This phase builds on the exercises you have completed during the first 9 weeks (phases 1 and 2) after your operation. The focus on improving your range of movement and daily function continues. This phase also introduces a progressive focus on strengthening the muscles around your hip.
Goals for Rehabilitation in Phase 3
The aims of rehabilitation between weeks 9 and 12 following your operation are:
- No pain in the affected hip
- Full mobility of the operated hip joint
- Normal walking pattern and ability to climb stairs
- Restoring muscle strength and endurance
You may still fully weight-bear on your operated leg. Your gait should be normalised; if not, this will be addressed in your rehabilitation. Speak with your physiotherapist about when it is appropriate to stop using crutches and how to return them to the hospital.
Training Guidance
It remains important to monitor any pain during exercises. Mild soreness is acceptable but should resolve with rest or within 24 hours.
If soreness persists beyond this, it may indicate overuse. In such cases, adjust your training and consult your physiotherapist if necessary.
Exercise Bike & Bicycling
Continue with interval training using an exercise bike. Begin with 10 minutes of gentle warm-up, followed by 3 to 5-minute intervals at increased resistance. Aim for a total cycling time of 20 to 30 minutes.
You may also start taking longer rides on a standard bicycle if comfortable.
Swimming
You may now swim using standard strokes (front crawl and breaststroke). Start with 10 minutes and gradually increase the duration. As you progress, you may use swim fins during front crawl to add resistance. If swimming more than once per week, ensure you have at least one day of rest between sessions.
Cross Trainer
You may use a cross trainer at this stage. Start with 5 to 10 minutes and increase gradually over several training sessions. If using more than once per week, ensure a minimum of one day’s rest between sessions. Talk with your physiotherapist if you experience any troubles or discomfort.
Leg Press
Sit with your feet flat on the footplate, pointing directly forward. Your hip should be bent no more than 90 degrees. Perform the extension movement at a slightly quicker pace without locking your knees. Return to the starting position slowly and with control. Use only light weights initially and perform 3 sets of 20 repetitions to focus on endurance. You may train one leg at a time if preferred and if allowed—ask your physiotherapist.
Towards the end of phase 3, you may gradually increase the weight so that you manage only 15, and eventually 12, repetitions per set. Always increase the resistance slowly (one step at a time). For optimal benefit, train 2–3 times per week, with at least one rest day between sessions.
Strengthening Home-Exercises
Perform the exercises 3 times each week. Complete 3 sets of 12–15 repetitions for each exercise (exercise 1–9).
Exercise 1 – Wall Squat with Ball (with or without resistance band above the knees)
- Stand leaning against a wall with a ball placed between your back and the wall.
- Your feet should be hip-width apart and pointing forward as much as feels relaxed and comfortable for your starting position.
- If advised, you may use a resistance band around your knees — ask your physio.
- Squat down until your hips are bent to a maximum of 90 degrees.
- Make sure your hip, knee, and toes remain aligned in a straight line throughout the entire movement.
- Return to the starting position by straightening your legs.
Exercise 2 – Standing External Rotation with Resistance Band
- Stand on your non-operated leg with a resistance band placed around both legs, just above your knees.
- Lift your operated leg and rotate your hip and knee outwards, holding the tension for 2–3 seconds.
- Ensure the movement originates from the hip only—do not let your body turn along with the leg.
- Slowly return your leg to the starting position.
- This exercise can be performed effectively with either leg.
Exercise 3 – Single Leg Bridge with Foot on Wall
- Lie on your back with your knees bent at 90–100 degrees and your feet resting with your toes just next to the wall (see picture).
- Keep your operated leg on the floor and place your non-operated leg on the wall.
- Engage your lower abdominal muscles, squeeze your glutes (buttocks) together, and lift your pelvis so the hip extends.
- Lift as high as possible without causing pain.
- Hold this position for 3–5 seconds, then slowly lower back down to the starting position.
- Repeat on both legs if possible.
Exercise 4 – Bird Dog (Diagonal Arm and Leg Lift)
- Start on all fours with your back in a neutral position (without excessive swaying).
- Engage your lower abdominal muscles to stabilise your lower back by tightening these muscles so your stomach lifts slightly towards your inner back.
- Extend one arm and the opposite leg until they are in line with your body.
- Hold for 3–5 seconds, then return to the starting position.
- You can also perform this exercise using just the legs if preferred.
Exercise 5 – Oblique Crunch
- Lie on your back with your knees bent and your hands placed gently behind your ears.
- Engage your lower abdominal muscles to stabilise your lower back.
- Slowly lift your shoulder blades and bring one elbow towards the opposite knee, rotating your torso slightly.
- Lower yourself slowly back to the starting position.
Exercise 6 – Supine Adductor Activation
- Lie on your back with your legs straight and a ball placed between your feet.
- Slowly squeeze your ankles together, pressing the ball firmly, and hold for 3–5 seconds.
- Slowly release the pressure and relax.
Exercise 7 – Standing Hip Flexor Training
- Stand with both hands supported on the back of a chair or on a table edge.
- Keep your lower back stable and straight throughout the exercise.
- Lift the knee of your operated leg towards your chest.
- Slowly lower the leg back down, fully extending the hip after each repetition.
- This exercise can also be performed using a resistance band if preferred.
Exercise 8 – Sideways Walking with Resistance Band
- Stand with a resistance band around your feet, keeping your knees slightly bent.
- Walk sideways while keeping your upper body stable and maintaining your knees and feet pointing forward (make sure they do not rotate).
- Maintain constant tension in the band throughout the exercise. Increase your step width gradually, walking from a wide stance to a wider one. Avoid stepping with your feet coming together.
Exercise 9 – Supine Hip Flexor Stretch