OrthoVirginia Blog

What to Expect in Physical Therapy (PT) After a Total Hip Replacement

Total Hip Arthroplasty:

First day in PT (evaluation)

Please arrive 15-20 minutes early to complete required paperwork.  The physical therapist (PT) will perform an evaluation to determine your needs for therapy.  The following is included in the evaluation:
• the PT will obtain measurements of hip motion and flexibility and lower extremity strength

• hip surgery precautions will be reviewed based on your surgical approach

• the PT will assess your gait and correct as needed for proper mechanics with a walker or cane

• a home exercise program will be developed specific to your needs, and all exercises will be reviewed with the therapist or aide. These exercises will be performed daily, at home

• depending on how you are feeling that day, a gym program may be started for you, which includes performing exercises using the clinic equipment

• at the end of your session, a cold pack will be issued for 15 minutes

• plan to spend about 60-75 minutes in the clinic your first day.


Follow-up visits

 • after a total hip replacement, the patient can expect to continue physical therapy sessions 2-3x/wk for an average of 3 months*

• each follow up session averages 60-75 minutes

• during each session, you will work 1 on 1 with the PT for about 25-30 minutes to work on stretching, strengthening and functional exercises, gait training (including progression from a rolling walker  cane  no assisted device) etc

• the patient will also work with the PT aides for an average of 20-30 minutes to perform a gym program designed by your PT, specifically for your needs

• after all exercises are complete, ice will be applied to the hip for 15 minutes

• on a monthly basis, a progress note will be written to discuss the plan of care with the patient and the physician


General timelines/goals*:

 • after the start of PT, most patients will use a rolling walker for about 2-4 weeks. Then a cane will be used for the following 4-8 weeks

• after starting PT, most patients will start going up stairs with a normal pattern in 4-6 weeks, and down stairs with a normal pattern in 8-10 weeks

• sleeping for 6+ hours without significant disruptions occurs after about 6-8 weeks from surgery

• driving can usually be resumed after 2-4 weeks (left leg surgery) or 4-6 weeks (right leg surgery), pending MD instructions and pain medication use

*Every individual responds differently to their surgery, and no two surgeries are the same. The numbers provided above are a general guideline. Please consult with your physician about any specific questions regarding your surgery.