When Can You Put Full Weight on Leg After Hip Replacement & Avoiding Activities Post-Surgery

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As an orthopedic physical therapist with over four decades of experience, I understand that the journey to recovery after a total hip replacement can be filled with questions.

One of the most pressing concerns for patients is understanding when they can safely put full weight on their leg and the importance of avoiding certain activities during the healing process.

This article aims to provide clear guidelines and expert insights to help you navigate the post-surgery period, promoting optimal healing and a return to your daily life with confidence.

Timeline for Full Weight Bearing After Hip Replacement

After undergoing a hip replacement, one of the most common questions patients have is, “When can I put full weight on my leg?” You will be eager to return to normal activities, but it’s crucial to understand the timeline for safely putting weight on your new hip.

Typically, weight-bearing can start immediately after surgery with precautions, often using assistive devices like walkers or crutches. Over time, you can gradually increase the weight you put on your operated leg.

You should adhere to the guidance provided by your surgical team and physical therapist, who will tailor the advice to your specific situation.

All of my total hip referring physicians allow full weight bearing on the new prostheses as soon as the patient feels confident.
The primary reason my patients initially use a walker is for balance and confidence.

Typically, what I read online says something like: “Within the first few weeks, you’ll likely use a walker or crutches to help support your weight. This aids in reducing the stress on your hip joint as it heals. By approximately six weeks after hip replacement, you could be in a position to put full weight on the leg, but this varies among individuals based on factors like overall health, the quality of your bone, and the type of hip replacement performed.”

That is not my experience at all!
Forty years ago, my total hip patients were weight-bearing restricted because the “cement” needed to cure or the prosthesis needed time for bone to grow into it for stabilization.

Today, my experience is that if “cement” is even used, it is 95% cured before the patient even wakes from the anesthesia.

My total hip post-surgery protocol of encouraging the patient to fully weight bare and abandon the walker is in concert with the peer-reviewed scientific research paper published in the National Library of Medicine.

And I never transition from a walker to a cane.
A cane reinforces the habitual limping the patient developed prior to surgery in an attempt to decrease the pain.
Read my article:
Walking After A Total Hip Replacement: (When and How Much?)

It’s imperative to avoid high-impact activities after total hip replacement surgery that could stress the joint, potentially delaying healing. Importantly, you should listen to your body and the advice of your healthcare professionals to ensure a safe recovery after hip replacement.

My advice is always, “When your hip first begins to give you increased pain signals, STOP THE ACTIVITY!
If the pain increase lasts more than five minutes after stopping the activity, then that activity is too much.
It does not mean don’t do the activity; it means decrease the duration of the activity.

Remember, patience and adherence to recommended protocols will be the keys to your success.
Read my article: Ice After Total Hip Replacement: A PT’s Complete Guide

Walking Stick Rear view cropped and watermarked 1
A walking stick, unlike a cane, does not reinforce
the bad habit of leaning toward the previously painful side
and helps break the habit of limping.
Read my article:
How Long After Hip Replacement Can You Walk Without a Limp?

When Can You Put Full Weight on Leg After Hip

As an orthopedic physical therapist with extensive experience, I understand how eagerly patients await the moment when they can safely put full weight on their leg after hip replacement surgery.

Typically, you can begin weight-bearing as tolerated immediately following the operation, but this can vary based on the surgical approach and your individual circumstances.

Gradually, you should notice improvements as you transition from partial to full weight-bearing. To optimize recovery after hip replacement, you should adhere strictly to your rehabilitation plan. It’s essential to note that every hip replacement journey is unique, and therefore, when you can place your full weight on the leg is dependent on your body’s healing process and the guidance of your healthcare team.

It’s equally important to recognize which activities you should avoid to prevent complications. For instance, high-impact activities that can stress your new joint are not advisable. As you recover, you can slowly reincorporate various movements under professional supervision.

After hip surgery, keep in mind that your leg will need time to regain strength.

You did not lose strength the day after total hip surgery because of muscle loss; you lost strength because of the brain not allowing you to recruit the muscle fibers in fear of causing additional damage to the hip.
The brain must be retrained to allow full recruitment of the muscle fibers before full strength will return.

To ensure successful outcomes, you can’t rush the process.
My biggest problem patients are Type A personalities who think if I recommend 6, 12 is better.
In my experience, about 50% of these patients who do not listen will set themselves back in recovery by a week to ten days because they caused a flare-up of inflammation and pain.

By following post-operative instructions diligently and attending physical therapy, you can work towards a safe return to normal function. Your commitment and patience pay off significantly in the long run as you aim for the longevity and durability of your hip replacement.

Assessing Your Progress After Hip Surgery

After hip replacement surgery, assessing your progress is crucial to a successful recovery. As you embark on your rehabilitation journey, it’s essential to understand that each step along the way is an integral part of regaining your full mobility.

