Hip Fracture Recovery: Physio’s Post-Op Guide
Tom wasn’t doing anything extreme. He simply stood up too fast and lost his balance. One moment, he was reaching for his water bottle. The next minute, he snapped, broken hip.
After surgery, the big question wasn’t just “How long until I walk again?” It was: “How do I resume moving like myself again?”
Here’s the thing: recovering from a hip fracture is about regaining strength, balance, and confidence, not just about healing bones. That’s where physiotherapy comes in, and the sooner you start, the better your recovery tends to go.
First, Let’s Talk Healing
After hip fracture surgery, whether involving pins, screws, or even a full replacement, your body needs a bit of time to calm down and adjust. But this isn’t one of those "stay in bed" recoveries.
Movement often starts as fast as within a day or two. Early mobilization after hip fracture surgery is linked to shorter hospital stays and better functional outcomes, according to PubMed. The reason is that the longer you wait, the harder it becomes to regain strength and mobility.
Week 1: Baby Steps—Literally
Right after surgery, your physio journey begins with small, gentle movements. Nothing too intense, but they make a big difference. You’ll likely start with:
- Ankle pumps to keep blood flowing
- Deep breathing to prevent lung problems
- Assisted walking with a walker or crutches
“The first thing I would focus on is getting patients walking and activating their muscles again. Even if it is for short distances, and requires a walker or cane. This is very important to avoid muscle atrophy or blood clots, and leads to a faster overall recovery.” — Ryan, Physiotherapist at River East Physiotherapy
Most people are out of bed the next day, with help. Your physiotherapist will walk you through standing, shifting weight, and slowly starting to walk again.
Tip: Don’t let pain hold you back. You’ll have medication to help with that; use it so you can move safely and comfortably.
Weeks 2–4: Learning to Move Again
This is where you start re-learning how to walk, step by step.
During this stage, your physio will focus on:
- Walking mechanics, to help you avoid limping or awkward habits
- Transfers, like safely getting in and out of bed or chairs
- Hip-strengthening exercises, with things like leg lifts, glute squeezes, and supported standing drills
- Balance training, to reduce the risk of falling again
Remember, here we aim for control and not speed. You want your muscles firing properly, notjust going through the motions. I spoke with the team at Brentwood Physio, who provide physiotherapy in Calgary. I asked for their thoughts on the rehab early stages after surgery. “After a hip fracture every step counts but it’s the quality of those steps that really matters,” says Lalitha, a physiotherapist at Brentwood Physio. “Our goal is to help patients move safely, build
strength and most importantly learn to trust in their body again.”
Weeks 4–8: Strength Mode Activated
Now things start picking up because you’re not just recovering, you’re rebuilding.
This phase often focuses on:
- Targeted work to rebuild hip and thigh strength
- Exercises like step-ups and sit-to-stand drills
- Walking longer distances and spending more time on your feet
- Gradually relying less on walkers or canes
You might still feel sore sometimes, and that’s okay. But if the soreness lasts longer than a day after exercise, tell your therapist. We want to challenge your body, not push it too far..
Month 3 and Beyond: Back to Life
You’re now thinking about living again, at this stage, not just about healing.
Your physio might now introduce:
- Advanced balance work, like standing on foam or multi-tasking while you move
- Stair climbing practice to get you confident with steps again
- Core strengthening to support your spine and hips
- Real-world tasks, such as getting in and out of a car or bending to pick up laundry
Some people feel about 70 to 90 percent back to normal around now. Others need more time, and that’s perfectly okay. What matters is showing up and sticking with the process.
Don’t Skip These Essentials
Some people honestly rush back to normal life too fast, while others wait too long. Here’s how to avoid the common pitfalls:
- Stick to the Plan
- Your physiotherapist isn’t guessing. They’re giving you a plan based on how your body is healing, so trust it.
- Keep the Routine Simple
- You don’t need a fancy gym. Just your body, a chair, some resistance bands, and a willingness to move.
- Fall Prevention Is a Must
- Most hip fractures happen from falls. So even once you feel better, keep working on balance, posture, and safe movement.
- Eat and Sleep Like It Matters—Because It Does
- Your body needs protein, calcium, and sleep to rebuild. You can’t out-exercise a bad recovery diet.
Final Thoughts
About Tom’s story, he committed to rehab, never skipping sessions, and didn’t push too fast. By month three, he’d put the cane aside and returned to enjoying his morning walks.
That’s the power of a solid physio plan.
Hip fracture recovery isn’t just about the bone, it’s about teaching your whole body to move again. With the right guidance, and a bit of daily grit, you can get there.
Let’s get moving.
