Post-Surgery Recovery

Hip Fracture Rehabilitation | Home Physiotherapy | Physio to Home

Michael Ghattas, Physiotherapist2 March 2026

Hip fracture is one of the most serious injuries an older Australian can sustain. North Tasmania's home physiotherapist explains the rehabilitation journey — from hospital discharge to regaining independence at home.

Micheal Ghattas

3/6/2026 · 8 min read

Hip Fracture Rehabilitation at Home: A Guide for Patients and Families in North Tasmania

By Michael Ghattas, DPT | AHPRA Registered Physiotherapist | 18 Years Experience

Physio to Home, North Tasmania | Last reviewed: March 2026

Hip fracture is among the most serious and most consequential injuries in older adults. In Australia, approximately 23,000 hip fractures occur each year, overwhelmingly in people over 70. The one-year mortality rate is approximately 20–30% — making it, statistically, one of the most dangerous injuries an older Australian can sustain. For those who survive, the rehabilitation journey is long, demanding, and critically dependent on consistent physiotherapy in the weeks and months following surgery.

For families in North Tasmania whose parent or loved one has come home from hospital after a hip fracture, the period after discharge can be overwhelming. The person is weaker than before, more fearful, often in pain, and facing a home environment that may not be well-adapted to their new needs. This is exactly when home physiotherapy matters most — and when access to consistent, skilled rehabilitation at the front door makes the difference between meaningful recovery and permanent decline.

This guide explains what happens after a hip fracture, what the rehabilitation journey involves week by week, and how Physio to Home supports patients and families through it in North Tasmania.

Important medical disclaimer

Hip fracture rehabilitation is an individualised clinical process. Recovery timelines and exercise programmes depend on the type of fracture, the surgical procedure performed, the patient's age and pre-fracture function, and their overall medical status. Always follow the specific instructions provided by your surgeon and treating physiotherapist. This guide provides general information only.

Who this guide is for

This article is for people in North Tasmania recovering from a hip fracture — and for their families, carers, and care coordinators — who want to understand the rehabilitation process and how home physiotherapy supports it. It is particularly relevant for those in rural areas where clinic attendance is not practical in the post-operative period.

Understanding Hip Fracture: What Has Been Broken and Fixed

The term "hip fracture" is used loosely to describe several types of fracture that occur in and around the proximal femur (the top of the thigh bone). The most common types are:

Neck of femur (NOF) fracture — a fracture through the narrow section of bone connecting the femoral head (ball) to the femoral shaft. This is the most common hip fracture type. Depending on the displacement of the fracture and the patient's biological age and bone quality, it is typically treated with either a hemiarthroplasty (replacing the femoral head with a prosthesis) or total hip replacement.

Intertrochanteric fracture — a fracture through the wider, more cancellous bone below the femoral neck, between the greater and lesser trochanters. This type is typically fixed with an intramedullary nail (a rod inserted down the femoral shaft) or a dynamic hip screw. The bone is preserved rather than replaced.

Subtrochanteric fracture — a fracture below the lesser trochanter. Less common and typically fixed with an intramedullary nail.

The type of fracture and the surgical procedure performed determine the specific precautions and rehabilitation pathway. Your surgeon will specify what applies to you. A home physiotherapist will review these at your first visit and apply them to your specific home environment.

The Stakes: Why Rehabilitation After Hip Fracture Is Non-Negotiable

The statistics around hip fracture outcomes are sobering:

Approximately 50% of people who sustain a hip fracture do not recover to their pre-fracture level of function within one year
Approximately 20–30% die within one year of their hip fracture, often from complications of immobility or the fracture itself
Many survivors experience a permanent reduction in mobility, independence, and quality of life

The single most important modifiable factor in determining outcomes after hip fracture is the quality, consistency, and early commencement of rehabilitation. Patients who receive intensive, early physiotherapy after hip fracture recover faster, regain higher levels of function, and return home at higher rates than those who receive standard or delayed rehabilitation.

For families in North Tasmania: the rehabilitation your loved one receives in the first 12 weeks after coming home from hospital will determine, more than any other factor, how much function they recover. Home physiotherapy is how you ensure that rehabilitation happens consistently, in the right environment, at the right frequency.

