Hip Replacement Prehab Exercises: The Weeks Before Surgery

If hip replacement is a few weeks away, the time before surgery is worth using well. A simple, repeatable plan of hip replacement prehab exercises can help you arrive at surgery day stronger, steadier, and more familiar with the movements you will lean on afterward — getting out of a chair, standing tall, and walking with support. This guide lays out a six-week structure adapted from a published NHS pre-operative hip program, along with an honest look at what the research does and does not show (NHS Wye Valley pre-op hip exercise guide).

What the evidence honestly says about hip prehab

We will not oversell this. The research on prehab specifically for total hip replacement is thinner than for knee replacement. A 2022 AHRQ-funded comparative effectiveness review looked at six hip-prehab trials covering 425 patients and concluded the evidence was insufficient or missing for every outcome it measured — meaning no reliable conclusion could be drawn about whether prehab changes hip-replacement results (Pinto et al., AHRQ review, 2022). A 2025 review of reviews covering hip and knee patients combined reported possible benefits in strength and function, but rated the underlying evidence quality as ranging from critically low to moderate, with any benefits generally limited to the first six months after surgery (JOSPT, 2025).

Interest in the question is still growing: a UK feasibility trial is currently testing home exercise plus protein supplementation for frail patients preparing for hip or knee replacement, though its results are not yet in (Khalid et al., Bone & Joint Open, 2023). So the fair framing is this: prehab for hip replacement is general fitness preparation, built from the same exercise categories used in hospital pre-op programs and national guidance — strength, mobility, and general conditioning — with the goal of going into surgery stronger, not a promised change in your surgical result (NHS Wye Valley; NICE NG157).

Check with your surgical team before starting, especially if you have heart or lung conditions, uncontrolled pain, or significant balance problems.

Hip replacement prehab exercises: the six-week framework

The structure below organizes movements from a published NHS pre-operative hip program into three sessions per week on non-consecutive days, progressing gradually across six weeks (NHS Wye Valley).

Build each session in three parts

1. Warm up and switch the right muscles on

Start with five minutes of gentle walking or seated ankle circles, then simple activation work: ankle pumps for circulation, static glute squeezes to wake up the muscles that stabilize the hip, and straight leg raises for the thigh muscles that support it (NHS Wye Valley). None of this should feel intense — the goal is quality of movement, not fatigue.

2. Strengthen the glutes, hips, and core

The middle of each session targets the muscles that matter most for walking and balance after hip surgery. Side-lying or standing hip abduction strengthens the outer hip muscles that keep your pelvis level when you walk (NHS Wye Valley; AAOS OrthoInfo exercise guide). Glute bridges build the strength you use for transfers and standing, and bird-dog adds core stability. From week three, standing hip extension and hamstring curls at a chair bring in the back of the hip and thigh.

3. Rehearse useful patterns and add optional conditioning

In the final weeks, the plan shifts toward movements you will use constantly right after surgery: sit-to-stand practice from a sturdy chair, and chair push-ups that build the arm strength for safe transfers and walker use (NHS Wye Valley). Optional low-impact conditioning — walking, a stationary bike, or pool walking — supports general fitness, which national guidance encourages before major surgery (NICE NG157).

Do hip precautions apply before surgery?

Mostly, no. The familiar hip precautions — avoiding deep hip bending, crossing the legs, or twisting — exist to protect healing tissue after the operation, so they generally do not restrict a pre-surgery exercise program, since your hip has not yet been operated on (Leeds Teaching Hospitals rehabilitation guide). After surgery is a different story: early recovery follows your hospital team's rules on movement, and most people are up and walking with support very early, progressing over the following weeks (NHS: recovering from a hip replacement). If your surgeon gives you specific pre-surgery restrictions, theirs win.

How to progress without forcing it

Progress one variable at a time: a few more repetitions, a slightly longer hold, or a light band or ankle weight once the current version feels easy. If something flares, use the easier version — a shorter lift, a partial range, a higher chair — rather than skipping the movement entirely. Mild muscle fatigue is expected; sharp or stabbing pain is not.

Pause and check in with your surgical team if an exercise consistently causes pain lasting more than an hour, if you feel unsteady or dizzy, or if your hip gives way. Seek care now for chest pain, severe shortness of breath, or new calf swelling, warmth, or pain.

Make prehab part of practical preparation

Exercise is one piece of getting ready. The free home prep checklist walks through safer walking paths, bathroom setup, and the essentials for your first days home. For what comes after surgery day, see the hip replacement recovery timeline. And if someone in your life is preparing for knee surgery instead, the knee prehab guide follows the same philosophy with knee-specific evidence.

The bottom line

Hip replacement prehab will not promise you a better surgical result — the research simply is not there yet for hip surgery specifically (AHRQ review, 2022). What a structured six-week plan can do is help you go into surgery stronger, steadier, and already fluent in the movements early recovery demands, using the same exercise categories found in published hospital pre-op programs (NHS Wye Valley). Keep it simple, progress gently, and let your surgical team have the final word on every detail.