When does Walking Unaided after Hip Replacement? (+Tips)

How to Start Walking after a Hip Replacement Surgery?

On the same day as the operation, whether you’ve had a partial or total hip replacement, you can start walking right away! You just need to adjust your walking technique based on your pain and discomfort:

1. Use crutches or a walker to support yourself and put less weight on the operated leg:
   • Relieve pain.
   • Prevent the weakened leg from giving way due to the effects of the surgery and anesthesia.
   • Promote proper healing of the damaged tissues around the prosthesis.
2. Start by taking a few slow steps to assess how you feel (pain in the hip, overall condition).
3. Begin walking using a “3-step” approach:
   1. Advance with both crutches or the walker.
   2. Next, move the operated leg, keeping it between the crutches or the walker.
   3. Finally, advance the other leg at the same level as the operated leg or slightly ahead.
4. Repeat this process.

When the average person can walk with crutches or walker?

Often, you’ll be asked to be accompanied by a caregiver or a physical therapist for your first attempts at standing up or taking a few steps. This professional can guide you on the most suitable walking technique.

The average time for resuming walking with crutches or a walker after a hip replacement surgery is around 4 days (Kim 2022). This statistic considers individuals over 90 years old, some of whom might have had limited mobility before the procedure.

In the days following the surgery, you can:

• Walk for longer durations.
• Climb up and down stairs (usually as soon as the day after surgery, with assistance the first time).
• Consider changing your walking pattern with the crutches by using an “alternating” or “marching” approach:
  • Advance the right leg and the left crutch.
  • Then advance the left leg and the right crutch.
  • Repeat this pattern.

If you are under the guidance of a physical therapist, they will help you identify the right time to progress to these stages—increasing your walking distance, using stairs, walking alternately, and eventually letting go of a crutch or walker (a few weeks after hip prosthesis placement).

These recommendations apply if weight-bearing is allowed after the surgery. This is the case in over 99% of situations, based on my experience. If this is not the case, you should have been informed, and typically, it involves situations like re-prosthesis after hip dislocation, prosthesis loosening, or requiring bone grafts.

When to switch from walker to cane after hip replacement?

Switch from walker to cane as soon as you feel ready after your hip surgery! The walker is primarily there to provide more stability if you are more comfortable and less off-balance with it.

If you find canes more convenient and are able to walk with them without imbalance, you can transition directly to using canes (even from the day after the surgery).

How far should I be walking 1 week after hip replacement?

In general, at this stage, most of my patients are able to walk indoors for a few tens of feet with canes.

• The more advanced ones have already resumed outdoor walking for several hundreds of feet.
• Those who are less comfortable are taking only a few steps with a walker.

You should fall somewhere between these two extremes 🙂.

How far should you be walking 4 weeks after hip replacement?

Four weeks after the hip surgery, most people are able to walk outdoors for several hundreds of yards (for those who had this level of autonomy before the surgery).

The more confident ones are covering several miles and might even start incorporating some inclines if desired.

Crutches are often still used, but not necessarily for those who are more comfortable.

Can you overdo walking after hip replacement?

I’ve come across more cases of patients experiencing complications due to prolonged bed rest and lack of movement rather than from overdoing walking.

However, yes, of course, if you go to extremes, if you resume walking too quickly without using a cane and cover long distances, it could be detrimental. Primarily, this might trigger or worsen pain.

The key is to gradually introduce any new activity or increase in the frequency, intensity, or duration of exercise. This applies even to simple walking!

How long after hip replacement can i walk unaided?

During the first days after hip replacement surgery, the question of walking without crutches doesn’t even arise: most people REALLY need crutches or walker to walk.

However, some individuals quickly feel like they can walk with just one crutch or even without any crutches. Sometimes, this happens within just a few days or 2-3 weeks.

Orthopedic surgeons, however, often advise not to let go of the crutches for at least 4 to 6 weeks after the operation, even if you feel capable. This is because:

• The tissues around the joint are damaged and require several weeks of healing time.
• They assume that walking too soon without crutches could risk damaging the prosthesis or delaying overall recovery time.
• There is a slight risk of falling due to potential muscle weakness in the hip muscles, which might not be felt.

Personally, when one of my patients asks me if they can stop using crutches, we discuss the advantages and “risks.”

• Generally, these people start by letting go of one, then two crutches indoors (sometimes just a few days or 2-3 weeks after the operation).
• They then transition to walking outside with walking sticks before eventually abandoning them as well (often after a few weeks).

Is there a maximum time limit for discontinuing crutch use after total or partial hip replacement surgery? Absolutely not.

Some people take several months to be able to walk without crutches or walker after a hip replacement. This is okay, and it doesn’t mean you will never be able to let them go someday 💪! The fastest leave the crutches after 1 to 2 weeks.

Can you overdo walking after hip replacement?

While walking is an important part of the recovery process, it’s possible to overdo walking after a hip replacement.

Initially, you may start with short walks (maybe 300 feets) and gradually increase your walking distance and intensity as your strength and mobility improve. Be attentive to your body’s signals and communicate any concerns with your healthcare team.

How long after hip replacement do you walk normally?

“When will I be able to walk normally again?” This is clearly one of the most common questions I hear from the patients I assist with hip rehabilitation.

And sometimes, these people are already walking “normally” according to my own criteria!