Hip Fracture Rehabilitation: Week by Week

Week 1 — Hospital Discharge

The most important transition in the rehabilitation journey

Most patients are discharged from hospital within 5–7 days of hip fracture surgery — often before their family feels ready and before the patient feels well enough. This early discharge reflects the evidence that returning to a familiar home environment supports recovery, but it means the rehabilitation responsibility shifts rapidly to the community.

Goals for Week 1 at home

Move safely around the home with the prescribed walking aid (typically a walking frame)
Manage pain with prescribed medications and ice
Perform the ankle and calf exercises prescribed in hospital to prevent deep vein thrombosis
Follow the weight-bearing instructions given by your surgeon — these vary by fracture type and surgical repair

Physiotherapy focus in Week 1

Confirming safe weight-bearing practice and walking aid technique at home
Sit-to-stand training from your specific chairs and toilet height
Bed mobility — rolling, sitting up from lying — which many patients find unexpectedly difficult
Assessment of the home environment for immediate hazards
Communication with the surgical team or GP about any concerns

Why home physiotherapy in Week 1 is critical

This is when patients are most vulnerable. Pain is significant, confidence is low, and the home environment has not yet been adapted for recovery. A home physiotherapy visit in the first week after discharge assesses all of this directly — and prevents the early complications (falls, wound problems, loss of walking confidence) that can derail recovery before it begins.

Weeks 2 to 4

Building walking confidence and regaining daily function

Goals for this phase

Walk independently inside the home with a walking aid for increasing distances
Manage essential daily activities — showering, dressing, light meal preparation — with the appropriate level of support
Manage pain with reducing reliance on strong opioid medications
Sleep more comfortably

Physiotherapy focus

Progressive walking distance inside and then outside the home
Hip strengthening exercises: hip abduction, hip extension, mini squats at the bench — introduced cautiously and calibrated to the surgical repair
Stair practice if the home has stairs — essential for independence and often not addressed adequately in hospital
Gait retraining: correcting the antalgic (pain-avoiding) walking pattern that develops and causes secondary back, knee, and hip problems if left unaddressed
Ongoing home environment assessment: bathroom safety, furniture heights, trip hazard removal

Weeks 4 to 8

Reducing walking aid dependency and rebuilding strength

Goals for this phase

Progress from a walking frame to a single crutch or walking stick if cleared by surgeon
Walk outdoors on flat ground for gradually increasing distances
Manage most daily living tasks with increasing independence
Attend surgical follow-up appointment (typically at 6 weeks)

Physiotherapy focus

Progressive lower limb strengthening: step-ups, bridging, wall squats
Balance and proprioception training: weight shifting, supported single-leg stance
Walking programme: structured outdoor walks building from 5 to 20 minutes
Functional practice: getting in and out of a car, navigating uneven surfaces, community mobility

Weeks 8 to 12 and Beyond

Rebuilding capacity for independent community living

Goals for this phase

Walk without a walking aid on flat, familiar surfaces (where surgically appropriate)
Return to community activities — shopping, social activities, religious attendance
Achieve a level of function that supports independent or semi-independent living

Physiotherapy focus

Progressive strength and balance programme targeting fall prevention — essential given that a previous hip fracture is one of the strongest risk factors for a second
Formal falls prevention programme including home hazard reassessment
Long-term home exercise maintenance programme
Coordination with GP, aged care provider, and family regarding ongoing support needs

The Psychological Dimension: Fear of Falling After Hip Fracture

Fear of falling after a hip fracture is almost universal — and it is one of the most significant barriers to recovery. The fear is entirely rational: the person has experienced the consequences of a fall firsthand, and the idea of another one is terrifying. But fear leads to inactivity, inactivity leads to deconditioning, and deconditioning leads to — paradoxically — higher falls risk.

A skilled physiotherapist addresses this directly. Not by dismissing the fear, but by rebuilding the physical capacity and movement confidence that makes it rational to be less afraid. Graded exposure to previously feared activities — walking outdoors, navigating stairs, moving through a crowded space — within a supported and progressed rehabilitation framework is the most effective approach.

Many home physiotherapy sessions after hip fracture are as much about confidence as they are about strength. Both matter.

Supporting a Family Member Recovering from Hip Fracture

For families of older Tasmanians recovering from hip fracture, the post-discharge period is one of the most demanding caregiving experiences there is. The person is dependent, often frightened, and may have significantly changed in function compared to before the fracture.

