Part of Total hip replacement rehab
How long do you use a walker after a hip replacement, and when can you walk without a stick?
Warning signs, and when to get help
How long do you use a walker after a hip replacement?
For as long as it takes to be safe without it, and the honest version of that answer is that nobody can hand you the date in advance.
Set the published figures side by side and notice how little they agree. The NHS recovery page says crutches or a walking frame will be needed at first, and then says nothing more about how long, which is a gap and not an oversight. Cambridge University Hospitals is more specific and more cautious at the same time: some people who left hospital on two crutches are down to one at around two weeks, most of its patients can walk without aids by twelve weeks, and the leaflet states plainly that no set timetable exists. It adds the part the week-by-week charts leave out: someone who already used a frame before the operation may take longer, and some people keep an aid permanently for reasons that have nothing to do with the new hip.
One instruction overrides all of that. If your surgeon or therapist told you how much weight to put through the operated leg, and OrthoInfo's exercise guide describes that as a normal part of being set up to walk, then that instruction decides what you hold on to and when it changes. Ask them what yours is, and ask when it is due to change, rather than working it out from a page. Nothing here is a reason to give up an aid your team asked you to keep using. A limit on weight is its own instruction and not part of a precaution list, it is set by what was done to the bone rather than by how the hip feels, and the day your precautions end is not automatically the day it ends. Hip replacement exercises in weeks 0 to 6 works that difference through. If you were given a limit and nobody has told you it has been lifted, it still applies to every step you take, which settles the question this page asks before any of the markers below come into it.
The surgical approach belongs in the same sentence. How the hip was reached, from the back, the front or the side, shapes the restrictions you were given and can shape how long the aid is required, and hip precautions, what they are and how long they last is where that is worked through.
One route matters more on this page than the others. To reach the hip from the side, the front part of the muscles on the side of the hip is lifted off the bone at the top of the thigh and stitched back through bone at the end of the operation, which a published surgical account of that closure describes (Agarwala and Jagani, 2018). Those are the same muscles that keep your pelvis level at every step, so if that was your approach, the thing in your hand is doing a second job besides keeping you upright. Measured in 24 people walking on a hip replacement, a stick held in the hand opposite the operated hip reduced the electrical activity in those muscles by about 31 percent, and by about 42 percent when they pushed down hard through it (Neumann, 1998). That is work a healing repair does not have to produce while the stick is still there, and taking it away hands the work straight back. Nobody has published a date for when an abductor repair may be fully loaded, which is the honest reason this particular step belongs to the team who did your operation and not to a page. Ask them which approach they used, and ask whether that changes when the aid comes away.
A word about the words, because the same object answers to different names depending on where you are reading this. The four-legged or wheeled thing you lean on and push along is called a walker in the United States and Canada. In the UK, Australia and New Zealand it is a walking frame, and British speech still reaches for Zimmer frame. The single item with one handle is a cane to a North American reader and a walking stick to everybody else.
Crutches are crutches in all five markets, and what a US reader buys as a forearm crutch is sold as an elbow crutch in the UK and Australasia. The person who teaches you to use any of it is a physical therapist, or PT, in the United States and Canada and a physiotherapist, or physio, in the UK, Australia and New Zealand. Use whichever words your own team used, since those are the ones that will come back at your follow-up.
The usual order: frame or walker, then crutches, then one stick or cane
The route is downhill in steps, and each step hands a little more of your body weight back to the leg.
What you start on gets settled on the ward, not in advance. The NHS names crutches or a walking frame for the early days, and which of the two you get depends on how steady you are, what your arms can do and what your home is like inside. NICE's joint replacement guideline expects the walking part to start almost immediately: a physiotherapist or occupational therapist should offer rehabilitation on the day of the operation where that is possible, and within a day of it otherwise. So you will be upright and moving with something in your hands long before any of the questions on this page become live.
From there the sequence is two crutches to one, then one crutch to a stick or cane, then nothing. Cambridge University Hospitals puts the first of those changes at around two weeks for some people and the last at around twelve for most, with the caveat about there being no timetable attached to both ends of it. When a stage gets skipped or repeated, the reason is usually geography and not healing. People put the aid down indoors weeks before they put it down outside, which is the opposite of what most of them expect. The stick that feels unnecessary in a carpeted hallway earns its place again on a slope, in a crowd or on a dark driveway.
