The First Week After a Hip Replacement: What to Expect

After hip replacement surgery, you will undoubtedly have many questions about what to expect during the first week. Will I be able to move around on my own? What kind of assistance will I need? How much sleep will I get? This article will answer all those questions and more.

We’ll also provide helpful tips for managing pain and review realistic expectations during the first week after surgery. You will be trying to plan for many unknowns, but it’s hard to plan if you don’t know what’s coming.

Congratulations on your upcoming or upcoming hip replacement surgery! We can’t wait to help you through the first week post-op.

How Mobile Are You After a Hip Replacement?

You will be more mobile than you think after surgery. It’s pretty amazing that you have a major surgery like a hip replacement and then walk on it the same day.

Your hip replacement surgery will require you to take it easy for the first week. You will likely be able to walk short distances with a walker, but long-distance walking is discouraged. Taking more frequent short walks around the house is much better than one to two longer walks.

Walking from room to room is painful during the first few days after surgery, especially getting up and down from chairs. You may need assistance getting in and out of bed, getting on and off the commode, and getting in and out of a car.

However, it’s critically important that you get up and move frequently throughout the day. The more you move, the better you will feel.

By the end of the first week, you’ll be surprised at how much you’re moving. You’ll still be using the walker, but going from room to room is much easier. You might be able to stand to help with meal prep for short periods of time, and you’ll be able to get in and out of bed.

Do You Have to Use a Walker After a Hip Replacement?

Using a walker during the first week after a hip replacement surgery is critical to your recovery. A hip replacement is a major surgery involving replacing the damaged hip joint with an artificial one. This surgery requires significant recovery time, and using a walker during the first week is essential to ensure that you do not put too much pressure on your new joint and that you do not fall or injure yourself.

Using a walker provides support and stability to your body as you begin to move around after surgery. It helps to distribute your weight evenly and reduces the amount of pressure on your hip joint. This is important because it allows your hip to heal properly and reduces the risk of complications. It’s important to return to walking normally as soon as possible to prevent the muscles from healing in a shortened position.

Additionally, using a walker can help to prevent falls, which can be dangerous and cause further injury. The only serious issues we tend to see after a hip replacement are due to falls, especially waking up in the middle of the night.

During the first week after hip replacement surgery, it is common to experience pain, swelling, and limited mobility. Using a walker can help to alleviate some of these symptoms and make it easier to move around. It can also help to reduce the risk of complications such as blood clots, which can be a serious problem after surgery.

Can You Use Crutches Instead of a Walker?

While, in theory, you could try and “tough it out” with crutches during the first week, it’s not recommended for a few reasons.

First, it forces you to place more pressure on the surgical hip, which usually results in more limping for longer. The longer that you limp, the longer it takes to get the muscles and ligaments stretched out during the recovery. The first week is critical to allow things to heal properly.

The second is the stability that a walker provides over crutches. This is most important when trying to get up from a chair or commode, where a walker is easier and more stable to use than crutches.

Most surgeons want to set their patients up for the most success possible and therefore have a hard “NO” when asked about crutches over a walker.

What Kind of Help Can You Get After Surgery?

You may need help with daily tasks such as dressing yourself, bathing, and grocery shopping, especially during the first 3-4 days after surgery. If your spouse is able, then this shouldn’t be an issue.

If your spouse is unable or you live alone, you should consider hiring a caregiver or getting help from family and friends can be helpful. It’s important to have someone available to assist you with some basic tasks like light housekeeping, errands, and meal preparation, especially when your hip is still very stiff and painful.

Depending on your health insurance, you may qualify for home health care, including help tidying up and home physical therapy.

If you have a posterior approach surgery, you will have surgical range of motion restrictions for the first 6 weeks that make certain tasks difficult. That is where the extra help comes in handy.

You may also need help with transportation in the first week after hip replacement. You should not drive until your hip has enough range of motion and you are fully off of pain medication. Therefore schedule any rides to physical therapy, the grocery store, or doctor’s appointments before surgery.

A lot of places also have ride-share services that will take patients to their medical appointments for a small fee or free.

Sleeping During the First Week After Hip Replacement

It’s very important to get sufficient rest during the recovery process. Many people find that sleeping in a recliner encourages better sleep since you can be in a semi-sitting position.

You may also want to consider sleeping with a pillow placed between your legs while lying on your side or back. This helps keep your hip more comfortable and supportive throughout the night.

Some surgeons may require that you use a hip bolster that prevents hip adduction while sleeping. These aren’t comfortable, but they keep the hip in a safe position while sleeping.

You might try starting off your night sleeping with an ice pack to numb the pain and help you fall asleep faster and with less pain.

Despite using the prescribed pain medication, most people struggle to get the quality nor the amount of sleep needed. It’s common to take short naps throughout the day and be surprised at how tired you are the first couple of weeks.

Expert tip: If you wake up in the middle of the night due to pain, consider getting up and walking for 5 to 10 minutes to loosen up the joint and reduce pain.

Pain Management During the First Week

Pain management is key during the first week after surgery.

Your surgeon will likely prescribe a combination of short-acting narcotic pain relievers and anti-inflammatory medications to help manage your hip pain. Be sure to take these regularly as prescribed so you don’t experience excessive hip discomfort or get behind on pain. Once you get behind, it makes it challenging to catch up on the pain.

