Part of Total hip replacement rehab
Things to avoid after a hip replacement: the three kinds, and which one your question belongs to
Warning signs, and when to get help
What should you avoid after a hip replacement?
The things to avoid after a hip replacement come in three kinds, and almost every list you will find folds them into one. That is why two lists contradict each other. It is also why your own question is easier to answer than it looks: work out which of the three kinds it belongs to, and the answer usually follows.
Kind one is your precautions. These are the positions your surgical team asked you to stay out of while the new joint settles, they were chosen for the operation you actually had, and they are the only items on this page that are rules. What hip precautions are and how long they last is the page for them, including what the usual lists cover and why yours may be thinner than your neighbor's.
Kind two has nothing to do with the angle of the joint. It is a short set of activities worth leaving alone while the hip heals, whether or not anybody handed you a precaution list, because what they load is impact, balance and the bone around the implant.
Kind three is the long term: what most surgeons advise against for the life of the new hip. No page can date that one. It belongs to your surgeon.
The quickest way to tell which kind you are holding is to ask where it came from. If it came from your own surgical team, written on the sheet they sent you home with, in a leaflet they handed you, or said to you on the ward, it is kind one: written for the operation you actually had, and a rule with a date on it. If you got it anywhere else, this page included, it is kind two or kind three: worth knowing, not written for you, and never a reason to go against what your team said. So when you are standing in your kitchen trying to remember whether you are allowed to do something, the question is not what you read online. It is whether it is on the sheet they gave you, and if the sheet does not mention it, it goes on the list of things to ask at the next appointment.
There is a fourth group, and it is the opposite of the question. Plenty of people avoid things nobody ever asked them to avoid, and it costs them months. A section near the end deals with those.
Before any of it, the plan your surgical team gave you beats this page. They know which operation you had, what they found while they were doing it, and what else is going on with you. Where their instructions and anything here point in different directions, do what they said and ask them why if you are curious.
Why there is no single list, and how to find out what yours is
Because a hip can be reached from three directions, and what the joint is least steady against afterward depends on which one your surgeon used. OrthoInfo is explicit that the precautions differ from one patient to the next according to the route taken into the hip. That is a polite way of saying a leaflet written around one approach can mislead a reader who had another.
The caution can point the opposite way. The familiar rules about deep bending and crossing the legs were written for a hip reached from the back. A hip reached from the front often raises the reverse question. How far may the leg travel backward, and how far may it turn out? A hip reached from the side raises a third, about how soon and how hard the muscles on the side of the hip may be worked. The hip precautions page is built around that problem and carries the detail.
So the real answer to what you should avoid starts with a question back: which approach, and what did your team tell you. Most people do not know the first part, and it is answerable.
If you do not know which approach was used, the leaflet you came home with, your discharge letter and the ward that looked after you can all tell you, and the scar on its own cannot, because a scar on the side of the hip can belong to more than one approach.
Ask at your next appointment if nobody has said, and write the answer down with your restrictions beside it. Until you have it, the careful way to wait is all three sets at once rather than the famous one. Keep the hip out of a deep bend. Keep the operated leg from traveling across your midline, and do not twist inward on it. Do not push the leg far back behind you and do not turn it far outward. And leave loaded work for the side of the hip alone, meaning no bands, no ankle weights and no repeated lifting of the leg out to the side, until you know whether the muscles there were detached and stitched back. The first three items are the posterior set, and a front approach does not usually restrict them. The next two are what a front or a side approach raises. The last one belongs to a side approach, and none of the early program depends on it, so waiting a few days for an answer costs you nothing. What this is not is a reason to walk less. The NHS asks you to walk every day as far as is comfortable, so the default is about not pushing the leg deliberately into the ends of its range, and it is never a substitute for being told what your own list is.