Stairs hold on to their support longest of all, and that is about safety rather than comfort. OrthoInfo calls stairs a particular hazard until the hip is strong and mobile, and asks you to use a cane, crutches, a walker or handrails, or to have someone help you, until your balance, flexibility and strength have improved. Its exercise guide adds a limit most people never hear: do not try to climb steps higher than the standard height, which it gives as 7 inches, and use a handrail every time. The foot order itself is on total hip replacement rehab, and the practical side of it, in the car and the bathroom as much as on the stairs, is on stairs, car transfers and the toilet.
Check the equipment as well as the plan. A stick or frame that came down from an attic or across from a relative was almost certainly fitted to a different body, and the rubber foot on the bottom wears smooth and begins to slip. If the thing is a fight to use, say so. Nobody expects you to soldier on with equipment that does not fit you. Crutches are hard work for the hands and wrists, and harder still for the shoulders, a frame is no help on a staircase, and trading one for the other is an ordinary request to make.
How do you know you are ready to walk without a stick?
Several services have published a marker for this, and not one of them is a week number. OrthoInfo's exercise guide is the most specific: a single crutch or cane becomes reasonable once walking and standing for more than 10 minutes is within your range, and once the operated leg is strong enough that your hands have stopped taking a share of the load through the frame or crutches. That second half is the part people skip. An aid you are leaning on is doing work, and the question is whether it is still needed, not whether you can get round the kitchen while gripping it.
Gateshead Health and Newcastle Hospitals both put the same step down to one crutch behind the same test, and it is the limp. Gateshead asks you to feel confident on your elbow crutches and to be walking without a limp first. Newcastle asks you to wean off the crutches as soon as you feel steadier on your feet, as long as doing so does not make you limp, and names the opposite hand for the one that stays. Cambridge University Hospitals is the only one of the hospital leaflets that takes on the last step, from one aid to none, and it says you can stop using walking aids altogether as soon as you feel able, with the reason attached: the crutches were there to lean on and take pressure off the new hip, and the aim is to be balancing on your own muscles as soon as you can be. OrthoInfo speaks to that last step too, and it names a gate rather than a feeling: walk with a cane until you have regained your balance skills. Note what none of them does. Not one sets a week number for going aid free, and the step most of them describe is the step down to one aid rather than to nothing.
The list below is what we look at in clinic when somebody asks. Practice experience, not a validated test, and your own team's instruction sits above all of it.
Three things stop the list before you start it, and they are worth meeting here rather than further down the page. If you were told to keep some weight off that leg and nobody has told you the limit has been lifted, none of this applies yet. If you have fallen in the past year, or you feel unsteady on your feet, the aid stays in your hand until somebody has watched you walk without it. And OrthoInfo's own instruction for the last aid is a condition and not a date: walk with a cane until you have regained your balance skills. Balance is the thing a flat hallway does not test, which is why the list below spends so much of its time on slopes, poor light and a full hand.
- The aid is in your hand but not under your weight for a decent spell of walking and standing.
- Put it down for a dozen steps indoors, along a kitchen counter or a hallway wall you could grab, with the stick still in your hand but off the floor. Not outdoors and not on the stairs, and not the first time while you are in the house on your own. Does the limp come straight back, or does it stay away.
- Is the other side taking over. A sound hip or knee that aches the evening after your walks is telling you where the load went.
- Uneven ground. A slope. Poor light. The hallway is the easy one.
- One hand full. Groceries, a mug, a phone. That is what really retires a walking stick.
- The morning after. A longer walk should leave the hip no sorer tomorrow than it was yesterday.
Read them together, not as a menu you pick from. Then take them to your physiotherapist or surgical team, because somebody has to see you move and a web page never will. NICE's guideline is useful here in a way most people never hear about: anyone getting on with rehabilitation by themselves is meant to have been given clear goals and a point of contact for advice, so there should be somebody to ask rather than a guess to make.
The exercises underneath all of this are the ones that teach the leg to accept weight again, which is why side to side weight shift sits at the front of the list, with standing with feet together and semi tandem stance for the balance the aid has been standing in for, and brisk walking once distance rather than safety is the question. The strength work after the six week mark is on hip replacement exercises after 6 weeks.
Why stopping too early is the risk, not stopping too late
Because the price of getting it wrong is wildly different in the two directions, and that is worth looking at squarely.
Hang on to a stick for a fortnight you did not strictly need and you have paid in nuisance and a little pride. Let go of it a fortnight early and what you are risking is a fall onto a hip that is weeks old. OrthoInfo is direct about where that leads: a fall in the first few weeks after surgery can damage the new hip and may result in a need for more surgery. That is why the emergency lines on this page read the way they do. A hip that comes out of its socket, or a bone that cracks around the implant, is not something to sleep on.
