Sports after a hip replacement: what the surveys actually say

Can you run after a hip replacement?

Some people run after a hip replacement, and most surgeons would prefer that they did not. That is the whole of the honest answer, and the reason the two halves sit so badly together is that no trial has ever been run to separate them.

OrthoInfo, from the American Academy of Orthopaedic Surgeons, says most surgeons advise against high-impact activity and names running, jogging and jumping among the examples. Running was in the not-recommended column of the oldest and most quoted of the sport lists, a 1995 questionnaire completed by 28 orthopedic surgeons at the Mayo Clinic in the United States, 13 of them consultants and 15 fellows or residents, who rated 28 sports (McGrory, Stuart and Sim, 1995). Three decades later that list is still being passed around as though it were current clinical consensus. It is not. It is what 28 American surgeons preferred in 1995. That is useful, and it is a different thing. One detail matters for readers outside North America: that survey listed football and soccer as two separate sports in its not-recommended column, because it was written in the United States, where football means the American game and soccer is the sport you may know as football.

If you have had a hip or knee replacement, get the go-ahead from your surgeon before you try running or jogging. Many surgeons advise against running and jogging after a joint replacement for good, not just for the first months, because each step sends impact through the new joint. The same goes for the impact that comes without the distance: if you have had a hip or knee replacement, get the go-ahead from your surgeon before you try jumping or hopping. Many surgeons advise against jumping and hopping after a joint replacement for good, not just for the first months, because each landing sends high impact through the new joint.

Running covers the training side for readers whose knees and hips have not been replaced, and the things to avoid after a hip replacement page sorts the restrictions by how firm they are. Neither replaces the answer from the surgeon who knows what your bone was like when they were in there.

One more thing shapes every answer on this page, and most readers do not know their own. The hip can be reached from the back, the front or the side, and the restrictions that follow differ by approach, sometimes in opposite directions. Several sports are made largely of rotation and extension, so this is not a detail. Hip precautions, what they are and how long they last explains the approaches and how to find out which you had. There is no sport-by-approach table on this page because no readable source supports one. The nearest thing is a 2024 review that pooled five studies and 204 patients to look at return to sport after the front approach, and found a rate of 76%, with 58% getting back to the same intensity, which its authors read as comparable to the rates reported when approach is not separated out at all (Pan and colleagues, 2024). So the approach you had changes which movements your protocol limits. It is not known to change whether you get back to your sport.

Which sports after a hip replacement are least argued about

A short list draws agreement from almost every direction. OrthoInfo names unlimited walking, swimming, golf, hiking, biking and dancing among the low-impact choices. The 1995 Mayo survey recommended sailing, swimming laps, scuba diving, cycling, golf and bowling. The overlap between a list written for American readers today and a questionnaire filled in by American surgeons in 1995 is where the argument runs out.

The pooled research points the same way. A systematic review of 57 studies on primary total hip replacement found return-to-sport rates ranging from 42% to 100% across studies, pooling at 85%, and when the studies were split by the intensity of the sport the pooled rate was 97% for low-intensity sports against 56% for high-intensity ones (Pasqualini and colleagues, 2023). Both of those tidy figures sit on top of studies that disagreed sharply with one another, by the review's own inconsistency measure of over 90% in each intensity group, so they describe a direction rather than your odds. The gap between the two is the part to carry away. The hard sports are not forbidden. The difference is in how many people actually get back to them.

Golf, tennis and the racket sports

Golf is the easy one. It is on OrthoInfo's low-impact list and in the Mayo survey's recommended column, which is as close to consensus as this subject gets. That still leaves three separate questions inside one round: the walking, the bending to the tee and the ball, and the twist through the hip at the end of the swing. A hip reached from the back and a hip reached from the front do not have the same relationship with that twist, which is why this is a question for your surgeon and not for a yes or no on a list.