Movements to avoid after a hip replacement, while your precautions are in force
Your own list governs this section. If your team gave you nothing of the kind, which happens and is not an oversight, nothing described here becomes yours by default. You are not left with nothing either. The NHS recovery page gives four of these to every reader of it, without naming an approach: do not sit with your legs crossed, do not bend your hip more than 90 degrees, which is a right angle, do not bend down to touch your feet or ankles, and do not sit down on a low chair, a low toilet seat, or any chair with no arms, since pulling yourself back up off one is the problem. Treat those four as the careful setting until your own team tells you otherwise.
What is useful is the pattern underneath the lists, because it covers the situations no leaflet mentions. Deep bending at the hip, bringing the operated leg across the middle of the body, and turning or twisting on that leg are the three themes the classic lists are made of. The detail sits on the precautions page.
Furniture decides more of this than carefulness does. OrthoInfo asks for a chair that is firm with a higher than average seat instead of a low, soft, cushioned one, on the sensible grounds that the low chair is the one you cannot get back out of. It asks you not to lean forward while you sit or as you sit down, not to reach for something on the floor while you are sitting, and to keep the operated leg out in front as you sit and as you stand. Where posterior precautions were given, it suggests a high chair or a barstool in the kitchen. A seat that is too low puts you under your own limit before you have moved at all.
The bed has an item nobody sees coming: OrthoInfo asks you not to reach down to pull the blankets up. The floor has the rest of them. A dropped sock, a cat bowl, a plug behind the furniture, a shoe with laces. The equipment people are given exists for exactly that, so the long-handled aids and the raised or elevated toilet seat are worth using while the restrictions run, not just while you feel clumsy.
The method, as opposed to the rule, lives on two sibling pages. Stairs, car transfers and the toilet covers getting down into and up out of a seat of any height, including the passenger seat of a small car. Sleeping positions covers the night, which is where the hospitals disagree most openly.
What to avoid while the hip is recovering, whatever your list says
This group is about impact, falls and load, not about the socket, so it applies just as much to the reader who was given no precautions at all.
Two items on the NHS recovery page's don't list cover this group, and between them they name four things. Exercise that involves jumping. Exercise with sudden turns. Anything carrying a high risk of a fall, for as long as the hip is recovering. And heavy objects, which it asks you not to lift or move until you are told that you may.
Heavy is the word readers get stuck on, and none of the sources used here puts a number on it, so neither does this page. The practical version helps more than a number would, and it is practice experience rather than a published limit. While you are still using a frame, walker, crutches or a stick, one hand is already taken, so what you carry has to sit comfortably in the other one without making you lean, snatch at the aid or hop the last step. A rucksack or backpack, a bag hooked on the frame if your team says that is safe with yours, a wheeled trolley, or simply sliding things along the counter all beat carrying. If you live alone, this is the part to arrange before you come home rather than to improvise once you are there: shopping delivered rather than carried, the heavy pans moved up to waist height, the laundry basket off the floor, and somebody asked to deal with the bins for the first few weeks. Nothing on this page is a reason to go without a meal because the pan was too heavy to lift.
Falls earn the most respect in that group, because a fall is how a small misjudgment becomes a second operation instead of a bad evening. OrthoInfo is blunt about the first few weeks and about stairs in particular, and the precautions page quotes what it says. Keep the walking frame or walker, and the stick or cane, for as long as your physio or physical therapist asks, not for as long as you feel you need it. Balance and falls prevention covers the rest of it, including how to get up and what to do while you wait. One of the fall lines below is worth reading before anything happens rather than afterward: a fall you cannot get up from, or one 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 or be hauled up. If you live alone, keep your phone in a pocket rather than in another room while that is still a possibility. If you have osteoporosis the same fall carries more consequence, and the answer to that is to be fussier about falling, not stricter about the precaution list.
One item in this group points the other way, and it is easy to miss. The NHS asks you to sit in a reclining position but also to try not to sit still for long stretches, and the reason it gives is swelling. There is a second reason, and it is the one the warning signs below are about: a spell of being much less mobile than usual is one of the things that raises clot risk after surgery, which is why two of those lines matter whatever else you are avoiding. A calf or thigh that is newly swollen, warm or tender. And sudden breathlessness or chest pain, even when the leg looks normal. Travel is the same problem with the seatbelt sign on. OrthoInfo says pressure changes and hours without moving can swell the operated leg, especially while it is still healing, and asks you to talk to your doctor before you fly. Newcastle upon Tyne Hospitals goes further with its own patients and asks them to avoid long haul flights for three months after surgery to lower the clot risk, which is a number worth putting to your own team if you have a long flight booked.
