Hip Fracture Rehabilitation.
What is a hip fracture?
A hip fracture is a break in the upper portion of the femur — the thigh bone — near the hip joint. It is one of the most serious injuries affecting older adults, carrying significant implications for independence, quality of life and survival. Every day, more than 40 Australians break their hip. Most are over the age of 65, and hip fractures represent a significant problem for older people, the hospital system and the community as a whole because of the increasing numbers of fractures and the cost of hospitalisation and ongoing care.
The mortality statistics associated with hip fracture are sobering — approximately 20 to 30% of patients die within twelve months of a hip fracture, and of those who survive, only around half return to their pre-fracture level of function. These outcomes are not inevitable, however. The quality and intensity of rehabilitation — from the acute hospital phase through to community-based physiotherapy — is one of the most significant modifiable determinants of outcome after hip fracture. Early, frequent and mobilisation-focused physiotherapy significantly improves discharge outcomes after hip fracture surgery.
Types of hip fractures
Hip fractures are classified by their anatomical location, which determines both the surgical approach and the rehabilitation implications.
Intracapsular fractures — inside the hip joint capsule — include femoral neck fractures and subcapital fractures. These fractures disrupt the blood supply to the femoral head, carrying a risk of avascular necrosis (death of the femoral head from loss of blood supply). Depending on the patient's age, activity level and fracture displacement, they are managed either with internal fixation (preserving the femoral head) or hemiarthroplasty / total hip replacement (replacing the femoral head). For more detail on the surgical fixation pathway, see our neck of femur fracture fixation page.
Extracapsular fractures — outside the joint capsule — include intertrochanteric and subtrochanteric fractures. These fractures do not disrupt the femoral head blood supply and are managed with internal fixation using intramedullary nails or sliding hip screws. They generally carry a better prognosis for bone healing than intracapsular fractures.
Stress fractures of the hip — fatigue fractures from repetitive loading rather than acute trauma — occur in younger athletic populations (runners, military recruits) and in older adults with osteoporosis. They are managed conservatively in incomplete fractures but may require surgical fixation if complete or at risk of displacement.
Why is physiotherapy critical after hip fracture?
The consequences of immobility after hip fracture are severe and compound rapidly in older adults. Deconditioning, pressure injuries, deep vein thrombosis, pneumonia, delirium, and loss of bone density from non-weight-bearing all develop within days of immobilisation. Early mobilisation — getting patients out of bed and onto their feet as soon as medically safe after surgery — is one of the most evidence-based interventions in hip fracture management and the primary physiotherapy priority in the acute hospital phase.
In the community rehabilitation phase — which is where Articulate's involvement typically begins — the goals shift toward restoring the strength, balance, confidence and functional independence that determine whether the patient returns to their prior living situation and activity level.
Physiotherapy following hip fracture plays a crucial role covering pain management to enable participation in rehabilitation, improving mobility and hip range of motion, strengthening the hip and core muscles to provide stability and prevent future falls, balance and coordination training, and education on the healing process, expected recovery and fall prevention. Every individual's situation is unique, requiring a personalised rehabilitation plan.
What does rehabilitation involve?
In the acute hospital phase — typically five to seven days post-operatively — physiotherapy begins the day of or day after surgery. The immediate priority is safe mobilisation: assisted standing, walking with appropriate aids, and teaching safe transfers. Breathing exercises reduce the risk of post-operative pneumonia. Hip precautions — which vary depending on the surgical approach used — are taught and reinforced.
In the subacute and community rehabilitation phase, the pace of recovery depends on the patient's pre-fracture functional level, cognitive status, bone quality and surgical fixation. Progressive gait training — moving from a walking frame through to a cane and eventually unaided walking — is the primary functional rehabilitation goal. Quadriceps and gluteal strengthening, hip abductor strengthening and hip flexor reactivation systematically rebuild the lower limb strength needed for safe independent function.
Balance rehabilitation is as important as strength in hip fracture rehabilitation — the fall that caused the fracture reflected pre-existing balance and reaction time deficits, and these must be addressed if the fracture risk is to be meaningfully reduced. Progressive balance training, reaction time work and home environment hazard reduction all contribute to falls prevention.
Falls prevention is a central clinical goal. Physiotherapists guide patients through specific exercises to strengthen muscles vital for stability and preventing future falls, and provide postural education to prevent undue stress on the healing hip. Our Balance and Bones exercise classes are specifically designed for older adults managing falls risk and bone health — they provide ongoing supervised exercise maintenance after the formal rehabilitation period ends.
Bone health management — adequate calcium and vitamin D, GP review of bone density and medication, and appropriate weight-bearing exercise — is an essential parallel goal. A hip fracture is the most significant clinical indicator of osteoporosis-related bone fragility, and without addressing the underlying bone health, the risk of a further fracture remains elevated.
For patients recovering from hip fracture in a residential aged care setting, telehealth physiotherapy is available for home exercise program progression and review.