If you are an older adult, if you went over at any point in the last twelve months, or if you simply do not trust your feet, then this is a falls question wearing a hip replacement's clothes. Get that work started while the aid is still in your hand, not once it has gone. Balance and falls prevention is the program for it, with strength for older adults underneath. If you have fallen recently or feel unsteady, do the standing exercises next to a kitchen counter.
If you live alone, that rule still stands, so plan around it rather than ignoring it. Try the first walk without the aid at your physio appointments or in a class instead, keep the aid in your hand when you are on your own, and ask your physio which walking you may do without it. Keep your phone in a pocket rather than in another room, so you can reach it from the floor, and ask about an alarm you wear. If you do fall 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. Do not let anyone haul you up first.
None of which makes an aid something to keep forever and never query. Lean on a stick you have outgrown and the lopsided pattern that goes with it sets as a habit, which is harder to undo later than plain weakness. The target is to let it go when you can do that safely, not to drift off it without noticing. The NHS puts the follow-up appointment at around 6 to 12 weeks after surgery, and that is the right room in which to ask.
Which hand, and how high: getting the stick or cane right
Side and height decide whether a stick helps you or annoys you, and most people arrive with at least one of them wrong.
Side first. It belongs in the hand on your non-operated side, which is what OrthoInfo's exercise guide specifies. Put it on the same side and you have given the new hip more to do, not less. That is why it feels like hard work, and why people decide the stick is useless and abandon it. Height second. Stand up straight, let the arm hang loose, and the top of the handle wants to sit at about the level of the crease in your wrist. Too low and you lean and stoop; too high and your shoulder does the work.
The stepping pattern, and the business of setting the stick down firmly instead of carrying it along in the air, is set out on walking with a cane, and the parent program covers the same ground in its own set-up notes.
Which hand the groceries go in is part of the same question, and it is the opposite answer to the stick. The same researcher tested 24 people with a hip replacement carrying loads of 5 to 15 percent of their body weight while using a stick, and the least demanding combination for the muscles on the side of the hip was the load in the hand on the operated side with the stick in the other hand, which came out about 40 percent below walking with neither (Neumann, 1999). The paper's own advice to anyone at risk of their implant loosening is to avoid carrying loads at all where that is possible, which is the better answer in the early weeks: make two trips, or use a backpack, rather than solving it with a grip.
If you have had the other hip or a knee replaced as well, the side question gets complicated and is worth asking rather than guessing. The knee version of this page, how long you use a walker after a knee replacement, covers that operation's own sequence.
Why you are still limping, and what to take to your physio
A limp that hangs around after the aid has gone worries people more than almost anything else in this recovery, and it is usually not what they fear it is.
Most of it comes down to strength and old habit. The muscles on the side of the hip take longer to catch up than comfort does, so the leg feels fine standing still and gives way to a dip when it has to hold you up through a stride. And a limp you carried for the years before the operation is a motor habit, not just a weak muscle, so it does not disband on its own when the joint underneath it is replaced. Both respond to loaded, specific work. Time on its own does very little for either.
There is one version of this that is not a muscle lagging behind, and it is worth being able to tell apart from the rest, because it is the reason a line in the warnings on this page exists. A limp that has been there since the operation and is slowly fading is the ordinary kind. A lurch that arrives suddenly in a hip that had been walking better, especially with a pop, a snap or a tearing pain over the side of the hip, and most of all if the hip now drops or will not lift the leg out to the side at all, is a different event. Muscle and tendon were cut and stitched back when the hip was replaced, and a repair that has pulled off the bone, or a crack through the bone it was stitched to, presents exactly like that in somebody who can often still walk about. Still walking on it is not reassurance in this one case. It is a same-day call to your surgical team, and the aid goes back in your hand while you wait.
What to raise, instead of training through it: a limp that has stopped changing from month to month, a limp or a lurch that is getting worse rather than standing still, or new pain as you put weight through the leg. Both appear in the warning signs on this page at the urgency each one calls for, and both are reasons to pick the aid back up while you wait to be seen. NICE's guideline is on your side if you need a push to ask: supervised rehabilitation, in a group or one to one, is meant to be offered to people who are struggling with daily activities, who have an ongoing problem with a specific rehabilitation need, or who are not reaching their goals working alone. Not meeting your goals is a reason to be seen, not a reason to try harder in silence.