Exercises and classes to be careful with
The name of the exercise or the class is no help as a filter. What counts is what the movement asks the hip to do, and how much of your weight arrives at the end of it.
Jumping is the clearest case. 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.
Several hip exercises elsewhere on this site are missing from the program here on purpose, for the same sort of reason, and the total hip replacement rehab program names them and explains the thinking. Read that before you add anything to your week. A couple of them sit right on the boundary. The mini squat is governed by depth, which is exactly what a protocol limits, so the depth you use is your team's to set. Plain sit to stand is governed by seat height, and that is why the program's version uses a high chair and the armrests.
Classes are harder, because a timetable tells you nothing about a hip. Yoga, Pilates, a mat class, a spin class: each is a sequence of positions, and the ones to ask about are the deep seated and cross-legged positions, the trips from the floor back up to standing, and anything that turns the body over a planted leg. Take the actual movements to your physio, not the name of the class, and ask what to skip and what to swap.
The opposite of avoidance belongs in this section too. OrthoInfo asks you to carry on with the exercises your physical therapist or physio gave you for at least two months after the operation, and if the muscles start to ache, to cut the amount down rather than stop. Hip replacement exercises after 6 weeks covers what changes when the first phase ends.
What most surgeons advise against for the long term
Impact. And the reason given for it is wear, not an accident waiting to happen.
OrthoInfo reports that most surgeons advise against high-impact activity after a hip replacement, naming running and jogging, jumping and other high-impact sport. Its activities page frames the same thing as a preference and not a ban: golf, cycling and doubles tennis or pickleball on one side, singles tennis, jogging, racquetball, basketball and skiing on the other, with the lower-impact group preferable once your doctor agrees. It also asks you to keep an eye on your weight, because extra body weight loads the joint, and says too much activity or too much weight can speed up the implant's normal wear. The NHS puts the same idea in a line: modern hip replacement joints are designed to last at least 15 years, and they can wear over time and cause pain or swelling.
Wear is not the only item on this tier, and the other one catches people out, because it is almost always described as an early problem. Dislocation is most likely in the first weeks and months, while the capsule and the muscles that had to be divided to reach the joint are healing. It then settles to a low rate that never quite reaches zero. In 6,623 hips followed at one center, the risk of a first dislocation was 1% at one month, 1.9% at one year, and then went on rising by roughly 1% every five years for as long as the hip stayed in place (Berry and colleagues, 2004). Every one of those hips was cemented with a 22 mm head and implanted between 1969 and 1984, so the numbers belong to that era rather than to your hip, and modern larger heads come out less often. What reads across is the shape of it.
Surgeons do different things with that, and this is worth asking at a review rather than assuming. Some treat the extreme position as something to stay out of for the life of the joint: a deep bend at the hip with the leg crossing the midline and turning inward, which is one position and not three, and which is what a very low sofa, a car seat, a deep squat or a seated twist can quietly produce. Others expect nothing of you at all once the soft tissue has healed, particularly after a front approach or with a large head. Neither camp is being careless. Your surgeon knows which hip you have, and the precautions page explains why the combination matters more than any single movement on it.
That leaves two things to say about this tier. It is advice, given by most surgeons and not by all of them, and your surgeon is the one who knows your implant, your bone and how the hip went in, so ask at a review instead of deciding from a web page, this one included. And high impact is not another word for active. Walking, swimming, cycling and golf all sit in the recommended group on the OrthoInfo pages.
Going back to sport after a hip replacement takes the sport question apart properly, including the activities that fall between the two groups, and the gym and lifting covers loaded work.
How long does each of these last?
Each kind runs on its own clock, which is why one number never covers the question.