Tennis splits in two, and OrthoInfo splits it the same way. Doubles tennis and pickleball are on its list of lower-impact activities it calls preferable; singles tennis is on the other side of the same sentence, with racquetball, basketball and skiing. So the question is not whether you may play tennis but which tennis you mean, and the Mayo survey is no help here, having put racquetball in its not-recommended column without rating tennis at all. The most useful readable study is recent: a survey of 1,284 respondents, out of 7,200 invited, who had at least one primary joint replacement at a single center, with a mean follow-up of 3.6 years. Of those who had played a racket sport in the two years before surgery, 71.9% returned to play, against 30.2% of people who had played at some point but not recently, and most of the recent players were back at their previous skill level by about six months, with higher physical function scores. Reoperation rates were not significantly different between the people who returned to play and the people who did not, which is worth stating in those words rather than as a clean bill of health, because a survey answered by fewer than one in five of the people it was sent to, at 3.6 years, is not the study that would find a difference in implant survival if one existed. The authors were plain that the long-term effects need further study, and the abstract does not separate hip replacements from knee replacements (Taylor and colleagues, 2025).

Two lessons come out of that study, and neither comes out of a list. Having played the sport recently matters more than the sport itself, so a reader who has been off court for three years is in a different conversation from one who stopped three months ago. And singles, doubles and the newer court sports are not one load. Padel and pickleball sit at different points on that scale again. OrthoInfo names doubles pickleball among the lower-impact choices; padel is named by none of the sources used here, and the two games are not interchangeable, so a surgeon who clears one has not cleared the other.

Cycling, swimming, walking and hiking

This group is where most readers end up, and it is the group the sources treat most generously. Swimming and biking are on OrthoInfo's list. Cycling, swimming laps and scuba diving were recommended in 1995. Walking is the one activity OrthoInfo describes without a limit attached.

Here the distinction that matters is balance, not impact. Swimming and a stationary bike ask nothing of your steadiness. A road bike, a towpath and a hill in the rain ask a great deal of it, and in each case the hazard is the fall and not the load. Brisk walking is the sensible first rung, and the balance and falls prevention program is worth running alongside if you are older, have fallen before or feel unsteady on rough ground.

Skiing, and the sports where the fall is the real risk

For skiing, skating, court sports played at speed and anything on a mountain bike, there are two questions and most pages only ask one of them. OrthoInfo asks the first: it names skiing among the high-impact activities it treats as less preferable than golf, cycling and doubles tennis, on the wear grounds that run through all of its advice. The second question is the one that gets left out, and for this group it is the bigger of the two. What happens when you come down?

The sources are clear on this. OrthoInfo says a fall in the first few weeks after surgery can damage the new hip and may result in a need for more surgery, and calls stairs a particular hazard until the hip is strong and mobile. The NHS advises against exercise involving jumping, sudden turns or a high risk of falling while your hip is recovering, and against lifting or moving heavy objects until you are told it is safe. Both are about the recovery period, and your team sets when that period ends for you. That lifting line is why barbell work belongs in the same conversation as the mountain, and the gym and lifting is the page for how load is built back generally.

Two practical things follow from that, and they apply to the quiet sports as much as the fast ones. If you go out alone, on a towpath, a hill or a golf course, carry the phone on you rather than in a bag strapped to the bike or left in the buggy, and tell somebody your route and roughly when you will be back. And read the emergency fall line below before you go, the one about a fall you cannot get up from: that, or a fall where you may have hurt your head, neck, back or hip, is an emergency call, and it asks you to stay where you are and keep warm rather than struggle up.

One thing changes the arithmetic of a fall, and people going back early are the ones it applies to. Clot prevention after this operation runs on for weeks, so if you are still on the tablets or the injections when you go back, you are going back on a medicine whose known trade-off is that you bleed more easily (NHS). A knock bleeds and bruises more than it would have, and a bang to the head is the one that matters: the warning line below asks for urgent advice after a head injury on medicine that thins your blood even if you feel fine, because only a hospital can scan for a bleed inside the head. So ask your team whether your sport fits while you are still on it, and ask about the ones with a hard fall or a stick, a ball or an elbow in them before the ones without. Never stop or change a prescribed medicine on your own.

A note on a figure that often travels further than it should: cross-country skiing was in the recommended column of the 1995 Mayo survey, but specifically after knee replacement. It does not read across to a replaced hip, and this page does not treat it as though it does.

Does sport wear a new hip out faster?

Nobody knows well enough to tell you, and the pages that sound certain in either direction are going beyond their evidence.

On one side, OrthoInfo says excessive activity may speed up the normal wear between the head of the implant and the socket, and that over a period of years a hip prosthesis may wear out or loosen, with a revision operation sometimes needed if the loosening is painful. On the other, the racket sport survey above found no significant difference in reoperation rates between the people who went back to playing and the people who did not, in a group followed for a mean of 3.6 years (Taylor and colleagues, 2025).