So, let’s clarify what we mean by “normal walking” or “normal gait” after hip replacmement surgery. For me, this can mean:

• Walking without crutches or walker (I’ve already addressed this point).
• Walking without any pain (refer to this article dedicated to the duration and type of pain after hip surgery).
• Walking without limping (I’ll discuss this shortly).
• Walking as long as before and on all types of terrain, including hiking. This naturally varies among individuals, but I would suggest a range of at least 2 months for the very early cases, up to 1.5 years for those progressing more slowly. On average, it tends to be around 4 to 5 months.

Even in the best scenarios, it takes several months to achieve normal walking after hip replacement surgery.

On average, 6 to 8 months after hip replacement, operated individuals have regained about 80% of their pre-surgery capabilities. Source: Alves 2022.

When walking without a limp after hip replacement?

It’s entirely normal to limp after a hip arthroplasty. This is the case for the vast majority of people, and it can last for several weeks!

There are at least three explanations for this:

• Your hip is stiffer and more painful than usual. Tissues and muscles have been affected during the prosthesis installation, requiring a few weeks to several months to heal. You might be putting less weight on your operated leg (sometimes without realizing it), which causes the limp.
• You might have a leg length discrepancy: if the implant’s length differs from your natural hip (which is quite common), it can lead to limping. Your body will likely adapt over time, as we often aren’t symmetrical from birth either!
• You might have reduced muscle strength in your buttock and thigh muscles. This can result from prolonged inactivity (including before the prosthesis placement if you walked less due to hip arthritis) or because these muscles are still healing. These muscles stabilize the hip while walking and prevent swaying.

This is why you might feel like you’re “waddling” or limping while walking. This sensation will diminish in the weeks following hip replacement surgery.

Are there things you can do to eliminate this limp? Here are some suggestions:

• Simply wait for time to work its magic.
• Keep walking as much as possible, with or without crutches or walking sticks; walking is an excellent muscle-strengthening exercise.
• Regularly climb up and down stairs; this movement further strengthens your buttock muscles.
• Optionally, engage in lower limb strengthening exercises like sit-to-stands and squats without added weight (see my eBook).

Some people might continue to limp after a hip replacement for life. However, when this occurs, it often stems from a pre-existing limp due to hip osteoarthritis.

On average, it takes 6 to 8 weeks to reapply equal weight on the operated side as the non-operated side while standing still. It might take a little longer while walking (Alves 2022).

Are walking poles good after hip replacement?

Absolutely, Nordic walking (walking with walking poles) is fully allowed after a hip replacement surgery. In fact, it’s an excellent way to continue recovering effectively on both muscular and cardiovascular levels, and to maintain your fitness.

Generally, walking with Nordic walking poles can be a bit more challenging than using crutches.

It’s often recommended to wait at least a few weeks (around 3 to 4, or even 6 to 8) before you can start Nordic walking or hiking with poles after hip surgery.

Of course, it’s essential to resume gradually and at your own pace!

Can I Run with a Hip Replacement🏃‍♀️?

Yes, it’s often possible to resume running after a hip replacement surgery. This largely depends on your fitness level BEFORE the surgical intervention.

❌ If you’ve never engaged in running or if it has been 10 to 20 years since you last ran, taking up running again might not be advisable due to physical deconditioning.

✅ On the other hand, if you were highly active in sports just before having a hip prosthesis (whether a few days, weeks, or months prior), considering a return to sports is more reasonable.

For instance, a study tracked 48 people aged 28 to 59 who competed in Ironman competitions and had undergone hip replacement surgery. Within 5 years following the hip replacement, 69% of them resumed running. Some even participated in Ironman events again.

Source: Girard 2017.

See also: Sport After Hip Replacement Surgery (coming soon in English)

Compression Stockings: When to Wear Them After Hip Surgery?

Often, your surgeon will recommend wearing compression stockings after your hip replacement surgery.

Compression stockings serve to:

• Reduce the risk of thrombosis, a rare but troublesome complication after hip surgery. You might also receive anticoagulant injections for this purpose.
• Control swelling in the leg: not just the hip, but also the thigh and foot might swell after hip prosthesis surgery.

The more you walk, the lower your risk of thrombosis and hip edema becomes. This is why some might suggest that you can comfortably discard the compression stockings once you are walking a few hundred meters consistently every day.

See also: Swelling after Hip Replacement Surgery

When to use stairs after hip replacement?

When I worked at a hip surgery hospital, we often had patients on the stairs the day after the surgery! Ideally, for the first time, it’s best to have someone accompany you who can help ensure your safety while going up or down the stairs.

You’ll also need two canes or a railing and at least one cane. In the beginning, you’ll need to take one step at a time.

Generally, you can start going up and down the stairs step by step as early as the day after hip replacement surgery, or in the days that follow.

How to go up stairs with a hip replacement?

Your physical therapist might have given you this mnemonic: “We ascend to heaven.” While going up stairs, you first place your non-operated leg on the step (the good leg, the angelic leg 👼) since it’s stronger and does most of the work.

Then, place the other leg beside it.

After a few days or weeks, you won’t need to take one step at a time anymore. First during ascent, then during descent.

How to go down stairs with a hip replacement?

For descending, it’s the opposite: “We descend to hell.” While going down stairs, start with your operated leg on the step (the bad leg, the devilish leg 😈) since it’s weaker and requires less effort when descending first.

Then place the other leg beside it.

As you progress to taking stairs two at a time during ascent, you should be able to do the same during descent in the following days!