Your precautions last as long as your team says. The published durations differ by hospital, not by patient, and how long hip precautions last lines up what the hospitals and OrthoInfo actually publish, with the source beside each one.
OrthoInfo attaches a figure to its own list, which is the nearest thing to a general answer anybody gives. It asks you not to cross your legs at the knees for at least 6 to 8 weeks, and says most people should manage most of the items on its list after 6 to 8 weeks with no effect on the implant. Read that as what one respected source says about its own list, not as a release date for yours.
The second kind carries conditions instead of dates. The NHS leaves its exercise item running while the hip is recovering, and the heavy lifting one until somebody tells you otherwise. Both are open on purpose: the end point is your recovery, not the calendar.
The third kind has no end date, since it is not a restriction with a clock attached.
There is one more reason no page can date any of this for you. Even how much weight the leg may take is individual: OrthoInfo says full weight bearing may be allowed straight away or held back for several weeks, depending on the type of replacement and the surgeon's instructions. When the starting point varies that much, everything downstream of it varies too.
What if you have already done one of them?
Usually nothing has happened, and the first useful move is to stop treating it as a verdict on your recovery. Then sort what you did into the same three kinds.
If it was a position on your own list, a sock reached for or a chair that turned out deeper than it looked, the precautions page walks through what to do in the moment and what to watch.
If it was something from the second kind, a heavy lift, a stumble, a jump off a curb, a sprint for a bus, the thing that matters is the knock or the fall, not the movement. The warning signs below carry a line for exactly that: a hip, groin or thigh that is newly painful, bruised or swollen after a fall or knock, even a small one, needs your surgical team the same day, with the exercises stopped and your weight off that leg on your crutches or your walking frame in the meantime, even if you can still walk and the leg looks normal.
One game or one run, which belongs to the third kind, is not what the long-term advice is about, because that advice is about years of load and not a single afternoon. Raise it at your next review all the same. This page cannot close it for you.
What changes all three is a symptom, not a judgment about how careful you have been. Two of those are worth knowing by heart. A hip that clunks and feels as though it slipped out and went back needs your surgical team today, even when it settles at once and the leg looks normal. A leg that has quietly changed shape or length, or whose foot now points in or out more than it did, is an emergency even when the pain is mild. Warning signs after a hip replacement has the rest of them.
The things people avoid that they do not need to
This section is a list of questions, not a list of permissions. Telling you that something is safe is not this page's job, because that is the one direction that always goes through the people who operated on you.
The big one is doing nothing. People come out of a hip replacement determined not to damage it, and what they get is a stiff hip and a weak leg, which is a problem of its own. NICE, in its guideline on hip, knee and shoulder replacement, asks services to start rehabilitation on the day of the operation where that can be done, and within 24 hours of it otherwise, which tells you how early the thinking starts. It also asks that anyone carrying on alone is given clear goals and a point of contact to use, and that supervised rehabilitation, in a group or one to one as an outpatient, is offered to people who are finding daily activities difficult, who have ongoing problems with particular needs, or who are not reaching their goals on their own. If that last description fits you, the answer is more help, not less activity.
Then the ones patients quietly stop doing and never ask about.
Walking. OrthoInfo's position is that you can walk as much as you like, with the caveat that walking does not stand in for the exercises you were given. Your aid and your distance still come from your physio.
Kneeling. OrthoInfo's own list puts it on the do side instead of the avoid side, on the knee of the operated leg. Ask your team before you treat that as settled, because the floor is also a place you have to get up from. If getting up off the floor is not something you could do today without a hand, treat the floor itself as the restriction rather than the kneeling: do not go down there until you have practiced the way back up with your physio or physical therapist, and not at all while you are in the house on your own. Getting up from the floor is the route to practice, with someone beside you.
Washing and swimming. OrthoInfo asks you to keep the wound clean and dry and to follow your doctor's instructions on how long to wait before showering or bathing, and it says swimming can start once the wound has healed enough, with your doctor the one who says when. The wound sets the timing there, not the activity.
