Hip Rehabilitation

Rehabilitation following hip surgery is a gradual and carefully staged process. The hip is the largest and most inherently stable joint in the body, yet it is also one of the most demanding — subjected to forces several times body weight with every step, and significantly more during exercise and sport. Surgery disrupts the surrounding soft tissue, and in some procedures — particularly periacetabular osteotomy (PAO) — the bone itself requires time to heal before full weight bearing and activity can be safely resumed.

A well-directed rehabilitation programme is essential to a successful outcome following hip surgery. It protects the healing tissue during the vulnerable early stages, rebuilds the strength and control of the surrounding musculature, and guides a progressive return to full function. The role of your physiotherapist throughout this process cannot be overstated.

The information on this page provides general guidance on hip rehabilitation following surgery. Specific rehabilitation protocols for each procedure are available to download below, and should be shared with your physiotherapist at the start of your recovery.

General Principles of Hip Rehabilitation

While the details of rehabilitation differ between procedures, a number of principles apply across all hip surgery:

Follow weight bearing instructions carefully. Weight bearing restrictions are an important component of hip rehabilitation, particularly following PAO, where the pelvis requires a period of protected weight bearing while the osteotomy heals. Advancing weight bearing before this healing has occurred risks complications that can significantly affect the outcome of your surgery. Your specific protocol will outline the weight bearing restrictions and progression relevant to your procedure, and these must be followed precisely.

Respect any movement precautions. Depending on the procedure performed, specific movement precautions may apply in the early stages of recovery — for example, limitations on hip flexion, rotation, or combined movements. These precautions exist to protect the repair and must be followed in all activities, including sitting, sleeping, and dressing. Your physiotherapist will guide you through the practical implications of any precautions specific to your procedure.

Manage pain and swelling. Some degree of pain and swelling following hip surgery is normal. Icing the hip and groin region for fifteen to twenty minutes several times a day is effective in managing both. Keeping the operated leg elevated when resting in the early stages assists with swelling management. Pain that is severe, worsening, or not responding to simple measures should be discussed with your physiotherapist or our rooms.

Rebuild gluteal and hip stabiliser strength. The gluteal muscles — and in particular gluteus medius — are the primary stabilisers of the hip and pelvis during walking, running, and sport. Weakness in these muscles places abnormal load on the hip joint and surrounding structures, and is a contributing factor in many hip conditions. Restoring gluteal and hip stabiliser strength is one of the most important goals of hip rehabilitation and underpins safe return to full activity.

Restore range of motion gradually. Range of motion exercises are introduced progressively following hip surgery, guided by the specific restrictions of your procedure. For arthroscopic procedures, range of motion is typically restored relatively quickly. Following PAO, range of motion is restored more cautiously over a longer period. Do not attempt to stretch or force range of motion beyond what your protocol and physiotherapist advise.

Progress gradually. Recovery from hip surgery follows a structured, staged progression — from protected weight bearing and gentle movement, through to progressive strengthening, functional training, and finally return to impact and sport. Each stage must be completed before advancing to the next. PAO rehabilitation in particular is measured in months rather than weeks, and patience is essential to achieving a good outcome.

Attend your physiotherapy appointments. Regular physiotherapy throughout your recovery is essential. For PAO in particular — which involves a major surgical procedure with an extended rehabilitation timeline — consistent professional oversight of your rehabilitation programme is critical. Your physiotherapist will monitor your progress, ensure milestones are being met, and advance your programme at the appropriate pace.

Be patient. Full recovery from hip surgery takes considerable time. Following arthroscopic hip surgery, return to full activity typically takes six to nine months. Following PAO, full recovery and return to sport may take twelve months or longer. This reflects the complexity of the procedure and the importance of allowing complete healing before subjecting the hip to high loads. Short-term setbacks are common and should be discussed with your physiotherapist or our rooms.

Your Rehabilitation Protocols

Procedure-specific rehabilitation protocols are available below. We will provide the protocol relevant to your procedure in your discharge paperwork — please bring this to your first physiotherapy appointment.

Hip — Arthroscopy

• Hip Arthroscopy Post-Operative Instructions

• Hip Arthroscopy Rehabilitation Protocol

Hip — Periacetabular Osteotomy (PAO)

• Periacetabular Osteotomy (PAO) Post-Operative Instructions

• Periacetabular Osteotomy (PAO) Rehabilitation Protocol

Hip — Proximal femoral osteotomy (PFO)

• Proximal Femoral Osteotomy (PFO) Post-Operative Instructions

• Proximal Femoral Osteotomy (PFO) Rehabilitation Protocol

Hip — Other Procedures

• Gluteal Tendon Repair / Iliotibial Band Lengthening Rehabilitation Protocol

• Proximal Hamstring Repair Rehabilitation Protocol

• Surgical Hip Dislocation Rehabilitation Protocol

Finding a Physiotherapist

A referral to a physiotherapist is not always provided automatically following surgery — in many cases, you will need to arrange this yourself. We recommend engaging a physiotherapist with experience in post-surgical hip rehabilitation before your operation, so that your first appointment can be scheduled promptly after surgery.

Hip surgery — and PAO in particular — is a specialist area of rehabilitation, and it is important to find a physiotherapist who is familiar with the specific demands and precautions of these procedures. A physiotherapist who has not previously managed PAO rehabilitation may need to familiarise themselves with the protocol before commencing your programme, and this is entirely appropriate — the protocol is designed to guide both patient and physiotherapist through the recovery process.

If you would like a recommendation for a physiotherapist experienced in hip rehabilitation in the Auckland area, please contact our rooms.

Further Information

For patients managing a hip condition without surgery, information on non-operative hip rehabilitation is available on our Hip Non-Operative Rehabilitation page.

For guidance on returning to the gym, running, and competitive sport following hip surgery, see our Return to Sport After Hip Surgery page.