Hip Fracture Recovery at Home: A Week-by-Week Physiotherapy Guide

Hip fracture recovery at home usually takes several weeks to a few months. It happens in stages: safe transfers and short walks first, then stairs and gentle strengthening, then balance and confidence. How quickly your parent moves through those stages depends on their operation and general health, so the surgeon's and hospital team's instructions always come first.

If your mum or dad has just come home after surgery for a broken hip, you may feel relieved and worried at the same time. That is normal. This guide, written by a physiotherapist, shows what to expect and when to ask for help. The timings are typical ranges, not promises.

How a hip fracture differs from a planned hip replacement

A hip fracture is an emergency. A planned hip replacement is not. That changes recovery in several ways.

• The bone has to heal. The surgeon may fix the break with screws, nails or a plate, or replace part or all of the hip joint. The NHS says a broken hip usually takes several weeks or months to heal, and sometimes longer.
• There was no time to prepare. People having planned surgery can get stronger and set up their home first. Your parent went from a fall to an operation to a hospital stay very quickly. The NHS says most people spend around 1 to 4 weeks in hospital.
• Age and other health problems matter more. Other conditions, and days in bed, can leave people weak and tired. Some feel confused after surgery. Tell the team if this carries on at home.
• The rules can be different. Some operations come with movement precautions, such as not bending the hip past 90 degrees. Others do not. Ask for written instructions. If your parent had a joint replacement, our guide to bending safely after a hip replacement explains the usual principles.

The good news is that hospital teams aim to get people moving early. NICE guidance says people should have a physiotherapy assessment and be helped to move on the day after surgery, unless there is a medical reason not to.

The first two weeks at home

Getting up and down (transfers)

• Use a firm, higher chair with arms. Low, soft sofas make standing much harder. A firm cushion can help.
• To stand, shuffle to the edge of the seat, put both feet flat and push up through the armrests. Do not pull up on the walking frame. It can tip.
• To sit, back up until the legs touch the chair, reach back for the armrests and lower slowly.
• Use a raised toilet seat or a toilet frame if the hospital team suggests one.
• Have someone close by for the first few days.

Walking aid

Use the frame or sticks the hospital physiotherapist chose. Take short walks around the house every hour or two while awake, with rests in between. Check your weight-bearing instructions. Many people are told they can put weight through the leg as comfort allows, but not everyone, so ask. Wear supportive, closed-back shoes. Remove loose rugs and trailing cables.

Pain

Take painkillers regularly, as prescribed. Do not wait until the pain is bad, especially before walking or exercises. Pain makes people stop moving, and moving is part of getting better. Some strong painkillers cause constipation or drowsiness, so tell the GP or pharmacist. Bruising and swelling in the thigh are common.

The wound

Keep it clean and dry. Follow the hospital's advice about dressings and when stitches or clips come out. Do not put creams on it unless you are told to. Check it every day. Our red flags box below lists what to look for.

Sleeping

Use a firm bed that is not too low. Only use pillows between the knees, or sleep on one side, if your surgical team has said so. Keep a commode or a clear, lit path to the toilet close by. Rest in the daytime if you need to, but try not to stay in bed all day.

Gentle exercises

Do these two to three times a day, within any precautions you have been given:

• Ankle pumps: move the foot up and down, 10 times, every hour or so. This helps blood flow.
• Thigh squeezes: press the back of the knee into the bed and hold for 5 seconds. Repeat 10 times.
• Buttock squeezes: squeeze and hold for 5 seconds. Repeat 10 times.
• Heel slides: slide the heel gently towards your bottom and back. Repeat 10 times, only as far as is comfortable.

A mild ache is fine. Sharp pain means stop and rest.

Weeks 2 to 6: walking further, stairs and gentle strengthening

In this phase, many people find pain easing and the wound settling. You may feel stronger, but tiredness often hangs around.

Walking further. Add a little each day: from room to room, to the garden, then to the end of the road. Stop for rests. Keep the same walking aid until a physiotherapist says it is safe to change.

Stairs. The usual rule is "up with the good, down with the bad". Going up, lead with the stronger leg. Going down, lead with the operated leg. Hold the rail, go one step at a time and have someone with you. If stairs feel unsafe, stay on one floor for now. Our guide to navigating stairs safely after joint replacement has more tips.

Hip fracture physiotherapy exercises. Stand at a sturdy worktop and hold on. Do each exercise 8 to 10 times, once or twice a day:

• Sit-to-stand: stand up from a firm chair and sit down slowly.
• Marching on the spot: lift one knee a little, then the other.
• Side leg lift: stand tall and move the leg out to the side. Do not lean.
• Leg back: move the leg gently behind you, keeping your back straight.
• Heel raises: rise up onto your toes, then lower slowly.