One mechanism is worth understanding before either side, because it changes what the word impact is doing in all of these lists. Wear of the plastic liner tracks how many times the joint is used rather than how many years it has been in the body. When 37 hip replacements were measured against their owners' step counts, wear correlated with use, and the paper reporting it was titled for that finding: wear is a function of use, not time (Schmalzried and colleagues, 2000). The same group had already counted the steps of 111 people with a hip or knee replacement and found an average of about 5,000 a day, which works out at roughly 0.9 million cycles a year through each leg, with a 45-fold spread between the least and the most active person in that group (Schmalzried and colleagues, 1998). Two cautions belong with those studies. They measured the plain polyethylene of the 1990s rather than the highly crosslinked polyethylene used in most hips now, which wears considerably less, and 37 hips is a small sample. What survives both cautions is the direction, and it is the useful part: cycles count. So the hours matter alongside the impact, and a sport played twice a week for two hours is not the same proposition as the same sport for half an hour, which is a distinction no list sorted by impact alone can show you.

The most direct look at the question is a 2025 systematic review of implant integrity, which searched four databases to May 2023 and included 16 studies covering 4,676 patients, 3,146 of them with a total hip replacement and 1,530 with a hip resurfacing. Median age at surgery for the total hip replacement group was 60 years and median follow-up was 7.1 years. Three of the 12 total hip replacement studies, between them covering 65.7% of the total hip patients included, found higher physical activity linked with poorer implant survivorship. The other nine did not. The reviewers rated average study quality as moderate and noted that how activity and implant integrity were measured varied widely between studies, and their own advice was moderate physical activity with possible avoidance of sports that load the implant excessively (Levett and colleagues, 2025).

Which bearing you have changes that conversation, and one type comes with a standing instruction. If your replacement was a metal-on-metal one, the NHS asks for regular check-ups and names new hip pain, feeling less mobile than usual, and a popping or clicking sound from the joint as reasons to contact your GP, meaning your family doctor or primary care physician, or your care team. A hip resurfacing is a metal-on-metal bearing as well, and resurfacing is an operation chosen for active people: 11.7% of the British surgeons surveyed below said it was what they would do for a sporting patient, so a reader of this page is likelier than most to be carrying one. The discharge paperwork or your surgeon will tell you which you have, and warning signs after a hip replacement carries that advice in full.

So the state of play is a split result from studies of moderate quality, measured in different ways, with no long-term prospective trial behind it. That is not nothing, and it is not an answer. What it means for you is that the trade is a real one and the person who can weigh it is the surgeon who chose your implant and saw your bone. If the hip starts telling you something has changed, the routine review line in the warning signs below is the one to use, and warning signs after a hip replacement covers the rest.

How do you know you are ready for your sport?

Not by the calendar. The published return-to-sport times exist, and they describe populations: a review of 37 studies, 14 of which reported on sport, found people returning to sport at a mean of 104% of their pre-surgery level and 82% of their pre-symptomatic level, with the time to return varying from 16 to 28 weeks between studies (Hoorntje and colleagues, 2018), and the 57-study review put the mean time to return at 16.1 weeks with individual studies ranging from 8 to 26 (Pasqualini and colleagues, 2023). Read those as averages from other people's hips. The 104% figure in particular is a group getting back to slightly more sport than it was managing in the months before the operation, when the hip was at its worst, and not a promise about the hip you had at forty.

What a physiotherapist actually looks at is the leg. Can you stand and control your weight on the operated side on its own? Can you lower and rise on that leg without the pelvis dropping? Has the limp gone when you are tired, and not only when you are concentrating? Can you walk on grass, gravel and a slope without watching your feet? Does the hip settle the same evening, or does it take until the next afternoon? We do not publish a percentage threshold on this page, because the single-leg percentage targets circulating online come from individual practices and not from published guidance, and a number borrowed from somebody else's clinic is not a test of your hip.

Be honest about what the real limit is, because it is often not the new hip. If the thing holding you back is the other hip waiting its turn, a knee, your back, or simply the condition you lost over a year of not playing, that changes the plan from protecting a joint to rebuilding a body, and it is worth saying out loud at the appointment. Older readers in particular tend to have more than one joint in the conversation, and the hip that was replaced is frequently the one in the best shape.

