The Best Sex Positions After a Hip Replacement

 If you’re looking for guidance on how to get your groove back after hip replacement surgery, you’ve come to the right place.

Hip replacement surgery is a major procedure that requires several weeks of recovery. And while many people look forward to an increase in mobility, others may wonder what restrictions they might face when returning to a sexual relationship with their partner.

The good news is you’ll be able to have sex (and comfortably!) after getting a new hip. The not-so-good news? It might take several weeks for the pain and discomfort to dissipate and for you to return to sexual activity safely.

Here, we go over the safest positions to have sex after hip replacement surgery, ones to avoid and tips for getting started.

Sex after hip replacement surgery is often more comfortable and enjoyable. In fact, a 2017 systematic review found that of 1,694 patients, 44 percent reported improvements in sexual satisfaction and a 27 percent increase in sexual intercourse frequency post hip replacement surgery.

Also, a group of New York physicians measured the quality of sex after total hip and knee surgery in patients under 70 years of age and found that 90 percent of patients surveyed reported an overall improvement in sexual function after surgery compared to before.

Furthermore, a higher number of women indicated an improvement in sex after hip replacement surgery than men. The physicians presented their findings in 2013 to the American Academy of Orthopaedic Surgeons.

“Sexual activity after total hip replacement should be more comfortable as your hip will be more flexible and less painful,” said board-certified orthopedic surgeon Robert Blais, MD, of Texas Orthopedics.

In fact, Blais says most people should be able to return to intercourse within 3 weeks after the surgery, with full activity possible in 8 weeks. However, individual return times may vary and depends on wound healing and range of motion.

Also, the ability to do any exercises or try sexual positions will vary from person to person based on levels of stability. Similarly, different leg positions affect surgeries differently, so be sure to talk with your doctor first.

With that in mind, here are four positions that are safe to try after hip replacement surgery.

Missionary position

Blais says common positions such as missionary are safe for both people. This includes the person on top or bottom. However, Blais says that if the person on top has a vagina, it may be more difficult initially, but it should not be a problem after a few months.

Both partners standing

If your balance is steady, physical therapist Rachel Gelman, DPT, says standing could be a safe position. If you can, use the wall for support so you can slightly bend over at the waist.

Lying on the bed with partner facing you

Lie on your back on the bed with your buttocks close to the edge of the bed so that your knees are bent, and your feet can rest on a stack of pillows placed on the floor. Your partner can stand or kneel facing you with their legs touching the end of the bed.

Side-lying position

You can have sex in a side-lying position on your nonsurgical side with your bottom leg supported to avoid twisting or crossing the top leg (operated leg).

After surgery, avoid positions that require your hip to move in extreme ranges of motion. More specifically, be cautions of excessive:

  • hip flexion
  • extension
  • abduction
  • internal and external rotation

Don’t move your knee across the body’s midpoint, and avoid raising your hip past knee level.

Here are four additional positions to avoid during the recovery period.

Hands and knees position

Gelman recommends avoiding positions where the recovering person is on their hands and knees, such as “doggy-style,” or crouching on top of their partner.

Sitting on your partner (face-to-face)

If your partner is in a chair, sitting on top of them with your hips open should be avoided, at least initially.

Kneeling on top of partner

Kneeling on top of your partner bends your hips too far and should be avoided.

Hips flexed past 90 degrees

Blais recommends avoiding positions where the hips are flexed past 90 degrees because this can increase the chance of dislocation, especially if the force is applied to the flexed legs. “The majority of the risk for dislocation is borne by the women as they are typically more flexible, to begin with,” he said.

If you’ve had surgery that was an anterior approach, which is a replacement through the front of the hip, avoid hip extension or moving your leg backward, Gelman says. Also, avoid crossing your leg or externally rotating it out. She also cautions against lying on your stomach or on the operated side during sex.

Your hip is a ball and socket joint that involves a wide range of motion, including rotation, flexion, and extension. If any movements are extreme, you may experience pain or increase the chance of injuring the area.

“There is a risk of dislocation of the hip or disruption of the surgical incision with vigorous activity of any kind in the first 6 weeks as the soft tissues around the hip are healing and muscles are still weak,” Blais explains. However, the risk of injury after 6 weeks is minimal.

According to a 2014 study review, sexual positions for women (or a person with a vagina) typically require an extreme hip range of motion, but sexual positions for men (or a person with a penis) require less mobility. Because of this, the authors found that men recovering from hip replacement surgery tend to return to sexual activity sooner.

Finding a comfortable position that allows you to enjoy sex while recovering from hip replacement surgery is the first step to resuming sexual activity. Here are some other tips to help you get started.

Get the OK from your doctor

Ideally, this is a conversation you have before surgery. That said, if you’re in the post-op period and feeling frisky, give your doctor a call.

If it’s before your post-surgery appointment, they can ask you a series of questions to determine whether you’re ready or let you know to wait until being examined in person.

Take it slow

The post-op period is not a time for fast, aggressive sexual escapades. Instead, for the first 3 to 6 weeks, and possibly beyond, slow and steady is the pace for safe and comfortable sex.

Find a way to support your hip joint

If you’re experiencing mild pain and discomfort when trying positions, try propping your leg up with a towel or folded blanket. This can help support your hip joint by reducing the weight.

Warm up your joints

While you might not equate sex with a vigorous workout, it’s not a bad idea to take a few minutes to warm up and move your joints and muscles through a few range of motion exercises. Be sure to talk with your doctor about the best stretches for you. A few could include:

  • gentle leg swings
  • marching in place
  • kneeling hip flexor stretch
  • standing hip extension abduction

Do all stretches modified with a shorter range of motion.

If sex is on your mind, then a conversation with your doctor is in order. Ideally, this should be a topic discussed before surgery, so you don’t have to wait for a post-operation appointment to get your questions answered. That said, your first post-op visit is a great time to go over a realistic return date to sexual activity as well as safe and unsafe positions.

Contact your doctor if you experience any of the following during sexual activity:

  • sudden or sharp pain
  • sensation of tearing or popping
  • pain that continues after sex

Hip replacement surgery can open up a world of possibilities for people who have lived with pain and restricted movement. Part of those possibilities includes a better and more comfortable sex life.

In general, you can resume sexual activity within 3 to 8 weeks after surgery, and sometimes sooner, if it is approved by your doctor. For comfort and safety, avoid positions that require an extreme range of motion or move your hip past 90 degrees. This still leaves several positions suited for sexual activity, including missionary, side-lying (on the non-operated side), and standing.

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