Check-ups and mood. Keep every follow-up appointment, as the team may check how the bone is healing. Feeling low is common, so speak to the GP if it lasts.

Some families like extra help now. A post-surgical home assessment lets a physiotherapist check the home, walking aid and exercises in person.

Weeks 6 to 12: strength, balance, confidence and outdoors

Typical progress here is a lighter walking aid, longer walks and better balance. Some people use a stick, and some need a frame for longer. Please do not compare your parent with anyone else.

Strength. Build up the sit-to-stand exercise to 10 to 15 repeats, using the hands less. Try low step-ups holding a rail. The NHS recommends that older adults do activities for strength, balance and flexibility on at least 2 days a week, if their health allows it.

Balance. Always stand at a worktop with a hand close by. Try these:

• Feet together for 20 to 30 seconds.
• One foot slightly in front of the other (as if on a tightrope).
• Shifting weight slowly from side to side.
• Holding on lightly while standing on one leg.

Outdoors. Practise in daylight on dry days. Start with short trips, then work on kerbs, slopes, uneven paths and getting in and out of a car. Build up to the shops. If your parent is scared to go out, our guide to post-fall anxiety can help. Ask the surgeon before driving.

Beyond 3 months

Recovery does not have a fixed end date. The NHS notes that you may never get back the same strength and movement as before the break, and you may need a stick or frame. That is not failure. It is a good reason to keep the exercises going.

• Keep up strength and balance work at least twice a week. Local classes, such as tai chi, can help.
• Set goals that matter, like a walk to the café.
• Book a physiotherapy review if progress stalls, or if there is a new limp, new pain, or a leg that looks shorter or turned out. Contact the surgical team or GP about these.

Preventing the next fall

A hip fracture is a warning sign. The aim now is to lower the chance of another fall. NICE guidance on falls recommends a falls assessment and a progressive exercise programme tailored to the person. Our falls prevention for older people page explains how we can help.

Bone health. A hip break after a small fall can be a sign of fragile bones (osteoporosis). Ask the GP or hospital team whether your parent needs a bone health check, treatment, or calcium and vitamin D. The NHS osteoporosis page explains more.

Home hazards.

• Remove loose rugs, clutter and trailing wires.
• Add night lights and good lighting on the stairs.
• Fit grab rails by the toilet and in the shower, with a non-slip mat.
• Keep everyday items between waist and shoulder height.
• Choose supportive shoes, not loose slippers.

Other causes. Ask about eyesight, dizziness and a medicines review. The NHS falls prevention advice also mentions checking medicines that affect balance.

Fear of falling. It makes sense after a fall. But avoiding activity makes legs weaker, which raises the risk. Small steps, done often, rebuild trust in the body.

How family can help

• Be around early on. The first week or two is the hardest. Help with meals, shopping, medicines and lifts to appointments.
• Help, but do not take over. Stand beside your parent, not in front. Never pull on an arm to help them up.
• Make a simple daily plan. A tick chart of walks and exercises on the fridge keeps things on track.
• Keep a phone within reach. Think about a pendant alarm too.
• Watch for changes. Notice new confusion, low mood, eating less, or changes to the wound.
• Look after yourself. Carers need rest and support too.

⚠️ Red flags: when to call the GP, 111 or 999

Call 999 or go to A&E if:

• There is sudden chest pain, trouble breathing or coughing up blood. This could be a blood clot in the lung.
• The face droops, an arm is weak or speech is slurred (possible stroke).
• Your parent has had a fall with severe new hip pain, cannot bear weight, or the leg looks shorter or twisted.
• They collapse, are very hard to wake, or are suddenly and severely confused.
• Bleeding will not stop.

Call NHS 111 (or the GP the same day) if:

• The wound has spreading redness, heat, swelling, pus, a bad smell, or opens up.
• There is a high temperature, or shivering.
• One calf or thigh is swollen, painful, warm or red. The NHS lists these as signs of a blood clot (DVT).
• Pain suddenly gets worse or painkillers are not working.
• Confusion or drowsiness is new or getting worse.

Call the GP (within a few days) about:

• Constipation, loss of appetite, or weight loss.
• Low mood, poor sleep or dizziness on standing.
• More falls or near-falls.
• Questions about medicines or bone health.

If you are unsure, call 111. If it feels like an emergency, call 999.

Ready for expert help at home? Book a post-surgical home assessment. The cost is £90 for 60 minutes, and no GP referral is needed.

This guide is general information, not personal medical advice. Always follow the instructions from your surgeon and hospital team.