Returning to sport after a replacement

The usual framework is to separate activities into low-impact (walking, swimming, cycling, golf, hiking on reasonable terrain), moderate-impact (doubles tennis, downhill skiing for experienced skiers, cross-country skiing), and high-impact (running, basketball, singles tennis, contact sports). Low-impact activities are generally encouraged and even therapeutic. Moderate-impact activities are often fine for people who did them confidently before surgery. High-impact activities are the ones surgeons are more cautious about, mainly because repeated impact loading is associated with faster wear of the implant over time — not because the joint can't physically do it.

These tend to come back fastest and are actively encouraged early in recovery — see our recovery timeline for the general pace. Stationary cycling is often started within the first few weeks as part of rehab. Outdoor cycling and longer hikes on uneven Alberta trails usually wait until balance and hip or knee strength are solid, often around six to twelve weeks, and longer for more technical terrain.

A very common question, and a very common return-to-activity goal. Putting and chipping can often resume within a few weeks. A full swing — which loads and twists both hips and knees — is usually held off until somewhere in the six-to-twelve-week range, and sometimes a bit longer after a knee replacement, since the twisting motion asks more of a healing knee than a hip. Most surgeons are comfortable with golf as a long-term activity after replacement; it's one of the lower-impact sports on the list.

For Calgarians, this one matters. Experienced skiers who skied confidently before surgery are often cleared to return to groomed runs, generally not before three to six months, once strength and reaction time are back to a reliable baseline. Surgeons are more cautious recommending someone take up skiing for the first time after a joint replacement, given the fall risk. Cross-country skiing on groomed trails is generally viewed as lower-impact and often welcomed sooner.

Doubles tennis and pickleball — with their shorter court coverage and less abrupt direction change — are usually fine for most patients once fully recovered, often in the three-to-six-month range. Singles tennis, with more running and sudden pivoting, is approached more cautiously and discussed individually, particularly for knee replacements.

This is the honest caveat in an otherwise encouraging picture. Most surgeons advise against taking up regular running after a hip or knee replacement, and are cautious even with patients who were runners beforehand, because the repetitive impact loading is linked to higher rates of implant wear and loosening over years of use. Some patients do return to light jogging with their surgeon's blessing, particularly after hip replacement, but it's a decision made case-by-case rather than a default recommendation.

Beyond the sport itself, the biggest factors are how your specific surgery and recovery went, your strength and balance testing at follow-up visits, your bone quality, and your fitness level before surgery. Someone who was cycling and swimming regularly before a knee replacement will generally get back to sport faster than someone who was largely sedentary due to years of pain — which is part of why pre-surgery conditioning is worth taking seriously.

The most useful step is a specific conversation with your surgeon about your sport, your goals, and a realistic timeline — general guides like this one are a starting point, not a substitute for that conversation.