There’s a strange gap between being told you need a hip replacement and having one.
You get a date. You get a pre-op appointment. And then, for anywhere from a few weeks to several months, most people wait — resting the hip, moving less, and quietly getting weaker while they count down.
That window is being wasted, and it’s one of the few parts of the whole process you fully control.
Research on preparing for joint replacement points in a consistent direction: people who go into surgery stronger and better prepared tend to get moving sooner afterward, need less help, and find the early weeks less overwhelming. The effects are modest rather than miraculous, and they’re most pronounced for people whose starting point is lowest — which is to say, exactly the people who assume it’s too late to bother.
Here’s how to use the time.
Start with the honest version of what’s coming
Hip replacement is among the most successful operations in modern medicine, with high satisfaction rates and reliable pain relief. That’s the good news, and it’s genuinely good.
The parts people find surprising:
It’s a real operation with a real recovery. Most people are up and walking with a frame or crutches within a day, but the first two weeks are demanding, and fatigue is far more significant than anyone expects.
The timeline is longer than the headline. Walking aids for a few weeks. A gradual return to normal activity over roughly three months. And continued improvement in strength and endurance for up to a year — long after the hip has stopped hurting.
Implants don’t last forever. Registry data suggests a large majority are still functioning at fifteen years, with something over half still going at twenty-five. Relevant if you’re younger, less so if you’re eighty.
Knowing this in advance doesn’t reduce the work. It does stop the normal course of recovery from feeling like something has gone wrong.
What to work on physically
The instinct is to rest the painful hip until surgery. It’s the wrong instinct. You’re going to need strength immediately afterward, and you can’t build it while lying in a hospital bed.
The muscles around the hip. Gentle side-lying leg raises, bridges, and standing hip work. Even a compromised hip can usually tolerate some strengthening if the dose is right — and going in with more muscle means having more left afterward.
Sit-to-stands. The single most functional thing you can practice. Rising from a chair without using your hands, repeatedly, from a height similar to what you’ll be dealing with at home.
Your arms. This is the one nobody thinks of and everybody wishes they had. You will be pushing up out of chairs, managing crutches or a walker, and levering yourself in and out of bed and cars using your upper body. Rows, presses, and pushing up from armrests all pay off directly in week one.
Your other leg. It’s about to do considerably more than its share.
Cardiovascular fitness. Whatever you can tolerate — stationary bike, pool walking, arm cycling if weight bearing is too painful. Better general fitness is associated with smoother recoveries and fewer complications.
Balance. Standing on one leg with support nearby. You’ll be navigating a house on crutches with an unfamiliar hip.
Everything above needs adjusting to your specific hip, your other conditions, and your surgeon’s advice. Some hips tolerate loading well; others need creative workarounds.
What to sort out medically
These are worth raising with your surgical team early, because several take weeks to act on.
Smoking. Of everything on this list, this has the strongest evidence behind it. Smoking meaningfully increases wound complication and infection risk, and stopping several weeks before surgery makes a measurable difference. If you’ve been looking for a deadline, this is one.
Blood sugar, if you have diabetes. Poorly controlled glucose is associated with higher infection risk. Ask your team what target they’d like to see.
Weight, if it’s been raised with you — though be realistic about what’s achievable in the time available, and don’t crash diet before surgery.
Dental problems. Some surgical teams want infections cleared beforehand. Ask.
Nutrition. Adequate protein supports healing. Anemia is worth checking and correcting if present.
Medications. Some need pausing before surgery, some don’t. Get the list confirmed rather than guessing.
What to set up at home
Do this before surgery, not from a hospital bed by phone.
The bathroom. A raised toilet seat and a grab rail are the two most commonly needed items. Consider a shower chair and a non-slip mat.
Your chair. You want something firm, with arms, high enough that your hips sit slightly above your knees. Deep soft sofas are the enemy of early recovery.
Your bed. Not too low. Clear space on the side you’ll get out of.
The floor. Remove loose rugs, tape down cords, clear pathways wide enough for a walker. Falls in the first weeks are a genuine risk and entirely worth designing out.
Reaching tools. A grabber, a long-handled shoehorn, and a sock aid. Bending to your feet is the thing people most reliably underestimate.
The kitchen. Move what you use daily to waist height. Batch cook and freeze meals now.
Stairs. If your bedroom is upstairs, plan for whether you’ll manage them, sleep downstairs initially, or arrange a second rail.
What to practice beforehand
Using your walking aid on level ground and stairs, before you’re sore and tired and trying to learn it for the first time.
Getting in and out of bed the way you’ll need to afterward.
Getting in and out of a car — a surprisingly awkward maneuver with a new hip, and much easier if it isn’t novel.
Any movement restrictions your surgeon gives you. These vary considerably depending on the surgical approach used, and some surgeons now use very few. Practice whatever your surgeon specifies rather than what a website or a friend describes — this is one area where generic advice genuinely conflicts.
What to arrange with people
Someone to drive you home and stay for the first few days.
Help with shopping, pets, laundry, and anything requiring bending for the first couple of weeks.
Work. Have the conversation early. Desk work and physical work have very different timelines.
Driving. Ask your surgeon directly, since it depends on which side, whether your car is automatic, and their own protocol. Also confirm the position of your insurer.
The admin worth doing while you feel well
Small things, all easier now than in week one.
Pack the bag early. Loose comfortable clothing, flat non-slip shoes you can get on without bending, a phone charger with an extra-long cable, your medication list, and anything you need for glasses, hearing aids, or a CPAP machine.
Fill prescriptions in advance where you can, and make sure you understand the pain management plan before you need it. Managing pain proactively in the first days is far more effective than chasing it.
Photograph your medication list and keep it on your phone.
Sort out insurance and authorization for any equipment and follow-up therapy before surgery, not after.
Plan your first two weeks of meals. Freezer, delivery, or willing relatives — decided in advance rather than negotiated while exhausted.
Two things worth knowing about afterward
Fatigue is the most underestimated part of recovery. It’s normal, it’s disproportionate to what you’re doing, and it lifts.
Know the warning signs. Contact your surgical team promptly for increasing redness, warmth, or drainage from the wound, fever, or calf swelling and pain. Call 911 for sudden shortness of breath or chest pain, or if the hip becomes suddenly severely painful and you can’t bear weight.
If you’re not sure you want surgery yet
Worth saying: not everyone at this stage has decided.
If you’re weighing it up, structured strengthening and load management are a reasonable thing to try first for many hips, and they aren’t wasted effort even if you do proceed. The work you do either delays the operation or prepares you for it. There isn’t a version where it costs you.
Let’s use the time you have
Beyond Care Physical Therapy offers a free discovery visit — no cost, no obligation, and no pressure to commit to anything.
Bring your surgery date if you have one. We’ll assess where your strength and mobility actually are, build a plan for the weeks available, and make sure your home and your expectations are ready alongside your body.