Worth taking to that appointment: how far you can walk before the limp arrives, which surfaces defeat you, what hurts the next morning, and what the other leg is complaining about. If the hip itself is the thing that hurts as you walk, hip pain when walking works through the causes.
Will I walk normally again?
Probably, and later than you will put the aid down, because those are two different milestones and they get merged into one.
Being safe without a stick means you will not fall over. Walking the way you used to means the leg can do a full day's work without complaint, and weeks or months often separate the two. The NHS puts recovery from a hip replacement at several months, and the figures from the hospital leaflets run further out than that again.
How long that second one takes is a different question, and it has its own page. Window by window, with every figure sitting next to the service that published it, it is all on the hip replacement recovery timeline. The walking aid is where this page ends.
Before the operation: what to borrow or buy
If you are reading this with the operation still ahead of you, you are in the better half of the audience, because this is far easier to arrange now than in week one.
Ask one question at your pre-operative appointment: which aid do you expect me to go home with. The answer tells you what to have waiting by the front door, what to practice on, and whether you need to think about a second set for upstairs. How aids are supplied differs by country and by service, and sometimes between one hospital and the next, so ask who provides yours instead of assuming, and ask whether anything has to go back and when. Some services hire it to you, some lend it, and some expect you to buy your own, depending on where you live.
Use it before you need it. A few laps of the hallway on crutches or a frame while you are still comfortable and unmedicated is worth more than any amount of reading, and it shows up the doorway that is too narrow or the rug that has to go. Equipment for sitting, including the item sold as a raised toilet seat in the UK, Australia and New Zealand and as an elevated or raised toilet seat in North America, belongs with stairs, car transfers and the toilet.
When to go back to using it, and when to get help
Going back to an aid is not a relapse. It is the whole point of having one, and erring in that direction costs you nothing at all.
Pick it up again, and keep your full weight off that leg, after any fall or knock, however minor it seemed, and have the hip looked at the same day even if you can still walk on it and nothing looks wrong. A break in the bone around a new hip does not always announce itself. Severe pain, a leg that will not take your weight, or a leg that looks shorter or turned needs an emergency department rather than a phone call, and somebody else does the driving. If you cannot get up, call emergency services.
Back to the crutches or the frame, with same-day advice, if the hip clunks and feels as though it briefly slipped and went back in, even where it settles immediately. Being on tablets or injections to lower your clot risk adds a second worry to any fall, and a bang on the head while you are taking one of them needs urgent advice even when you feel perfectly fine. Never stop or change a prescribed medicine on your own.
Same-day advice is what these need: a calf that becomes newly swollen, warm or tender; new numbness or tingling in the leg or foot; a foot that drags, catches on the ground or slaps down when you walk; a hip or a wound growing hotter, redder or more painful. If your walking has simply stopped improving over a week or two, ask for a review instead. Every one of them appears in the warning signs on this page with its own level of urgency.
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.
- Same day: a leg or foot that is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop). Get medical advice the same day. If the weakness is getting worse by the hour, go to an emergency department.
- Same day: new numbness, tingling or burning in your operated leg or foot, beyond the numb patch of skin around your scar. Contact your surgical team or get medical advice the same day. If it started after a fall or an injury, or your foot or toes turn cold, pale, blue or gray, call emergency services or go to an emergency department straight away, and do not drive yourself.
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: since the operation your leg has felt a little longer or shorter than the other one, with no sudden change and no new pain. This is not unusual after a hip replacement. Mention it to your physio or at your follow-up appointment, as some people are more comfortable with a shoe raise.
- 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
How long do you use a walker after a hip replacement?
There is no national timeframe for it, and the published figures are not consistent with each other. The NHS says crutches or a walking frame will be needed at first and stops there, with no duration attached. Cambridge University Hospitals describes a drop from two crutches to one at around two weeks for some people and most patients walking without aids by twelve weeks, while saying in the same leaflet that no set timetable exists and that someone who used a frame before the operation may progress more slowly or keep an aid permanently for reasons unrelated to the new hip. Your own team's instruction, including anything they said about weight through the leg, outranks every figure in that paragraph.
How long do you use a stick or cane after a hip replacement?
It usually outlasts the frame and the crutches by a long way, and outdoors it tends to be the last thing surrendered. Cambridge University Hospitals puts most of its patients walking without aids by the twelve week mark and says there is no fixed schedule behind that. What settles it in clinic is whether the stick is still doing a job. Plenty of people are safe without one along a carpeted hallway and nowhere near safe without one on a rainy high street, and keeping it for the second while dropping it for the first is a sensible division rather than a sign of slow progress.
