Rehabilitation after hip fracture surgery: getting moving again

The NHS describes three surgical options for a broken hip: fixing the broken bone with screws, nails, rods or plates; replacing part of the joint with an artificial part, called a hemiarthroplasty; or replacing the whole joint. Which one is used depends on the type and position of the break and on the person.

The type of operation shapes the detail of rehabilitation, such as how much weight may be put through the leg early on, so the instructions on your own ward are the ones to follow. In every case the aim is the same: to get you standing and walking again as soon as is safe, because long periods in bed carry their own risks.

Physiotherapy begins soon after surgery. The NHS describes regular sessions to help you start standing and moving again. A typical early session focuses on sitting out of bed, standing with support and taking first steps with a frame or sticks, under supervision.

The NHS says hospital stays are around 1 to 4 weeks. That is a wide range, and the difference usually reflects how well you were before the fall, whether you have other health conditions, and what support is available at home. If you are an older person, relatives often ask about this on your behalf; the ward team should explain what has to be in place before you can leave.

On discharge you are given exercises to carry on at home. The NHS notes some people need help from carers or other health professionals when they return, for example with washing, dressing, shopping or getting up from a chair.

It is reasonable to ask before discharge about equipment such as a raised toilet seat, a perching stool or rails, about who will visit, and how to reach the team if you have a problem. Where the hospital offers early supported discharge or a community rehabilitation team, you may be seen at home rather than on a ward. Availability varies between areas, so ask what applies where you live.

The NHS says healing usually takes several weeks or months and may take longer. It also says plainly that you may never get back the same strength and movement as you had before the break. That honesty is useful: it means the realistic target for many people is regaining safe independent walking and getting back to daily life, not necessarily returning to exactly the previous level.

No official page retrieved for this guide gives a fixed timetable for each milestone, so this guide does not either. Your physiotherapist will set goals that fit your hip, your general health and your home, and adjust them as you progress.

Some people need a walking stick or frame after a hip fracture, as the NHS notes. If an aid is recommended, using it consistently matters more than looking independent, since another fall is the main thing to avoid while the bone and muscles recover.

• Ask your physiotherapist to check that the aid is the right height and that you are using it on the correct side.

• Keep floors clear of loose rugs and trailing cables, and have lighting you can reach from bed.

• Wear secure footwear indoors rather than loose slippers.

• Keep doing the home exercises you were given, as they are designed to rebuild the muscles that keep you steady.

A hip fracture can be a sign that the bones have become fragile. The NHS says people over 50 may be able to use a fracture liaison service, which exists to help prevent further breaks. That can include reviewing bone health, medicines and falls risk, so it is worth asking whether you have been referred.

The NHS lists symptoms that need immediate help. These are written for an injury before surgery, but they are also a reasonable reminder of what a serious hip problem looks like at any stage.

• Severe hip pain after a fall or injury, being unable to walk or put weight on the leg, or tingling or numbness after an injury: call 999 or go to A&E.

• Sudden severe hip pain without an injury, a swollen or hot hip, skin discolouration or a fever with hip pain: seek an urgent GP appointment or call NHS 111.

• If your operation involved replacing part or all of the joint, the NHS hip replacement guidance adds that throbbing or cramping pain in the hip or leg, a high temperature or chills, oozing or pus from the wound, or worsening redness, tenderness or swelling needs an urgent GP appointment or a call to NHS 111. Leg or hip pain and swelling together with difficulty breathing or chest pain is a 999 situation, because it may be a blood clot in the lung.

The NHS lists several complications after a hip replacement that are relevant if you were given a partial or total replacement for your fracture: blood clots, wound infection, a replaced leg that ends up slightly longer, nerve or tissue damage, and dislocation of the new joint. Dislocation is the reason hospitals give movement advice after these operations, such as which positions to avoid. The details differ between surgeons, so rely on the leaflet you were given rather than general rules.