Hip Fracture Recovery in Older Adults: The Role of Physical Therapy

A hip fracture is a serious injury, especially for older adults, but with the right care and physical therapy, many people recover strength, mobility, and independence. The Physical Therapy Management of Older Adults with Hip Fracture guideline offers evidence‑based recommendations to support your recovery from the hospital through rehabilitation and beyond. 

Why Physical Therapy Matters After a Hip Fracture

After hip fracture surgery, your body needs to rebuild strength, regain balance, and learn safe ways to move again. Physical therapy:

• Starts early to prevent complications

• Helps reduce fall risk and future injuries

• Improves mobility and confidence in everyday activities

Physical therapists work with you and your care team to tailor your plan based on your health and goals.

What to Expect in Physical Therapy

1. Early Movement and Daily Therapy

Getting moving soon after surgery is important. Your therapist will help you with:

• Assisted standing and walking as soon as it’s safe

• Taking steps, transferring from bed to chair, and practicing balance

• Daily therapy while you’re in the hospital or rehab unit

These early steps help prevent complications and build the foundation for recovery.

2. Regular Physical Therapy Sessions

Your therapist will likely work with you daily in the early phase, with exercises and movement training as you can tolerate. This may include:

• Safe walking practice with a walker or cane

• Balance training to improve stability

• Strengthening exercises for legs, hips, and core

Consistent therapy helps you regain confidence and reduces the chance of another fall.

3. Home Exercise Program

As you progress, your therapist will give you exercises to do at home. These help maintain and build strength and mobility between formal sessions and may include:

• Sit‑to‑stand practice

• Heel‑to‑toe walking

• Gentle leg strengthening activities

Doing these regularly supports steady improvements in daily life.

4. Long‑Term Strength, Balance, and Function

Recovery doesn’t end when you leave the hospital. The guideline recommends ongoing care if you still have:

• Weakness

• Difficulty walking

• Balance or mobility problems

This may include outpatient therapy, home health visits, or community exercise programs that focus on strength, balance, and safe movement patterns.

5. Preventing Future Fractures

Physical therapists also work with your healthcare team to address factors that affect bone health and raise the risk of future fractures. This may include:

• Fall‑risk assessment and strategies

• Guidance for osteoporosis screening and treatment

• Safe activity recommendations to stay active and strong 

Tips for Recovery and Independence

✔ Start moving safely as soon as you are medically cleared
✔ Practice exercises every day, even at home
✔ Use assistive devices (walker, cane) as recommended
✔ Ask your therapist questions — your comfort and safety matter
✔ Be patient — recovery is a gradual process

With guided physical therapy, many older adults regain the ability to walk, perform daily activities, and enjoy a higher quality of life after a hip fracture.

Reference

Physical Therapy Management of Older Adults With Hip Fracture Journal of Orthopaedic & Sports Physical Therapy. 2021;51(2):CPG1–CPG81.doi:10.2519/jospt.2021.0301