Cold therapy can also be helpful in managing hip pain. Using an ice pack on the hip for 20 minutes at a time (multiple times per day) can help reduce hip swelling and decrease pain.

Exercise can actually help reduce pain levels and stiffness.

After surgery, the hip experiences large amounts of swelling that sits in the joint, causing an increase in pain. With exercise, you are pumping that swelling out and promoting blood flow into the joint. You’ll quickly realize a short walk sure takes the edge off. Using a stationary exercise bike at home is a great way to exercise safely.

Other helpful ways to reduce pain include a compression wrap, trialing a heating pad after 72 hours from surgery, light massage around the hip joint, and topical pain cream.

Incision Care and Management

Keeping your hip incision clean and free of infection is important.

Your surgeon will provide you with specific instructions regarding the care and management of the hip incision. Most likely, you’ll have a large waterproof bandage that should remain on for a minimum of 1 week but sometimes as long as 2 weeks.

Be sure to check the bandage daily to see if there is an increase in blood or drainage from the joint. If there is dried blood, trace the diameter with a sharpie to track any changes over the week.

You can typically shower with the bandage on but don’t hit the surgical incision with direct water. It’s fine if the water rolls over the bandage, but you don’t want direct pressure.

If the bandage starts to peel off, use a hypoallergenic tape to hold the bandage in place until it’s time to remove it.

Scar management techniques aren’t a focus on after the second week from surgery to ensure that the incision has time to heal.

Showering the First Week After a Hip Replacement

Most hip replacement patients can shower the first week after surgery if they follow certain guidelines.

The hip is typically covered with a large, waterproof bandage that helps keep the incision clean and dry while it heals. You should avoid having direct water hit your hip incision, but it’s ok if the water rolls onto the bandage.

We recommend getting a few additional safety features to help make the shower a safe and easy experience. Of the few negative results from a hip replacement that we’ve had in the clinic, they have all been due to serious trauma from a fall in the bathroom!

We recommend getting and installing grab bars in the bathroom and shower, even if they are for temporary use in the first few weeks. We also highly recommend a shower chair. This way, you can easily sit down and clean off without the fear of falling. You can clean all the necessary areas with a removable shower head and maintain low pain levels.

Using a non-slip mat or device in the shower is also important to prevent falls. Many hip replacement patients find that using a handheld showerhead helps them stay safe and comfortable while showering.

Exercises for the 1st Week After Hip Replacement Surgery

The first week after hip replacement surgery is all about rest, healing, and light-duty exercises to promote hip strength and mobility.

Unfortunately, what has become the norm these days is that surgeons tell you to do nothing but walk for your exercise and, in some cases, no longer prescribe physical therapy.

While walking is extremely important, we are starting to see people 2-3 months out from a hip replacement with poor gait mechanics and significant weakness in their hip because they didn’t do anything but walk from the couch to the fridge during recovery.

Your surgeon will likely provide you with physical therapy instructions, but if they don’t, here are a few exercises you can safely do in the first week:

• Glute Squeezes: Lay on your back and squeeze your glute muscles (your butt muscles) for 10 seconds and then relax. Repeat this 10 times, 3 times a day.
• Heel slides: Lay on your back with your hip bent and feet flat. Slowly slide one heel out and then slowly return it to the starting position. Repeat 10 times on each side, 3 times a day.
• Calf Raises: Stand with the toes pointed forward. Slowly raise up on your toes and then slowly lower yourself back down. Repeat 10 times, 3 times a day.
• Clamshells: Lay on your side, hip bent, and feet together. Gently lift the top knee towards the ceiling, keeping both hips still, and then return to the starting position. Repeat 10 times on each side, 3 times a day.

It’s important to do gentle exercises and gradually increase intensity as your hip strength increases. If you experience any pain or swelling, take a break and try again the next day.

Managing Expectations After Hip Replacement Surgery

Finally, managing expectations during the first week after hip replacement surgery is important.

Missed expectations lead to unhappy results.

While hip replacements can be life-altering procedures, you should expect to move slowly in the beginning as you build up hip strength and mobility.

You may have hip pain, stiffness, and swelling during the first week. This is normal and should subside over time.

Also, remember that hip replacement surgery is major surgery with a long recovery process. It has taken you weeks or months to get to this point—it will take you weeks or months to get back up to full strength. People tend to be impatient and don’t realize how long six weeks of pain really is.

For normal healing timelines, it takes 6-8 weeks for bones to heal and around 12 weeks for soft tissue, such as muscles, tendons, and ligaments, to heal.

This is why it is common for people to still have some pain and stiffness up to 12 weeks after a hip replacement, and most people report it takes a full year to feel “normal” again.

Patience and persistence will get you to your desired hip strength and mobility faster than anything else!

Conclusion

Having hip replacement surgery can be a scary and overwhelming experience.

The key is understanding what you should expect during the first week after hip replacement surgery so you can plan ahead and set yourself up for success.

This includes understanding how mobile you’ll be, what kind of assistance you’ll need, sleeping during the first week, pain management, incision management, exercises you can perform, and managing expectations.

The first week after hip replacement surgery is about taking it slow, managing pain, following instructions from your surgeon and physical therapist, and doing exercises that promote hip strength and mobility. Be patient with yourself and the healing process; you will be on your way to a successful hip replacement recovery.

Good luck!