Pilates For Those With Hip Replacements

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Pilates can be very beneficial for people with hip replacements because it focuses on controlled strength, mobility, and alignment without excessive joint impact. However, exercises should respect post-surgical precautions, especially in the first months after surgery.

Below are key principles and Pilates exercises that are generally safe and helpful.

Important Hip Replacement Precautions

Most surgeons recommend avoiding positions that combine:

  • Deep hip flexion (hip bending past ~90°)

  • Crossing the legs past midline

  • Excessive internal rotation

These precautions vary depending on the surgical approach (posterior vs anterior), so clients should always follow their surgeon’s guidelines.

Benefits of Pilates After Hip Replacement

Pilates can help:

  • Restore hip stability

  • Strengthen glutes and core

  • Improve gait and posture

  • Increase range of motion safely

  • Reduce low back and knee compensation

Safe Pilates Exercises

1. Pelvic Tilts

Goal: Activate core and gently mobilize the pelvis.

How to do it:

  • Lie on your back with knees bent, feet hip-width apart.

  • Gently tilt pelvis to flatten the low back into the mat.

  • Return to neutral.

Benefits:

  • Improves pelvic control and core engagement.

2. Heel Slides

Goal: Gentle hip mobility and control.

How to do it:

  • Lying on your back, slowly slide one heel toward the glutes.

  • Keep pelvis stable.

  • Slide back to start.

Benefits:

  • Restores hip flexion without excessive load.

3. Glute Bridges

Goal: Strengthen glutes and posterior chain.

How to do it:

  • Feet hip-width apart, knees bent.

  • Press through heels and lift hips.

  • Lower slowly.

Benefits:

  • Builds hip stability and supports walking mechanics.

4. Side-Lying Leg Lifts

Goal: Strengthen hip abductors (glute medius).

How to do it:

  • Lie on your side with hips stacked.

  • Lift top leg slightly without rotating pelvis.

  • Lower with control.

Benefits:

  • Improves lateral hip strength and balance.

5. Clamshells

Goal: Strengthen deep hip stabilizers.

How to do it:

  • Side-lying, knees bent.

  • Keep feet together while opening the top knee.

  • Avoid rolling the pelvis back.

Benefits:

  • Targets glute medius and external rotators.

6. Seated Leg Extensions

Goal: Strengthen quads while maintaining hip alignment.

How to do it:

  • Sit tall.

  • Extend one leg straight.

  • Lower slowly.

Benefits:

  • Improves knee stability and walking strength.

Pilates Reformer Options

If using a reformer:

Good choices:

  • Footwork (parallel and small V)

  • Bridging on the carriage

  • Standing side splits (light resistance)

  • Scooter

Avoid early on:

  • Deep frog positions

  • Extreme turnout

  • Short spine / long spine

Goals and Tips 

  • Emphasize neutral pelvis and hip alignment

  • Work in smaller ranges of motion

  • Focus on glute and core activation

  • Avoid over-stretching the hip joint

  • Use props for support when needed




Jupiter Massage and Pilates, LLC

125 W. Indiantown Road Suite#102 Jupiter, FL 33458 
561-529-2093 
www.jupitermassageandpilates.com 


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