The groundwork for most of those qualities is strength and balance work, not sport-specific drills. A mini squat, a step up and semi-tandem stance are the kind of thing that sits underneath them, and hip replacement exercises after 6 weeks is the window where that work usually starts. Build these up gradually, and your physiotherapist or physical therapist will adjust the amount to your hip and not to a page.

If your sport is the goal you cannot reach on your own, that is a reason to ask for help instead of waiting quietly. NICE asks that people having a joint replacement are given clear rehabilitation goals and a point of contact if they are doing their rehabilitation themselves, and that supervised outpatient rehabilitation, in a group or one to one, is offered to people who have difficulty with daily activities, who have an ongoing functional impairment with specific needs, or who are not meeting their goals alone. A sport you cannot get back to is a specific need, and it is worth naming in those words.

Going back in stages

The pattern that works is dull and it holds for every sport. Put the parts back one at a time, and change one thing a week, not three.

Take golf as the worked example. Walking the distance comes first and on its own. Then putting and chipping, where the twist is small. Then a short swing. Then a full swing without a ball. Then the range. Then nine holes with a buggy or cart before eighteen on foot. A racket sport takes the same shape: hitting from a standing position, then moving to the ball, then changing direction, then playing points, then playing a match. Each rung tells you something, and the hip gives its verdict the following morning, not during the session. No source on this page publishes a staircase like that one. It is practice experience, and your own team's version of it replaces ours.

Two rungs on the golf ladder are worth naming for surgical reasons rather than fitness ones, and they are the two people skip. The first full-speed swing, which is usually the first one with a ball in front of it, puts the most twist through the implant of anything in the round, and more so with a driver than with an iron, so it is a separate decision from the slow swing you take without a ball. And bending down into the hole for the ball, or down to the tee, is deep bending with a turn in it, which is the restricted direction after some approaches and not after others. Both of those go on the list you take to your team, not inside a swing thought on the course.

If golf is what you actually came here for, this is what to do next week rather than what to think about. Ask your surgical team three things, close to these words: is there anything about my hip or my implant that should keep me off a golf course for good, how long do you want me to wait before a full swing with a ball, and is the twist at the end of my swing one of the directions my approach restricts. Write the answers down, because they are different answers from different people and you will want them in six months. Then start the ladder above one rung below where you think you are, note what the hip did the following morning rather than during the round, and take that note to your physiotherapist or physical therapist instead of deciding alone whether an ache means stop or carry on. A sport nobody has cleared yet is not the same thing as a sport that has been refused, and the way to move it from one to the other is the appointment, not the reading.

Two rules sit over all of it. Your surgical team's plan outranks this page every time, because they know how the hip was reached and how stable it felt when they tested it. And soreness that settles is not the same signal as a hip that is worse the next day; the second one means you went up a rung too early. The total hip replacement rehab program carries the exercise stages and the doses the leaflets give.

Your surgical approach belongs in this plan too. Whether the limiting direction for you is deep bending and turning in, or going back and turning out, or loading the side of the hip, is set by how the operation was done, and it changes which rung of a staircase is the hard one. Take that to the hip precautions page and then to your team.

If you have not had the operation yet, raise your sport before it

This is the group with the most to gain from one short conversation, and the one most likely to miss it.

The British Hip Society survey is the evidence for why. Of 260 members invited, 109 answered, and the authors describe them as a specialist group, most of whom consider themselves young adult hip specialists, answering about the patients they treat who play sport. That is the population these numbers describe, so read them as what a sport-minded surgeon does for a sport-minded patient rather than as the general practice of hip surgery. They differed on fixation, with uncemented preferred by 33% and hybrid by 29.1%, on bearing surface, with ceramic on ceramic at 39.8% and ceramic on polyethylene at 36.9%, and on head size, with about half choosing under 36 mm and 22.3% choosing 36 mm or larger. The one thing most of them shared was the way in: 68.9% preferred the standard posterior approach for these patients, and 11.7% would do a resurfacing. They also differed on timing: about a third would allow a return to sport at 6 to 12 weeks, and 43.7% advised waiting until 3 months. Every respondent allowed low-impact activity, and the authors reported significant caution across the group about high-impact activity (Bradley and colleagues, 2017).

