What to Know about Running After Hip Replacement

If you’re considering or planning to have a total hip replacement, you might think your running career is over. But it doesn’t have to be. While most people believe they won’t be allowed to return to running, that’s not necessarily the case. 

“This has been an area of controversy for many years and continues to be controversial,” says Edwin Su, MD, an orthopedic surgeon at HSS. “With the prior generation of implants, there was a link between high-impact activity and speeding up deterioration of the hardware. However, with the newer materials being used today, the evidence is less conclusive.”

Currently, there are no standardized surgical recommendations for when or if patients can return to high-impact activities after a total hip replacement, so it’s up to each individual surgeon to make their own recommendations. “But several surgeons—including me—are confident enough in today’s materials to support their patients’ return to high-impact activities like running,” says Dr. Su. That being said, other surgeons still feel that high-impact activity might damage the artificial hip and don’t endorse a return to them. 

Return to Running Safely after Hip Replacement

If your surgeon allows you to get back to running, it’s important that you start slowly and safely—and at the right time. When that can occur is determined by a combination of how far out you are from surgery as well as your muscle strength, flexibility, balance and coordination, says Dr. Su. 

“In general, it will take close to six months for the bone to heal to the implant, although some patients can achieve it a bit earlier,” says Dr. Su. While there’s no particular test that you or your doctor can perform to be sure you’re ready, Dr. Su says the strength and flexibility of the leg with the artificial hip should be at least 80% of the other leg.

“We’re testing some wearable sensors that measure symmetry of loading of the legs, which means how much weight each leg bears,” he says. “We feel that when the operated leg is within 10% symmetry of the other leg, the patient is ready to begin running.”

How to Prepare for Running after Hip Replacement

To prepare your body, make sure to strengthen your gluteal muscles, including the gluteus maximus, medius and minimus, all of which are crucial to help absorb the weight placed on the leg and stabilize the pelvis while running. Strong quadriceps and hamstring muscles are also important, as they help support the hip and knee joints, to prevent buckling with impact activity. (Think exercises like squats, deadlifts, lunges, hip bridges and clamshells.)

When you do get onto the road (or treadmill), always start slowly. Make sure you warm up and do some dynamic stretches to prime your body and mind. Then start with easy intervals. Don’t set a mileage goal for running immediately. “I recommend you start with a minute of jogging on a soft surface and then walking for a minute or two,” says Dr. Su. As you get stronger and feel more comfortable, you can increase the jogging intervals and shorten the walking recoveries.  

Doing static stretches after running is more important than ever after a hip replacement to prevent inflammation. Dr. Su says stretching the muscles around the iliotibial (IT) band (a wide strip of tissue that runs from just above the hip down the outside of the thigh, attaching just below the knee) is particularly important, as it’s susceptible to inflammation when you run. Standing IT band stretches, supine IT band crossovers and seated figure-four stretches are especially useful here.

Cross-training is also important for runners after a total hip replacement, to prevent overuse injuries from the repetitive motion and all the pounding. Plus, targeting different muscles, tendons and ligaments will help you improve your overall fitness level and enhance your running performance.

When to Call Your Doctor

If you feel any pain in the hip joint, buttock or thigh, stop running immediately. Remember, there’s a difference between soreness and pain. “In general, pain will be a more significant, sharp sensation that doesn’t feel muscular,” says Dr. Su. Never run through pain. If the sting disappears within a day or two, you can return to running. However, if the ache persists or has created a limp while walking, give your surgeon a call immediately.

In general, most people who have had a total hip replacement should follow up with their surgeon every five years or so, but people who run regularly should check in every two to three years. “It’s like bringing your car in for inspection. The more miles you drive it, the more often it needs to be checked,” says Dr. Su.