Home physiotherapy visits provide direct practical guidance for family members and carers, including:

Safe techniques for assisting with standing and walking without creating dependency or increasing fall risk
How to set up the home to support safe mobility and reduce carer burden
Recognising early warning signs of complications — wound problems, pain changes, reduced weight-bearing
Understanding the realistic recovery trajectory and what to expect at each stage

Carer involvement in rehabilitation after hip fracture is associated with better outcomes for both the patient and the carer.

Funding Hip Fracture Rehabilitation in North Tasmania

My Aged Care — Home Care Package — Physiotherapy is a covered allied health service under all package levels. Hip fracture rehabilitation is a high-priority clinical use of aged care funding. If the patient does not yet have a package, an urgent review can be requested given the changed care needs following fracture.

Medicare GP Management Plan — Up to five subsidised physiotherapy sessions per year for patients with a chronic condition. Hip fracture and its consequences qualify. Speak to the patient's GP about establishing a plan promptly after discharge.

NDIS — For eligible participants, physiotherapy for hip fracture rehabilitation may be funded under Improved Daily Living.

Private health insurance — Most extras policies cover physiotherapy including home visits.

Private self-funding — Direct payment for home visits.

Contact Physio to Home and we will identify the most appropriate funding pathway before the first visit.

Frequently Asked Questions

How soon after coming home from hospital should physiotherapy start?

As soon as possible — ideally within the first week of discharge. The evidence for early, intensive rehabilitation after hip fracture is very clear: the earlier and more consistently rehabilitation begins, the better the outcomes. Do not wait to feel well enough. The physiotherapy is part of what helps you feel well enough.

My parent is 85 years old. Is physiotherapy still worthwhile at that age?

Yes, absolutely. Age alone is not a contraindication to rehabilitation after hip fracture. Function, cognition, and pre-fracture health status are more relevant than age. Many 85-year-olds recover excellent function after hip fracture with appropriate rehabilitation. The question is not whether to rehabilitate, but how to calibrate the programme appropriately to the individual.

Can hip fracture rehabilitation be done entirely at home in North Tasmania?

Yes. The full post-fracture rehabilitation programme — from the first week at home through to longer-term falls prevention and strength maintenance — can be delivered entirely in your home. Physio to Home covers Launceston, George Town, Longford, Deloraine, and surrounding rural areas across North Tasmania.

My parent refuses physiotherapy after their hip fracture. What should I do?

Reluctance to engage with physiotherapy after hip fracture is common and understandable — the person is in pain, frightened, and exhausted. A home visit is often more acceptable than a clinic appointment because it requires no effort from the patient. Sometimes the most effective approach is a first visit framed simply as a check-in and a conversation, with no pressure to "exercise." A skilled physiotherapist builds rapport and engagement before building a programme.

Recovering from Hip Fracture in North Tasmania?

Whether your family member has just come home from hospital, or recovery stalled weeks ago and you need a new plan — Physio to Home is here. We provide AHPRA-registered, evidence-based hip fracture rehabilitation in your own home across North Tasmania, funded through My Aged Care, Medicare, NDIS, and private health insurance.

Book your first home visit today — the earlier, the better →

About the Author

Michael Ghattas, DPT

AHPRA Registered Physiotherapist | Doctor of Physical Therapy | 18 Years Clinical Experience

Michael is the founder of Physio to Home, a mobile physiotherapy practice serving older adults and rural residents across North Tasmania. He specialises in post-fracture rehabilitation, falls prevention, and aged care physiotherapy delivered entirely in the home setting.

References & Further Reading

Australian and New Zealand Hip Fracture Registry (ANZHFR). Annual Report 2023. Sydney: ANZHFR, 2023.

Auais MA, et al. Extended exercise rehabilitation after hip fracture improves patients' physical function. *Physical Therapy*, 2012.

Handoll HH, et al. Multidisciplinary rehabilitation for older people with hip fractures. *Cochrane Database of Systematic Reviews*, 2009.

Australian Institute of Health and Welfare (AIHW). Hip fracture incidence and outcomes in Australia. AIHW, Canberra, 2022.

My Aged Care. Home Care Packages Program. Commonwealth of Australia, 2025. www.myagedcare.gov.au

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