Exercises After Hip or Knee Replacement: What Comes After Physical Therapy

You had the surgery. You did the physical therapy. Your surgeon cleared you for activity. And now you're standing in your living room thinking... okay, now what?

If you live in Rancho Mirage or anywhere in the Coachella Valley, chances are you had your procedure done at Eisenhower Health or one of the orthopedic groups in the area. The surgical care out here is excellent. The rehab programs are solid. But there's a gap that nobody really talks about: the space between finishing physical therapy and actually getting back to the kind of life you want to live.

Physical therapy gets you to a baseline. You can walk without pain. You can get in and out of a car. You can go up stairs. That's the goal of PT, and it does that job well. But baseline isn't the same as strong. It's not the same as confident on the golf course, or able to hike with your spouse, or feeling like your body actually works the way it should. That next phase requires something different. It requires progressive strength training with someone who knows what they're doing with post-surgical clients.

Why People Stall After PT Ends

Here's what usually happens. You finish your last PT appointment. The therapist gives you a handout with a few exercises to "keep doing at home." You do them for a week or two. Maybe three. Then life takes over and the sheet ends up in a drawer somewhere. Without accountability, without progression, and without someone watching your form, the momentum dies. Within a few months, you're essentially back where you were before PT started. Not in pain necessarily, but not getting any stronger either.

The other common path is people join a regular gym. They walk on the treadmill. They sit on a few machines. Nobody shows them what to do or checks their form. They don't push hard enough because they're scared of re-injuring themselves. Or they push too hard on the wrong exercises because they don't know any better. Either way, the results are disappointing and they quit.

Neither of those paths works because they're both missing the same thing: a coach who understands your surgical history and knows how to build you back up safely.

What Your Body Actually Needs After Joint Replacement

After a hip or knee replacement, your new joint is mechanically sound. The hardware is solid. But the muscles around that joint have been weakened by months (sometimes years) of compensating for the old, damaged joint. Then the surgery itself requires cutting through muscle tissue, which needs time and targeted work to rebuild. PT addresses the initial healing, but the real strengthening work is a longer process.

For knee replacements, the priorities are rebuilding the quadriceps, hamstrings, and glutes. These muscles control how your knee tracks and absorbs force during walking, stairs, and everything else. Calf strength and ankle stability matter too, because they affect how your entire leg functions from the ground up. You also need to restore full range of motion gradually, especially deep flexion, which takes time and consistent work.

For hip replacements, the focus shifts to the glutes, hip abductors, and deep hip stabilizers. These muscles got weakened and often atrophied before surgery because you were limping, avoiding movement, and favoring your good side. Your core also needs attention because it's been compensating for the unstable hip for a long time. Rebuilding hip extension, rotation, and lateral stability is what gets you moving normally again.

In both cases, balance training is critical. Your proprioception (your body's sense of where it is in space) takes a hit after any major joint surgery. If you don't retrain it deliberately, your fall risk stays elevated even after the joint itself feels fine.

Exercises That Work Well After Joint Replacement

These aren't the only exercises that work, but they're the types of movements that tend to be safe and effective for people 3 to 6 months or more post surgery. Your specific program should be tailored to your surgery type, your surgeon's guidelines, and your current strength level.

Bodyweight squats to a box or chair. This is one of the best exercises for rebuilding knee and hip strength. Sitting down to a controlled depth and standing back up teaches your legs to work together and builds the muscles that matter most. The box gives you a target depth so you don't go too low too fast. As you get stronger, the box gets lower and eventually you can squat without it.

Step-ups. Start with a low step, maybe 4 to 6 inches. Drive through the working leg to step up, control the descent back down. This is real-world functional strength. You step up to curbs, into cars, onto patios. Training the movement with good form makes all of it easier and safer.

Glute bridges. Lying on your back with knees bent, you push your hips toward the ceiling. This targets the glutes without putting stress on the knee or hip joint. Great for hip replacement recovery and for anyone with weak glutes from years of sitting.

Wall sits or isometric holds. Holding a squat position against a wall for 10 to 30 seconds builds muscular endurance in the quads without the stress of repetitive bending. Good option for people who are still early in their post-PT phase and need to build strength before doing full range movements.

