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Pilates for Hip Replacement Rehabilitation: A Global and NHS-Informed Perspective

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For Pilates teachers, understanding the specific needs of clients who have undergone hip replacement surgery is essential. This blog explores global guidelines, with a particular focus on NHS recommendations, to ensure we provide safe and effective rehabilitation practices in the UK.

Understanding Hip Replacements and New Surgical Techniques

Hip replacement surgery, often necessitated by conditions like osteoarthritis, involves replacing a damaged hip joint with an artificial one. Traditionally, lateral (side) approaches were common, but recent advancements have seen the rise of non-lateral approaches like the anterior (front) approach. This method potentially allows for less muscle disruption, potentially leading to a quicker recovery.

Pilates in Rehabilitation

Pilates offers unique benefits for post-hip replacement rehabilitation, including restoring body alignment, strengthening muscles in correct alignment, and improving core strength. It's adaptable to various stages of recovery, making it an ideal method during rehabilitation.

Global Guidelines and Insights

Internationally, Pilates protocols for hip replacement patients recommend modified exercises focusing on core, joint range of motion, and strengthening surrounding muscles. Regular Pilates exercises are crucial for full recovery, enhancing strength, and mobility.

Early Postoperative Exercises

Initially, exercises like ankle pumps and rotations, knee bends, and buttock contractions are advisable. These activities improve circulation, prevent blood clots, and strengthen muscles.

Standing and Walking Exercises

As clients regain strength, standing exercises such as knee raises, hip abduction, and extensions are beneficial. Proper walking is crucial for recovery, with gradual increases in distance and duration.

NHS Guidelines

The NHS provides specific post-surgery precautions for hip replacement patients:

  • Avoid bending the hip beyond a right angle.

  • Avoid twisting the operated leg.

  • Avoid lifting heavy objects.

  • Do not cross legs or ankles.

  • Sit on chairs with arms to assist in standing. These precautions guide Pilates teachers in selecting appropriate exercises and ensuring clients' safety.

UK-Specific Approach

In the UK, Pilates classes typically start around six weeks post-surgery, focusing on low-impact, controlled movements. Teachers should tailor exercises to each client's recovery stage and capabilities, always adhering to healthcare professionals' advice.


As Pilates teachers, we have a vital role in our clients' recovery after hip replacement. By combining global insights with NHS guidelines, we can ensure a safe, effective, and responsive Pilates program that supports clients in regaining strength, mobility, and confidence in their daily activities.


  • Pilates Bridge

  • IDEA Health & Fitness Association

  • PubMed

  • Noah Strength

  • OrthoInfo - AAOS

  • NHS Guidelines on Hip Replacement

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