Those are not four pieces of trivia. Each one bears on sport in a different way, which is why the answer you get is specific to the hip you were given rather than to hip replacement in general. Fixation decides what is holding the implant while you are getting going again: cement grips as soon as it sets, whereas an uncemented implant is held at first by the press fit of metal into bone and only later by bone growing onto or into its surface, and movement at that interface while that is happening can leave scar tissue there instead of bone (Vajapey and colleagues, 2024). The bearing surface is the pair of faces that will do the wearing over the decades, which is the question the section above is about. Head size is about stability: in a randomized trial of 644 hips, a 36 mm head dislocated less often in the first year after a primary replacement than a 28 mm head, 0.8% against 4.4%, in middle-aged and elderly patients with metal running on highly crosslinked polyethylene, and the authors were careful to add that late dislocation, wear and liner fracture with the bigger head still needed establishing (Howie and colleagues, 2012). And the approach sets which directions your hip will be told to avoid. None of that is a shopping list to take to a surgeon. It is why your sport is worth naming while those choices are still open.

Those are choices made before or during your operation. The consensus guidance that exists was written for surgeons and not for you: the Hip Society and the American Association of Hip and Knee Surgeons survey, with 549 replies and 30 activity groups graded as allowed, allowed with experience, not allowed or undecided, was published in a surgical journal (Klein and colleagues, 2007), and an earlier review and survey of the Hip Society, the Knee Society and the American Shoulder and Elbow Surgeons was addressed to surgeons and primary care physicians (Healy, Iorio and Lemos, 2001). The way that guidance reaches you is through the person in front of you, so tell them what you play, how often, and at what level.

Rehabilitation starts earlier than most people expect. NICE asks that rehabilitation is offered on the day of surgery if possible, and within 24 hours of it. If you are still at the stage of deciding, why a hip replacement is needed sets out what the decision is actually made of, and the recovery timeline gives the shape of the months that follow. Readers coming at this from the other knee or hip may also want returning to sport after a meniscus tear, which is a different joint and a different problem.

A short word on the operations this page is not about. Revision surgery, a hip replaced as part of treating a broken hip, and a partial replacement can all come with quite different plans, and the sources used here were not written about them.

When to stop and get advice

Sport brings two of the problems after a hip replacement within reach at once: the positions and twists that can take the joint toward coming out of its socket, and the falls that can break the bone around it. Both have clear signs, and both are better learned before you go back than afterward.

The first of those is usually described as an early problem, and that is only half right. The risk is at its highest in the first weeks and months, while the capsule and the muscles that had to be divided to reach the joint are healing, and it then settles to a low level that does not reach zero. In 6,623 hips followed at one center, the cumulative risk of a first dislocation was 1% at one month and 1.9% at one year, and then went on climbing by roughly 1% every five years for as long as the hip was in place. Every one of those hips was cemented with a 22 mm head and implanted between 1969 and 1984, so the figures belong to that era's implant and not to yours, and the trial above suggests today's larger heads come out less often (Berry and colleagues, 2004; Howie and colleagues, 2012). The shape of the curve is what reads across, and it is the reason the dislocation lines below are worth knowing in your fifth season back and not only in your first.

A third one is on the list below for a different reason. Returning to sport is also where a clot gets mistaken for training. New calf pain, a calf that is swollen, warm or tender on one side only, or a pain that does not feel like ordinary soreness after a session needs advice the same day rather than a week of stretching, and sudden breathlessness or chest pain is an emergency call even when the leg looks completely normal. Those two lines are written in the words that separate them from exercise soreness, which is why they are worth reading before the first hard session rather than after it.

Read the warning signs below properly once. The ones that matter most to a reader going back to sport are the dislocation lines, the line about a knock or a fall even when you can still walk, the clunk that settles and seems to come to nothing, the clot pair, the infection lines, since a new joint can be infected years later and a hot, red or swollen hip with a temperature is a same-day call however long ago you were operated on, and the routine line about pain that had settled and has come back. A temperature is not the test for an infected joint, and a hip that comes back sore after a season of sport is the reader this matters to. OrthoInfo names increased pain or stiffness in a joint that had been working well among the signs of an infection around a new joint, says the signs can be as little as mild redness and swelling, and says fever is no longer considered a sign of one. Hip replacement warning signs covers the whole set in detail. Nothing on this page is personal advice about your hip, and nothing here clears a sport for you. That remains your surgeon's to give.

Related exercise programs

• Total hip replacement rehab
• Balance and falls prevention

Common questions

References

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Written and checked by the PocketPhysio editorial team. Last updated 2026-10-17.

This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.