Sex. The two sources used here differ, which is worth knowing before you take either as the rule: the NHS suggests trying to avoid sex for 6 to 8 weeks after the operation, while OrthoInfo asks you to talk to your own doctor and notes that some people are able to resume within several weeks. Ask yours.
The dentist. Avoiding dental treatment is the wrong instinct. OrthoInfo notes that some doctors want patients to take antibiotics before dental work to help prevent infection, so the move is to tell your dentist you have a joint replacement and ask your surgical team what they want done. Never stop or change a prescribed medicine on your own.
And if your recovery has stalled without starting to hurt, that has its own line in the warning signs below. It asks for a review within a week or two, which is the opposite of more rest.
One version of a stalled recovery is faster than that, and it is worth separating from the rest of this page because it gets filed as being out of condition. Getting more and more tired in the days or weeks after the operation, breathless walking to the toilet or getting dressed, dizzy, racing, or paler than usual is not the usual recovery and is a same-day call rather than a review. Blood loss during and after a hip replacement can leave you short of red blood cells, which the Royal Orthopaedic Hospital describes as common around major planned surgery and treatable, and a slow bleed or an infection can look the same from the outside. The full wording is in the warning signs below.
Signs that need help the same day, and the ones that are an emergency
Most of this recovery is uneventful. A few things are not, and they do not wait for your next appointment. The warning signs below are sorted on that basis: the emergency group is a call to emergency services and not to your team, and the same-day group is a call to your surgical team today.
Learn the dislocation pair, because they are the reason the first kind of avoid exists at all. One of them is loud: severe pain that arrives suddenly in the hip or groin, often with a clunk, and a leg that will not move or take weight. The other is quiet, and it is the one people sit on for a day: a leg that looks shorter, or a foot that turns in or out more than it did, with pain that is nothing remarkable. Both are an emergency. Neither is something to test by walking on it or pushing at it.
There is a third mechanical sign below, and it is the one people put down to having overdone it. A pop, a snap or a sudden tearing pain over the side or the back of the hip, or a leg that will not lift out to the side any more or will not hold you up when you stand on it, so the hip drops and you lurch, is a same-day call to your surgical team. Reaching the joint means cutting muscle, tendon or capsule and stitching it back, and a repair that has given way is to be assessed rather than exercised through.
The next two owe nothing to how careful you have been and everything to having had an operation. Sudden breathlessness, chest pain or coughing up blood is an emergency call even with a leg that looks perfectly normal. A calf or thigh that is newly swollen, warm, tender or sore needs advice the same day.
The medicine that lowers your clot risk has a line of its own below, and it belongs on a page about falls. The NHS is direct that bleeding more easily is the trade-off of these medicines, so unusual bleeding or bruising is a same-day conversation about the dose rather than a reason to stop. The part worth knowing in advance is the head: if you bang your head while you are on one of them, that is an emergency department visit even when you feel fine.
Then the slower ones, which belong on this page because they are the ones a careful reader explains away. Pain, redness or swelling in the hip that is not settling or is getting worse. New hip pain with a temperature, at any point in the years ahead. A temperature is not what qualifies it, either: 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. Dizziness on standing or feeling faint with exercise, which carries more weight here because a faint onto a new hip can damage it. And pain that had gone and has come back, month by month. The full wording for each is below.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: sudden severe pain in your hip or groin, sometimes with a clunk or pop, and you cannot move the leg or put weight on it, or the leg suddenly looks shorter or turned in or out. Do not try to walk on it or push it back into place. Keep still and call emergency services or go to an emergency department, and do not drive yourself. Your new hip may have come out of its socket (dislocated), and a medical team needs to put it back.
- Emergency: your operated leg looks shorter than it did, or its foot turns in or out more than before, or the hip moves in an unusual way, even if the pain is not severe. Keep your weight off it and go to an emergency department straight away, and do not drive yourself. If you are in severe pain or cannot move the leg, call emergency services.
- Emergency: you have just fallen and cannot get up, or you think you may have hurt your head, neck, back or hip. Stay where you are, keep warm and call emergency services, or get someone to call for you. If you got up and walked without trouble and only notice pain later, use the same-day lines in this list instead.
