The distance walked one week after a total hip replacement is less important than the frequency and quality of movement. Recovery protocols vary based on the surgical approach and the patient’s individual health status. The primary goal of early mobility is to promote blood circulation and prevent complications like deep vein thrombosis, not to achieve distance milestones. This article provides general guidance, but all activity must be strictly cleared and directed by your orthopedic surgeon and physical therapist.
Immediate Post-Operative Mobility Goals
One week post-surgery, activity should focus on short, frequent sessions rather than continuous walking. Most physical therapy plans recommend walking for approximately five to ten minutes per session. These short bursts should be performed several times throughout the day, typically three to five times daily, to maintain muscle tone and stimulate circulation.
The emphasis is on incorporating movement into the daily routine, such as walking to the kitchen or bathroom. Early ambulation helps reduce the risk of blood clots, improves lung function, and promotes the integration of the new joint. While you may walk 100 to 300 feet during each session, this distance is a byproduct of the time goal, not the main objective.
Gradual progression is the foundation of recovery. If a five-minute walk is tolerated well, the duration can be minimally increased in subsequent sessions. Any increase in duration or frequency must be minimal and approved by a physical therapist. The quality of the gait is more important than the quantity of steps taken during this initial healing phase.
Essential Safety Protocols and Assistive Devices
Supportive devices are mandatory during the first weeks of recovery to ensure stability and protect the surgical site. Patients must use a walker or crutches to support their weight and maintain balance. The amount of weight you can bear on the operated leg is a specific instruction provided by your surgeon.
Certain movements must be strictly avoided, known as hip precautions, which vary by surgical technique. The traditional posterior approach requires avoiding three movements for six to twelve weeks: flexing the hip past 90 degrees, crossing the legs, and rotating the leg inward. For example, the 90-degree rule necessitates using a raised toilet seat to prevent excessive hip bending.
The anterior approach is often muscle-sparing and may have fewer precautions, such as avoiding excessive hip extension or external rotation. Proper technique is necessary for transfers, such as using the arms to push up when getting out of a chair while keeping the operated leg slightly forward. When managing stairs, lead up with the non-operated leg and down with the operated leg, often summarized as “up with the good, down with the bad.”
Recognizing Signs of Overexertion
Differentiating between expected post-surgical discomfort and signs of overexertion is necessary for a safe recovery. Muscle soreness and a dull ache are normal as the surrounding muscles adjust to the new joint. This discomfort typically resolves with rest, ice, and prescribed pain medication.
Acute, sharp, or throbbing pain that does not subside after resting warns that the hip has been pushed too hard. Increased swelling, sudden redness, or warmth around the incision site suggests rising inflammation or a possible infection. A fever is another significant indicator of infection and requires immediate medical attention.
Signs of a deep vein thrombosis (DVT) include pain or tenderness in the calf or leg unrelated to the incision. Severe swelling of the thigh, calf, or foot that does not improve when elevated is also a concern. If these warning signs appear, rest and apply ice, then contact the surgeon or physical therapist immediately for evaluation.