Which movements should you avoid after a hip replacement?

Why are movement precautions given?

After a hip replacement, the ball of the new joint sits in a socket, and the soft tissues around the hip need time to heal and tighten. In the early weeks, certain positions can push the ball out of the socket, causing a dislocation. The risk is highest in the first months after surgery.

Precautions aim to avoid those positions while healing takes place. However, they can also slow return to normal activities, increase dependence on equipment and cause anxiety.

What are the traditional precautions?

For operations performed through the back of the hip, called the posterior approach, traditional precautions include not bending the hip beyond 90 degrees, not crossing the legs or ankles, and not turning the operated leg inwards 1. Practically, this means avoiding low chairs and toilets, not bending down to put on socks and not twisting while standing.

For operations through the front of the hip, the anterior approach, the risky positions are different and may include stepping backwards with the leg turned outwards. Some surgeons give few or no restrictions after this approach.

What does the evidence say?

A Cochrane review found very low-quality evidence from single trials, so it is uncertain whether hip precautions, with or without equipment and functional restrictions, prevent dislocation or improve outcomes after hip replacement 1. Some surgical teams now give fewer restrictions, but the evidence is not strong enough to recommend a single approach for everyone.

UK guidance on joint replacement supports providing clear information and rehabilitation tailored to the person 2. Your surgeon considers the approach used, the implant, the stability of the hip during surgery and your individual risk factors.

What practical tips help in the early weeks?

Using a raised toilet seat and a firm chair with arms, getting into bed from the operated side if advised, using a long-handled reacher, sock aid and shoe horn, and turning by taking small steps rather than twisting on the spot reduce strain on the hip.

Getting into a car by sitting sideways on the seat first, then swinging both legs in together, is often recommended. A pillow between the knees can help when lying on the side, if side-lying is allowed.

When can restrictions be relaxed?

Many restrictions are relaxed around six weeks after surgery or after the first follow-up appointment, depending on the surgeon's advice. Some people continue to avoid extreme positions, such as deep squatting with the leg turned inwards, for longer.

Returning to activities such as gardening, sports or sexual activity is guided by the surgical team. Gradually reintroducing movements with good control helps build confidence.

What are the signs of a dislocated hip?

Sudden severe pain in the hip or groin, inability to put weight on the leg, the leg looking shorter or turned in or out, or a clunk followed by pain may indicate dislocation. This needs urgent medical attention.

Do not try to move the hip back into place. Keep still and seek emergency care.

How does exercise protect the new hip?

Strong hip and thigh muscles help stabilise the joint. Exercises such as gentle hip abduction, bridging, sit-to-stand and walking practice, prescribed by a physiotherapist, improve control and reduce the risk of falls, which are a common cause of dislocation.

Balance training and a safe home environment, with clutter removed and good lighting, reduce fall risk during recovery.

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