- Emergency: you have had a fall or an injury and now have severe hip pain, or you cannot walk or put weight on the leg. Call emergency services or go to an emergency department. This can be a sign of a broken hip (hip fracture).
- Emergency: since your operation, you suddenly become short of breath, you get chest pain or pain in your upper back that may be worse when you breathe in, you cough up blood, your heart is beating very fast, or you faint. Call emergency services straight away, even if your leg looks normal. These can be signs of a blood clot in the lungs (pulmonary embolism).
Get help today
- Same day: after a fall or a knock, even a small one, your hip, groin or thigh is newly painful, bruised or swollen, even if you can still walk and your leg looks normal. Stop the exercises, go back to your crutches or frame and keep your full weight off that leg, and contact your surgical team or get medical advice the same day. A break in the bone around a new hip is not always obvious at first, and walking normally on one can move the broken ends apart.
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- Same day: you are taking tablets or having injections to lower your risk of a blood clot and you notice blood in your urine, black or bloody stools, bleeding gums, a nosebleed that goes on and on, bruising far beyond what the knock would explain, or you are being sick or coughing up blood. Get medical advice the same day, and do not stop the medicine on your own. Bleeding more easily is the known trade-off of these medicines (NHS), and the dose or the type may need looking at. Go to an emergency department if the bleeding will not stop, you feel faint, or you bang your head while you are taking it, even if you feel fine, because the NHS advises getting urgent advice after a head injury on medicine that thins your blood and only a hospital can scan for a bleed inside the head.
- Same day: your wound becomes more red, hot, swollen or painful, starts to leak or ooze, is still leaking in the second week or has never stopped, has pus coming out of it or its edges start to come apart, or you have a high temperature or feel hot, cold or shivery. Contact your surgical team or get medical advice the same day. Redness can be harder to see on brown or black skin. If you feel very unwell, go to an emergency department. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- Same day: in the days or weeks after your operation you are getting more and more tired, breathless doing everyday things such as walking to the toilet or getting dressed, dizzy or lightheaded, your heart is racing, or your skin looks paler than usual. Contact your surgical team or get medical advice the same day. Tiredness and breathlessness that build up like this are not part of the usual recovery. Blood loss during and after a hip replacement can leave you short of red blood cells (anemia), which is treatable, and a slow bleed or an infection can show up the same way. If breathlessness comes on suddenly, or you get chest pain, call emergency services, as the emergency line above explains.
- Same day: dizziness, lightheadedness, blurred vision or feeling faint when you stand up that is new for you, does not pass within a minute or two, keeps happening, or has made you fall. Sit or lie down, and get medical advice the same day. This can be a drop in blood pressure on standing (postural hypotension), a type of low blood pressure, which the NHS lists among the causes of falls, and your doctor can check it. Tell them about your medicines, because some can cause it. If it does not settle within a few minutes of sitting or lying still, call emergency services. If you faint, call emergency services, even if you come round quickly, because the NHS says to call them when someone faints while exercising or is badly hurt, and a faint onto a new hip can dislocate it or break the bone around it.
- Same day: dizziness or feeling faint during or after exercise, other than the brief lightheadedness as you stand up covered in the line above, without any of the emergency signs above. Stop the exercises and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
- Same day: since your operation, the pain, redness, warmth, tenderness or swelling in your hip or leg is not getting better or is getting worse, for example the hip pain keeps building both when you move and when you rest, or you have a new throbbing or cramping pain in your hip or leg. Contact your surgical team or get medical advice the same day, as this can be a sign of infection around the new joint or a blood clot. If you feel very unwell, go to an emergency department.