Typically, after surgery, your medical team will closely monitor your rehabilitation progress. It can vary from person to person, depending on factors such as your overall health and the surgical approach used.
It’s important to adhere to the guidelines provided by your surgeon to avoid complications.

Range of Motion (ROM) restriction guidelines are different between the anterior and posterior approaches to total hip replacement surgery:
Read my article: Total Hip Precautions: Anterior, Posterior & Lateral Approaches

A gradual increase in activity is key. If you attempt too much too soon, you risk setting back your recovery. In the initial weeks after hip surgery, you will likely use walking aids such as crutches or a walker, and your physical therapist will guide you through exercises tailored to enhance your hip’s strength and flexibility.

If you’re wondering if you can start weight-bearing activities, it’s important to follow your surgeon’s instructions, but without special circumstances preventing immediate full weight-bearing, my expectations would be they allow full weight-bearing as soon as tolerated.

Surgeons are in the best position to give specific recommendations based on how well your hip is healing. After hip replacement, avoiding activities that exert excessive stress on your new joint, at least until you’ve been cleared to do so, is important for your long-term joint health.

Always remember, the goal after surgery is not only to return to daily activities but to do so safely and effectively, ensuring a smoother recovery and a better quality of life post-surgery.

Initial Steps to Take After Hip Replacement Surgery

After undergoing a hip replacement, it’s crucial to understand the initial steps that should be taken to ensure a successful recovery. Once your surgery is complete, the journey to full weight-bearing starts with a focus on healing and gradually increasing mobility. After surgery, you should be particularly cautious to avoid certain activities that might jeopardize your new hip.

Rarely, after hip replacement, placing full weight on your leg may not be advised.
In my experience, weight-bearing restrictions are because of some complication factors or conditions.

Your surgical team, which includes your orthopedic physical therapist, will guide you through the appropriate steps after hip replacement to manage pain and swelling, and protect the hip joint.

After hip replacement, using assistive devices like walkers or crutches will help maintain stability while your hip heals.
For my patients, the use of ambulatory assistive devices is about balance and fall risk, not about weight-bearing on the new prosthesis.

You’ll need to take directives from your healthcare professionals, understanding that these guidelines are established to promote optimal healing.
Remember, each step after surgery is as critical as the procedure itself, and following the plan you’ve received after hip replacement will lead to the best outcomes for your mobility and quality of life.

How to Safely Increase Weight on Your Leg After Hip Replacement

After hip replacement surgery, if you have been instructed to do partial weight-bearing on the new total hip, understanding how to safely increase weight on your leg is crucial for a successful recovery.

Initially, your physical therapist, at the direction of your doctor, will guide you on when you can begin to place weight on your leg after surgery. It’s essential to follow this timeline meticulously to prevent injury to your new hip. 

During the early phase of recovery, while weight-bearing restricted, you’ll work gradually to increase weight on your leg, using assistive devices like crutches or a walker. As you progress, you’ll perform specific exercises tailored to boost the strength and flexibility of your leg, facilitating an increase in weight-bearing capacity.

Don’t rush the process; you can’t hasten your healing. Your hip needs time to integrate with the prosthesis properly during this specialized partial weight-bearing restriction. Your physical therapist can have you start putting full weight on your leg after a surgeon-given go-ahead, however, it varies from patient to patient depending on the reason for the partial weight-bearing restriction.

It’s essential to assess your progress regularly after surgery under the guidance of a healthcare professional. They’ll advise how to continue increasing weight through prescribed exercises and activities.

The Dos and Don’ts to Protect Your New Hip Post-Surgery

After undergoing hip replacement, it’s crucial to know the dos and don’ts to protect your new hip.

The journey to recovery post-surgery usually allows for full weight bearing after hip replacement as soon as tolerated by the patient.

Following hip replacement, your physical therapist will provide a tailored plan for progressing your rehabilitation after hip surgery that has been approved by your surgeon.
This approved program will also include any weight-bearing restrictions, if any.

Adhere to these guidelines to protect your new hip post-surgery. Engage in activities approved by your surgeon and stick to recommended exercises that help strengthen the muscles surrounding your new hip, ensuring lasting stability.

Don’t rush the recovery process or ignore your healthcare provider’s orders, patience is essential. After hip replacement, activities involving high-impact or twisting motions should be avoided to prevent complications.

Do pay attention to body signals. If you experience pain or discomfort while increasing weight-bearing on your leg after hip replacement or performing the exercises, communicate with your healthcare providers. The dos and don’ts after surgery serve as a map for navigating through the recovery period. Adhering to these parameters will aid in protecting your new hip from undue stress, leading to a successful outcome post-surgery.

