surgery, and how well you follow your exercise plan. If you are not improving after 8 to 12 weeks, tell your surgeon — they may adjust your therapy, check for complications, or refer you to a different therapist. Pushing too hard too fast can slow recovery, but not doing enough will also hold you back.