- Same day: at any time after your operation, even years later, new pain in your new hip along with a high temperature or feeling hot, cold or shivery, or a hip that becomes hot, red or swollen, which counts on its own, with or without pain and with or without a temperature. Contact your surgical team or get medical advice the same day. A new joint can become infected long after the operation, and that needs treating quickly. A normal temperature is not an all clear: OrthoInfo says fever is no longer considered a sign of an infection after a joint replacement, that the signs can be as little as mild redness and swelling and sometimes there are none at all, and that increased pain or stiffness in a joint that had been working well is one of them. So do not wait for a temperature before you report new or increasing pain in your new hip to your surgical team.
- Same day: your hip clunks and feels as if it partly slipped out of place and went back, even if it settles straight away and your leg looks normal. Stop the exercises, avoid the movement that brought it on, go back to your crutches or frame, and keep away from deep bending, crossing your legs and twisting on that leg until you have been seen. Contact your surgical team or get medical advice the same day. If the leg then looks shorter or turned, or you cannot move it or put weight on it, call emergency services.
- Same day: you felt a pop, a snap or a sudden tearing pain over the side or the back of your hip, or your hip will not lift the leg out to the side any more, or it will not hold you up when you stand on that leg, so your hip drops or you lurch to one side. Stop the exercises, go back to your crutches or frame, and contact your surgical team or get medical advice the same day. Muscle and tendon are cut and stitched back during a hip replacement, and a repair that has given way needs assessing rather than exercising. If you cannot put weight on the leg at all, or the leg looks shorter or turned, call emergency services.
Book an appointment
- Within a few days: you have had a fall, even if you were not hurt, or you keep tripping, stumbling or feeling that your legs might give way. Book an appointment with your doctor within a few days and ask about a falls assessment. Tell them about every fall, even the ones where you were not hurt.
- Routine: pain in your new hip that had settled and has come back, or pain that is getting worse month by month, for example in the groin or thigh when you first stand up and start to walk. This is not an emergency, but ask your surgical team for a review, as the parts of a new joint can loosen or wear over the years. Get medical advice the same day instead, not a routine appointment, if the hip also becomes hot, red or swollen, or you have a high temperature or feel hot, cold or shivery, or the pain is building week by week rather than month by month. A new joint can become infected years after the operation, and the two can feel similar at first.
- Routine: your walking or movement has stopped improving over a week or two, you still limp badly, or you cannot manage the exercises your team gave you, but your pain, redness and swelling are not getting worse. This is not an emergency, but ask your physio or surgical team for a review in the next week or two.
Common questions
Can I cross my legs after a hip replacement, and when?
Crossing the legs sits on almost every posterior precaution list, and the date it comes off yours belongs to your surgeon. The two sources used on this page do not even frame it the same way. OrthoInfo asks you not to cross your legs at the knees for at least 6 to 8 weeks, and says most people should manage most of the items on its list after 6 to 8 weeks with no effect on the implant. The NHS recovery page asks you not to sit with your legs crossed and gives no end date for it at all. Neither of those is your date. If nobody has given you one, ask at your follow-up and ask about the actual movement, because crossing at the ankles while you sit and crossing at the knees are not the same thing to a new hip.
What should you never do again after a hip replacement?
Less than most people fear, and very little of it is a never. What exists is advice, and it is strongest about impact. OrthoInfo reports that most surgeons advise against high-impact activity, and on its activities page it puts golf, cycling and doubles tennis or pickleball on the preferable side against singles tennis, jogging, racquetball, basketball and skiing. The reason it gives is wear, not an accident waiting to happen, and the NHS makes the same point from the other end: modern hip replacement joints are designed to last at least 15 years, and they can wear over time and cause pain or swelling. One item that is not a sport belongs here too. The position that takes a new hip toward the edge of its socket, a deep bend with the leg crossing the midline and turning inward, is one plenty of surgeons treat as a lifelong habit rather than a six week rule, because the chance of a dislocation drops a long way after the first year but never reaches zero (Berry and colleagues, 2004). Others let it go completely once the soft tissue has healed. Whether one particular sport, or that position, is off your list for good is a question for the surgeon who did the operation, and surgeons differ on both.
Which exercises should I avoid?
