A total hip replacement will always require extensive physical therapy that includes range of motion exercises to stabilize the hip joints. Once you have medical clearance to progress to exercise in a gym, do so by implementing a very gradual program that might include biking and using exercise machines that will work the supporting muscles to stabilize the hip joints.
Exercise Bicycle
Biking on an exercise bike at the gym is appropriate for most people after they have had some physical therapy after a hip replacement. According to the American Association of Orthopaedic Surgeons, it is best to begin by pedaling backwards for a few minutes as this will be easier. They recommend pedaling forward once you can do so without any discomfort. Once you are able, pedal forward 10 to 15 minutes twice a day to start. Build up to 20 to 30 minutes, three to four times a week. This range of motion exercise is healthy for both the hip and knee joints and works all the support muscles of both of these joints.
Standing Hip Extension
Once you are able to comfortably walk up and down stairs and ride an exercise bicycle, you can carefully proceed to the standing hip extension machine. Select no weight or a very light weight, such as 10 lbs., and adjust the knee pad so that it is at the level of your hip. Stand on your left foot as you carefully drape your bent right knee over the knee rest. Holding the hand grips on your sides, move your right knee from the 90-degree angle down until it is alongside the left knee of your standing leg. Do eight to 12 reps slowly. Repeat to the other side. This exercise strengthens the hamstrings at the back of the thighs and gluteus maximus of the hips. The range of motion is hip extension.
Standing Hip Abduction
Use the same exercise machine to do standing single hip abduction. Again select no or very little weight. For standing hip abduction, lower the padded arm of the machine so it about 30 to 35 degrees below your waist so it is near your lower shin. Standing on your left foot, carefully cross your right ankle over the padded arm and, holding the hand grips at your sides, move your right leg to the right --- an action of hip abduction. Slowly do eight to 12 reps. Repeat to the other side.
Hip Adduction Machine
For standing hip adduction, change the setting so the padded arm of the machine is at about 20 to 25 degrees below your waist. Perform hip adduction by standing on one leg. Drape the opposite leg over the machine arm. and this time move your leg towards the midline of your body for hip adduction. Do eight to 12 reps on each side. Doing gentle hip adduction works the inner adductor muscles of the inner thighs to improve hip joint stability.
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