Rehab after hip fracture surgery starts in the hospital, usually the day after the operation, and often continues in a rehab facility or at home before outpatient therapy. Outpatient work focuses on walking with less support, getting up from low chairs and the floor, stairs, balance and lowering the risk of another fall, which is the reason many families seek it out. Once the person recovering can manage the car trip, the matching team can propose an independent, licensed therapist who works one-on-one in a quiet private suite in Carmel.
Last reviewed By the Monon Therapy Collective editorial team
- Surgery timing
- Often within 24 to 48 hours of the break (AAOS)
- First walk
- Most people get up the day after surgery
- Hospital stays
- Nearly 319,000 older adults a year in the US (CDC)
- Main cause
- Falls (CDC)
Where does outpatient therapy fit in hip fracture recovery?
Outpatient therapy usually comes last, after the hospital stay and a period of inpatient rehab, skilled nursing or home health therapy. You are typically ready for it when you can get in and out of a car safely and tolerate the trip and a session of exercise.
OrthoInfo describes the earlier steps: surgery as soon as possible, often within 24 to 48 hours, and getting out of bed with therapy the day after surgery to reduce the risk of blood clots, pneumonia and pressure sores. Some people go home with in-home therapy; others stay in a rehab facility until they can walk and manage daily tasks safely. Our answer on home health versus outpatient therapy explains the handover.
The CDC reports that nearly 319,000 older people are hospitalized for hip fractures each year and that falls cause 88 percent of those hospital stays. That is why outpatient rehab after a hip fracture is as much about the next fall as about the broken bone.
How does walking progress after a fractured hip is repaired?
Walking usually progresses from a walker, to a cane, to no aid indoors, then to longer distances and uneven ground outdoors. How quickly depends on the fracture, the repair, your strength and health before the fall, and how you tolerate exercise.
| Time after surgery | Goals | Typical milestones |
|---|---|---|
| Days 1 to 5 | Get up safely, prevent complications | Standing and walking with a walker in the hospital; bed and toilet transfers |
| Weeks 1 to 4 | Independence at home | Inpatient rehab, skilled nursing or home health therapy; walker around the house; stairs if needed |
| Weeks 4 to 12 | Less support, more strength | Outpatient therapy often starts; cane or no aid indoors; hip and thigh strengthening; balance training |
| 3 to 6 months | Community walking and confidence | Longer walks, curbs and ramps; getting up from the floor; errands without help |
| 6 to 12 months | Return to prior level where possible | Strength and balance keep improving; recovery speed varies a great deal |
What does a hip fracture rehab session work on once you are walking?
It works on the strength, balance and skills that keep you independent: standing up from low seats, walking with a steady stride, turning, stepping over things, climbing stairs and curbs, and getting down to and up from the floor. Hip abductor strength, the muscles on the side of the hip that hold the pelvis level, is a common focus.
In a private suite, your therapist can use the rack uprights as a stable handhold for balance work, a bench at a set height for sit-to-stand practice, and the cable system for light hip strengthening. The sit-to-stand exercise and the single-leg balance exercise show two common building blocks, but your therapist sets the dose.
Many people lose confidence after a fall and start avoiding walking, which weakens them further. A therapist can address fear of falling directly, with graded practice and clear tests you can watch improve, such as how many chair stands you complete in 30 seconds.
- Chair stands from a gradually lower height
- Side-stepping and hip strengthening with light resistance
- Walking practice with turns, stops and head movements
- Curb and stair practice with a rail
- Floor transfers: how to get up safely if you fall
Is prehab possible before hip fracture surgery, and what helps instead?
Prehab is not realistic before hip fracture surgery, because the operation is an urgent repair done within a day or two of the break. What helps instead is the strength and fitness you had before the fall, and early movement afterward: sitting up, standing and walking with help as soon as the team allows.
If you or a parent are at higher risk of a fracture, the time to build strength is now. Lower-body strength, balance practice and a review of fall hazards reduce risk, and our page on physical therapy for seniors explains how that work is usually structured. After a first hip fracture, the same work becomes protection against a second one.
Nutrition and bone health belong in the picture too. Your doctor may check vitamin D, calcium intake and bone density, and may suggest medicine for osteoporosis. A therapist adds weight-bearing and strength exercise matched to what your bones and balance can tolerate.
What do the surgeon and other doctors decide after hip fracture surgery?
The surgeon decides how much weight you may put through the leg and any movement precautions. OrthoInfo notes that after a hip replacement for a fracture you can usually bear weight fully right away, while after fixation with screws, a nail or a plate your surgeon gives specific limits.
Your primary care doctor manages medicines, blood clot prevention and bone health. Asking about a bone density test and osteoporosis treatment after a hip fracture is worthwhile. For Medicare patients, a physician or qualified provider must certify the outpatient therapy plan of care, and the therapist’s office handles that paperwork.
A therapist may notice problems that need a doctor, such as dizziness on standing, new confusion or wound changes, and will refer you back promptly. Our page on balance and fall prevention therapy describes the fall-risk side in more depth.
How can family members help with hip fracture rehab at home?
Family help most by making the home safer and by encouraging regular, safe walking rather than doing everything for the person recovering. Clear walkways, add nightlights and grab bars, remove loose rugs, and make sure shoes fit well and grip.
Indiana winters raise the stakes: ice on driveways and parking lots is a common hazard, and our guide to preventing falls on winter ice has practical tips. A family member is welcome to complete the two-minute questionnaire with the person who had surgery. Garage parking at Carmel City Center is a short walk from the suites, so ask the matching team about the route if walking distance is still limited.
Get medical help quickly after hip fracture surgery if you notice
- Sudden shortness of breath or chest pain (call 911)
- Calf pain, swelling or warmth in either leg
- New confusion, fever, or redness and drainage at the wound
- A sudden increase in hip pain, a leg that looks shorter or turned, or inability to bear weight
If you think it is an emergency, call 911.