The ones your own team has not cleared, which is a smaller answer than it sounds. Several hip exercises elsewhere on this site are deliberately left out of the program here because they take the joint into a deep bend, across the midline or into a turn, and the program page names them and says why. Past that, the useful test is not the name of an exercise but what it asks the hip to do and how hard the landing is. Anything you find online, including anything on this site, goes past your physio or physical therapist before it goes into your week, because they know which approach was used and what your protocol allows.
Can I kneel again, or sit on a low sofa?
Both get asked constantly and neither has a universal answer. OrthoInfo's list carries kneeling as something to do rather than avoid, on the knee of the operated leg, which surprises people who have spent months keeping off the floor entirely. It takes a firmer line on low soft seating: it asks for a chair that is firm with a higher than average seat, because the low cushioned one is the chair you cannot get out of, and it asks you not to lean forward as you sit down. That is about the mechanics of standing up rather than about damaging anything. Ask your own team before you treat either as settled.
How long do I have to avoid all this?
A different length for each of the three kinds, which is why one number never fits. Your precautions run until your team says otherwise, and the published durations differ by hospital rather than by patient. The second kind carries conditions instead of dates: the NHS leaves its exercise item running while the hip is recovering and its heavy lifting item until you are told you may. The third has no end date at all, because it is advice and not a restriction with a clock on it. Even how much weight the leg may take is set person by person: OrthoInfo says full weight bearing may be allowed straight away or held back for several weeks, depending on the type of replacement and the surgeon's instructions.
References
- NHS. Recovering from a hip replacement. Page last reviewed 6 March 2024. https://www.nhs.uk/tests-and-treatments/hip-replacement/recovering-from-a-hip-replacement/
- NHS. Complications of a hip replacement. Page last reviewed 6 March 2024. https://www.nhs.uk/tests-and-treatments/hip-replacement/complications-of-a-hip-replacement/
- NHS. Sepsis. Page last reviewed 14 May 2026. https://www.nhs.uk/conditions/sepsis/
- NHS. Anticoagulant medicines. Page last reviewed 9 September 2024. https://www.nhs.uk/conditions/anticoagulant-medicines/
- NHS. Falls. https://www.nhs.uk/conditions/falls/
- NHS. Low blood pressure (hypotension). Page last reviewed 11 July 2023. https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
- NHS. Fainting. https://www.nhs.uk/symptoms/fainting/
- American Academy of Orthopaedic Surgeons. Total hip replacement. OrthoInfo. https://www.orthoinfo.org/en/treatment/total-hip-replacement/
- American Academy of Orthopaedic Surgeons. Activities after total hip replacement. OrthoInfo. https://www.orthoinfo.org/en/recovery/activities-after-hip-replacement/
- American Academy of Orthopaedic Surgeons. Infection after joint replacement. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/joint-replacement-infection/
- National Institute for Health and Care Excellence. Joint replacement (primary): hip, knee and shoulder. NICE guideline NG157. Published 4 June 2020. https://www.nice.org.uk/guidance/ng157
- NHS. Deep vein thrombosis (DVT). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
- NHS. Pulmonary embolism. Page last reviewed 25 May 2023. https://www.nhs.uk/conditions/pulmonary-embolism/
- NHS. Head injury and concussion. Page last reviewed 29 May 2025. https://www.nhs.uk/conditions/head-injury-and-concussion/
- NHS. Iron deficiency anaemia. Page last reviewed 26 January 2024. https://www.nhs.uk/conditions/iron-deficiency-anaemia/
- Royal Orthopaedic Hospital NHS Foundation Trust. Orthopaedic surgery and anaemia. Published 5 March 2024. https://roh.nhs.uk/news-events/orthopaedic-surgery-and-anaemia
- The Newcastle upon Tyne Hospitals NHS Foundation Trust. Total hip replacement. Patient information. https://www.newcastle-hospitals.nhs.uk/resources/total-hip-replacement/
- Berry DJ, von Knoch M, Schleck CD, Harmsen WS. The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty. Journal of Bone and Joint Surgery (American). 2004;86(1):9-14. https://doi.org/10.2106/00004623-200401000-00003
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.