Recovery at Home: Guidelines After Hip Replacement

As you venture into the recovery phase at home after your hip replacement, it’s crucial that you adhere to the essential guidelines after hip replacement to foster healing and prevent complications.

The question you’re likely pondering is: “When can you put full weight on your leg after hip surgery?” Typically, you’ll be allowed to fully weight-bearing as soon as you feel comfortable doing so.
Ambulatory assistive devices are much more about balance and confidence than concerns about weight-bearing.

Initially, you should utilize assistive devices to avoid falling and build confidence in your new hip.

During the first few weeks of recovery at home, it’s imperative that you follow the specific guidelines given by your surgical team. These will include exercises to promote mobility and guidance on how to safely transition to full weight-bearing on your leg after hip replacement

Although eagerness to resume normal activities is understandable, remember that you should avoid high-impact activities immediately after surgery to protect the integrity of your new hip. It’s critical that you consult with your physical therapist or surgeon before venturing beyond the advised activity level after hip replacement.

While you should enjoy a vastly improved quality of life post-surgery, care and patience are paramount. Adhering to these guidelines after hip replacement will ensure that you provide your body with the best circumstances for a successful outcome. You are encouraged to remain vigilant about your activities, especially in the initial phase after surgery, to secure the longevity of your hip prosthetic and overall well-being.

Resuming Normal Activities After Hip Replacement

For many patients, the prospect of resuming normal activities after hip replacement is a motivating factor in choosing the surgery.After your hip replacement, you’ll likely be anxious to return to the parts of your life that involve physical activity. However, it’s crucial that you don’t rush the process.

The timeline for full weight-bearing after hip replacement varies based on individual factors, including the the patients confidence and fall-risk assessment.
Read my article:
Walking After A Total Hip Replacement: (When and How Much?)

Assessing your progress after hip surgery is key to a successful recovery. Usually, you’ll begin by taking small steps, gradually increasing the weight you place on your hip, and meticulously following the recovery guidelines provided by your healthcare team.

The initial phase of my walking protocol addresses the usual gait abnormalities of unequal step length and shortened stance phase on the new hip.
At the same time, my protocol focuses on walking cadence and endurance.

As eluded to earlier in this article, my weight-bearing protocol for total hip replacement is in concert with the NIH published article that recommends full weight-bearing as soon as possible.

Remember, recovery at home after hip replacement requires adherence to specific dos and don’ts to protect your new hip post-surgery. You’ll want to avoid certain activities that can strain your hip joint and impede healing. It’s essential to embrace patience, you will not be able to jump back into all your normal activities immediately after surgery, but with time, you will progressively reclaim your life’s rhythm.

I think you will find that getting back to the normal activities of daily life will happen much more quickly than you thought.

Read my other articles about Total Hip Replacement

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Q: When can I put full weight on my leg after hip replacement surgery?
A: The timeline for putting full weight on your leg after hip replacement surgery varies among individuals. Generally, barring any complications, you can full weight-bear on the new hip immediately after surgery if your confidence and balance permit. Always follow your healthcare team’s guidance for weight-bearing activities.

Q: What activities should I avoid after hip replacement surgery?
A: After surgery, you should avoid high-impact activities that can stress the new joint, such as running, jumping, or any vigorous sports, at least until you are cleared by your surgeon. It’s also wise to avoid any activities involving twisting motions or excessive strain on your hip. Your healthcare team will provide a comprehensive list of activities to avoid during your recovery period.

Q: How is the recovery process after hip replacement monitored?
A: Your progress after hip replacement surgery is closely monitored through regular assessments by your surgeon and physical therapist. They’ll check your ability to bear weight on the operative leg, ensure proper healing, and assess your strength and mobility. These assessments help them guide you on how to safely increase activity levels and progress to full weight-bearing.

Q: What kind of assistance will I need at home after hip replacement surgery?
A: At home after hip replacement surgery, you’ll need assistive devices like a walker or crutches to help support your balance while your hip heals. In the initial weeks, you’ll also perform prescribed exercises to promote mobility and build strength. It’s crucial to follow the guidelines after hip replacement, provided by your surgical team, to avoid complications and ensure optimal recovery.

Q: How do I know if I am ready to progress to full weight-bearing after hip replacement?
A: Readiness for full weight-bearing after hip replacement usually depends on your confidence in the new hip and your balance. Improvements, as evidenced by reduced pain, enhanced endurance, and brief walks within the home without an assistive device, suggest readiness to transition from partial to full weight-bearing permanently. However, you should not rush the process, and continue to follow the tailored guidelines provided post-surgery for the best outcomes.


Dr. Donaldson is dually licensed; physical therapy in 1975 and doctor of chiropractic in 1995. He held credentials of Orthopedic Clinical Specialist in physical therapy for 20 years, QME in California, and taught at USC. He owns and operates an orthopedic physical therapy practice. See "About Me" page.

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