How do I know when I am ready to put the stick down?
Several services publish a marker, and every one of them is about what your walking and your balance look like rather than about dates. OrthoInfo's exercise guide puts the step down to one crutch or cane at more than 10 minutes of walking and standing, with the leg strong enough that your hands are not taking a share of the load. Gateshead Health and Newcastle Hospitals both tie that same step to walking without a limp, Gateshead adding that you should feel confident on the crutches first and Newcastle that you should wean off them as soon as you feel steadier, as long as it does not make you limp. Cambridge University Hospitals covers the last step, from one aid to none, and puts it at as soon as you feel able, with most of its patients walking without aids by twelve weeks. OrthoInfo attaches a condition to that step rather than a date: walk with a cane until you have regained your balance skills. Beyond that, what a physiotherapist looks at is whether the limp reappears the moment the aid leaves your hand, whether the other hip or knee is quietly doing extra work, and whether you are steady on a slope, on uneven ground and in poor light rather than only on a flat hallway. None of that is a self-discharge. Take the list to your physio or surgical team and let them watch you walk.
Which hand does the walking stick go in?
The hand on the opposite side to the operated hip, which is what OrthoInfo's exercise guide specifies and what most people have back to front when they first come in. A stick on the same side as the new hip loads that hip instead of relieving it, which is why it feels like more effort rather than less. Height matters as much as side: stand up straight with the arm hanging loose, and the top of the handle belongs at about the level of your wrist crease. The stepping pattern is on our walking with a cane page.
Why am I still limping without it?
Almost always strength and old habit, rather than anything having gone wrong inside the hip. The muscles on the side of the hip lag behind comfort, so the leg feels fine standing still and dips when it has to hold you up mid stride. On top of that, a way of walking you had for years before the operation does not reorganize itself just because the joint underneath it was replaced. What does need raising is a limp that is no longer changing from month to month, or new pain as you put weight through the leg, both of which are in the warning signs on this page. One version is not weakness at all and is on those warnings as a same-day call: a lurch that arrives suddenly in a hip that had been walking better, with a pop, a snap or a tearing pain over the side of the hip, or a hip that now drops or will not lift the leg out to the side, which can mean a repair made during the operation has given way. Being able to walk on it does not rule that out.
Do I need a walker at all after a hip replacement?
Yes, in the sense that you will leave hospital holding something, and the decision about what belongs to the staff who see your first attempts rather than to you in advance. Crutches or a walking frame are what the NHS names for those early days, and a frame rather than crutches is a choice made on balance, arm strength, confidence and the shape of the house you are going back to. Starting there says nothing about how your recovery will go. Ask at your pre-operative appointment what they expect to send you home with, so that the right thing is standing by the front door on the day.
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. 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/
- 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/
- American Academy of Orthopaedic Surgeons. Total hip replacement. OrthoInfo. https://www.orthoinfo.org/en/treatment/total-hip-replacement/
- American Academy of Orthopaedic Surgeons. Total hip replacement exercise guide. OrthoInfo. https://www.orthoinfo.org/en/recovery/total-hip-replacement-exercise-guide/
- Cambridge University Hospitals NHS Foundation Trust. Hip replacement, total: advice and exercises following. Patient information. https://www.cuh.nhs.uk/patient-information/hip-replacement-total-advice-and-exercises-following/
- Gateshead Health NHS Foundation Trust. Physiotherapy following hip replacement surgery. Patient information. https://www.gatesheadhealth.nhs.uk/resources/physiotherapy-following-hip-replacement-surgery/
- The Newcastle upon Tyne Hospitals NHS Foundation Trust. Total hip replacement. Patient information. https://www.newcastle-hospitals.nhs.uk/resources/total-hip-replacement/
- Agarwala S, Jagani N. Osteotendinous suturing for anchorage of hip abductor mechanism in total hip arthroplasty through a lateral approach: a technical note. Journal of Orthopaedic Case Reports. 2018;8(2):26-29. https://pubmed.ncbi.nlm.nih.gov/30167407/
- Neumann DA. Hip abductor muscle activity as subjects with hip prostheses walk with different methods of using a cane. Physical Therapy. 1998;78(5):490-501. https://pubmed.ncbi.nlm.nih.gov/9597063/
- Neumann DA. An electromyographic study of the hip abductor muscles as subjects with a hip prosthesis walked with different methods of using a cane and carrying a load. Physical Therapy. 1999;79(12):1163-1173. https://pubmed.ncbi.nlm.nih.gov/10630285/
- 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
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.