Resistance band walks. With a band around your ankles or just above your knees, stepping side to side fires up the hip abductors. These muscles stabilize your pelvis when you walk and are almost always weak after hip surgery.

Single-leg balance holds. Standing on one foot for 20 to 60 seconds sounds simple, but it's one of the most important exercises for fall prevention and proprioceptive retraining. You can progress to doing it on an unstable surface or with your eyes closed as you improve.

Upper body pressing and pulling. Don't neglect your upper body just because your surgery was in your lower half. Chest press, rows, overhead press, and pulldowns all help with overall functional strength and keep your training balanced. Plus, being stronger in your arms and shoulders makes it easier to push yourself up from a chair or catch yourself if you stumble.

What to Avoid (At Least Early On)

High-impact activities like running, jumping, and plyometrics are generally not recommended after joint replacement, especially in the first year. Your new joint has a lifespan, and excessive impact can shorten it. That doesn't mean you can't be active. It means you choose smarter exercises that build strength without pounding the joint.

Deep lunges and heavy loaded squats should be approached carefully and only with proper coaching. Deep knee bends past 90 degrees can be risky for some knee replacement patients, depending on the type of implant and your surgeon's guidelines. Same with hip flexion past a certain point after hip replacement. Your trainer needs to know these specifics.

Machines that lock you into a fixed path of motion can sometimes be a problem because they don't allow your body to move naturally around the new joint. Free weights and cable machines tend to give you more freedom to adjust your movement pattern, which is usually better for post-surgical training.

What to Look for in a Post-Surgical Trainer

Not every personal trainer is equipped to work with someone after a joint replacement. You want someone who has actual experience with post-surgical clients, not just a certification they got online. Ask how many clients they've worked with after hip or knee replacement. Ask what they would do differently for a hip replacement versus a knee replacement. If they can't give you specific answers, keep looking.

You also want a trainer who will communicate with your surgeon or physical therapist if needed. A good trainer isn't trying to replace your medical team. They're trying to continue the work your medical team started. That means respecting precautions, understanding timelines, and knowing when to progress and when to hold back.

Small group settings tend to work well for this population because you still get personalized attention from your coach while training alongside other people who understand what it's like to work around limitations. There's something motivating about seeing someone else your age pushing through the same kind of recovery and getting stronger week after week.

The Cost of Doing Nothing

Here's the part nobody wants to hear. If you finish physical therapy and then do nothing, the muscles around your new joint will continue to weaken. Your balance will stay compromised. Your risk of falling stays elevated. And the surgery that was supposed to give you your life back ends up just keeping you at the same limited level you were at before.

We see this a lot with people who come to our Rancho Mirage area studio six months or a year after surgery. They're frustrated because they expected to feel better than they do. The joint is fine. The problem is that nobody helped them rebuild the strength around it. Once they start training consistently, the difference shows up fast. Within a few weeks they're walking better, sleeping better, and doing things they hadn't done in years.

Where Rancho Mirage and Coachella Valley Residents Can Train After Surgery

If you live in Rancho Mirage, Palm Desert, Indian Wells, or anywhere in the valley and you're looking for a gym that actually understands post-surgical training, we built Strong Republic for exactly this. Our trainers work with clients recovering from hip replacements, knee replacements, rotator cuff repairs, and spinal procedures every single week. Sessions are capped at six people so your coach can watch your form on every rep. And everything is modified to your body, your surgery, and your surgeon's guidelines.

Our 14-Day Jump Start is a good way to try it out without a long commitment. You'll get 4 to 6 coached sessions, meet your trainer, talk through your surgical history and goals, and experience what a session feels like before deciding if it's the right fit.

We also offer stretch therapy for post-surgical stiffness and mobility work, nutrition coaching to support recovery, and training programs specifically for women dealing with bone density concerns alongside their joint recovery.

If you're still weighing your options, take a look at our guide on the best fitness options for adults over 50 in Rancho Mirage. It breaks down the different choices available out here so you can figure out what makes sense for your situation.

The surgery was the hard part. The rehab was the boring part. Now comes the part where you actually get your strength and your life back. Don't let this phase slip through the cracks. It's the one that makes all the difference.