Our physiotherapists Bethany Kippen and Emma Cameron and Exercise Physiologist Ash O'Regan all have experience in older adult rehabilitation and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
A hip fracture is a break in the upper portion of the femur — the thigh bone — near the hip joint. It is one of the most serious injuries affecting older adults, carrying significant implications for independence, quality of life and survival. Every day, more than 40 Australians break their hip. Most are over the age of 65, and hip fractures represent a significant problem for older people, the hospital system and the community as a whole because of the increasing numbers of fractures and the cost of hospitalisation and ongoing care.
The mortality statistics associated with hip fracture are sobering — approximately 20 to 30% of patients die within twelve months of a hip fracture, and of those who survive, only around half return to their pre-fracture level of function. These outcomes are not inevitable, however. The quality and intensity of rehabilitation — from the acute hospital phase through to community-based physiotherapy — is one of the most significant modifiable determinants of outcome after hip fracture. Early, frequent and mobilisation-focused physiotherapy significantly improves discharge outcomes after hip fracture surgery.
Types of hip fractures
Hip fractures are classified by their anatomical location, which determines both the surgical approach and the rehabilitation implications.
Intracapsular fractures — inside the hip joint capsule — include femoral neck fractures and subcapital fractures. These fractures disrupt the blood supply to the femoral head, carrying a risk of avascular necrosis (death of the femoral head from loss of blood supply). Depending on the patient's age, activity level and fracture displacement, they are managed either with internal fixation (preserving the femoral head) or hemiarthroplasty / total hip replacement (replacing the femoral head). For more detail on the surgical fixation pathway, see our neck of femur fracture fixation page.
Extracapsular fractures — outside the joint capsule — include intertrochanteric and subtrochanteric fractures. These fractures do not disrupt the femoral head blood supply and are managed with internal fixation using intramedullary nails or sliding hip screws. They generally carry a better prognosis for bone healing than intracapsular fractures.
Stress fractures of the hip — fatigue fractures from repetitive loading rather than acute trauma — occur in younger athletic populations (runners, military recruits) and in older adults with osteoporosis. They are managed conservatively in incomplete fractures but may require surgical fixation if complete or at risk of displacement.
Why is physiotherapy critical after hip fracture?
The consequences of immobility after hip fracture are severe and compound rapidly in older adults. Deconditioning, pressure injuries, deep vein thrombosis, pneumonia, delirium, and loss of bone density from non-weight-bearing all develop within days of immobilisation. Early mobilisation — getting patients out of bed and onto their feet as soon as medically safe after surgery — is one of the most evidence-based interventions in hip fracture management and the primary physiotherapy priority in the acute hospital phase.
In the community rehabilitation phase — which is where Articulate's involvement typically begins — the goals shift toward restoring the strength, balance, confidence and functional independence that determine whether the patient returns to their prior living situation and activity level.
Physiotherapy following hip fracture plays a crucial role covering pain management to enable participation in rehabilitation, improving mobility and hip range of motion, strengthening the hip and core muscles to provide stability and prevent future falls, balance and coordination training, and education on the healing process, expected recovery and fall prevention. Every individual's situation is unique, requiring a personalised rehabilitation plan.
What does rehabilitation involve?
In the acute hospital phase — typically five to seven days post-operatively — physiotherapy begins the day of or day after surgery. The immediate priority is safe mobilisation: assisted standing, walking with appropriate aids, and teaching safe transfers. Breathing exercises reduce the risk of post-operative pneumonia. Hip precautions — which vary depending on the surgical approach used — are taught and reinforced.
In the subacute and community rehabilitation phase, the pace of recovery depends on the patient's pre-fracture functional level, cognitive status, bone quality and surgical fixation. Progressive gait training — moving from a walking frame through to a cane and eventually unaided walking — is the primary functional rehabilitation goal. Quadriceps and gluteal strengthening, hip abductor strengthening and hip flexor reactivation systematically rebuild the lower limb strength needed for safe independent function.
Balance rehabilitation is as important as strength in hip fracture rehabilitation — the fall that caused the fracture reflected pre-existing balance and reaction time deficits, and these must be addressed if the fracture risk is to be meaningfully reduced. Progressive balance training, reaction time work and home environment hazard reduction all contribute to falls prevention.
Falls prevention is a central clinical goal. Physiotherapists guide patients through specific exercises to strengthen muscles vital for stability and preventing future falls, and provide postural education to prevent undue stress on the healing hip. Our Balance and Bones exercise classes are specifically designed for older adults managing falls risk and bone health — they provide ongoing supervised exercise maintenance after the formal rehabilitation period ends.
Bone health management — adequate calcium and vitamin D, GP review of bone density and medication, and appropriate weight-bearing exercise — is an essential parallel goal. A hip fracture is the most significant clinical indicator of osteoporosis-related bone fragility, and without addressing the underlying bone health, the risk of a further fracture remains elevated.
For patients recovering from hip fracture in a residential aged care setting, telehealth physiotherapy is available for home exercise program progression and review.
Our physiotherapists Bethany Kippen and Emma Cameron and Exercise Physiologist Ash O'Regan all have experience in older adult rehabilitation and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
