020 - Hypertrophy Training After Total Hip Replacement: Building Strength, Not Just “Recovering”.
Hypertrophy After a Hip Replacement? It’s Not Just Possible—It’s Necessary.
Total hip replacements are no longer just for retirees.
Younger, more active individuals are getting them, and they’re not just trying to walk without pain. They want to get back under the bar, back to the field, and back to life. That means muscle regrowth matters. And standard rehab protocols? They’re not cutting it.
This new literature review breaks down 16 studies on hypertrophy-based training after total hip arthroplasty (THA) and makes one thing clear:
Progressive resistance training (PRT) is key if you want strength, function, and longevity post-op
Key Takeaways You Can Use
No “gold standard” exists yet, but successful programs share common traits.
Compound lifts like leg press, hip abduction, and knee extension were consistently used across studies.
Strength gains were reported in 13 of 16 studies—especially when 1RM testing was used to guide load.
Supervised training outperformed home programs. Period.
Intensity matters: 60–90% of 1RM, 8–12 reps per set is the sweet spot.
Longer programs (12+ weeks) produced better results than short-term fixes.
Some protocols stacked NMES (neuromuscular electrical stimulation) on top of lifting for added benefit.
The Data-Proven Red Flags for Re-Injury
Poor movement & balance scores (Y-Balance, Functional Movement Screen, Triple Hop Test).
Slower 2-mile run times—each extra minute = higher injury risk.
Asymmetries in ankle dorsiflexion & weight-carrying ability.
Pain during movement assessments.
Higher BMI, smoking, & prior deployments = increased risk.
Tactical Application:
Rehab isn’t just about getting out of pain, it’s about rebuilding function and load tolerance.
That means hypertrophy work isn’t optional, it’s essential!
3 Actionable Steps:
Progress the Load Intelligently
Use 1RM-based metrics and gradually increase intensity. This isn’t “3 sets of 10 forever” rehab.
Supervise the Process When You Can
Patients make faster gains with coaching and accountability.
Think Long-Term
12+ weeks. Not 4. Not 6. Muscle takes time. Stay consistent.
Stay Thick.
Bull T, Erzen A, O'Donnell J, et al. Hypertrophy Training Following A Total Hip Replacement: A Literature Review. Int J Sports Phys Ther. 2024;19(3):337-350. Published 2024 Mar 2. doi:10.26603/001c.93075