Episode 6 - Top 5 Aches and Pains After a Hip Replacement

June 11, 2025

Aches and pains after hip replacement surgery are common — but most are fixable once you know where they come from.

Top Aches and Pains After Hip Replacement Surgery (and What Actually Helps Them Go Away)

Experiencing aches and pains after hip replacement surgery can be confusing, frustrating, and even scary — especially if they show up months or years after you thought recovery was complete. Many patients quietly wonder, Did something go wrong? Is my hip failing? Do I need another surgery?

In this episode of The Hip Replacement Podcast, host Chris Bystriansky breaks down the top aches and pains after hip replacement surgery that he has personally experienced more than 10–12 years after having both hips replaced — and what he’s done to successfully manage them.

Chris is a double hip replacement patient, endurance athlete, and longtime student of recovery. In this episode, he reassures listeners that post–hip replacement pain doesn’t automatically mean something is wrong with the implant. In many cases, discomfort is caused by muscle tightness, gait changes, leg-length differences, or prolonged sitting — all of which can often be improved with the right approach.

This episode covers:

Front-of-hip tightness and aching after hip replacement
IT band pain along the side of the leg
Hip pain on the longer leg and knee pain on the shorter leg
Heel and ankle pain caused by gait changes
How inactivity and over-activity both contribute to pain
Why sitting posture and office chairs can make symptoms worse

Chris explains how each ache and pain showed up, what initially caused concern, and how physical therapy principles, stretching, strengthening, shoe inserts, and daily movement helped resolve them. He also discusses why anterior hip replacement patients may experience certain tightness patterns and why consistency matters more than intensity.

This episode is especially helpful if you:

Have aches and pains after hip replacement surgery
Feel stuck or plateaued in recovery
Are years post-surgery and experiencing new discomfort
Worry that pain means implant failure
Want practical, non-alarmist guidance

Most importantly, this episode helps normalize the recovery experience. Aches and pains can — and often do — appear long after surgery. Understanding where they come from and how to address them can restore confidence and prevent unnecessary fear.

If you’re searching for honest insight into pain after hip replacement, this episode offers reassurance, clarity, and real-world strategies from someone who has lived it.

New hips. New you. Let’s go.

Thanks for joining THE HIP REPLACEMENT PODCAST.

-Chris

LINKS & RESOURCES

Download my Top 12 Tips for Hip Replacement Patients here

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Episode Transcript

The Hip Replacement Podcast – Episode 6 - Transcript

Welcome to The Hip Replacement Podcast, where recovery meets motivation and healing leads to a whole new lifestyle. I’m Chris Bystriansky, your host. I’m an author, athlete, and double hip replacement patient.

I’ve been through the surgeries, the setbacks, and the comebacks, and I’m here to help you do the same. Each week, I’ll bring you tips, tools, expert advice, and inspiring stories to help you take back your life one step at a time.

Thanks for joining The Hip Replacement Podcast. New hips, new you. Let’s go.
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Welcome back to The Hip Replacement Podcast. I’m Chris Bystriansky, your host. I’ve had both of my hips replaced — one more than ten years ago and the other more than twelve years ago.
Since then, I’ve done some great things. I’ve completed IRONMAN triathlons, participated in other endurance events, coached my daughter’s athletic teams, and lived a very active life. I’m here to share what I’ve learned over the past 10 to 12 years, and I hope you find it helpful.

In this episode, I’m going to share the top five aches and pains I’ve experienced since my hip replacement surgeries — and what I’ve done to address them.

If I’ve experienced these issues, there’s a good chance you may have felt something similar. And maybe the way I’ve handled them can help you manage yours.
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Before we get into it, a quick disclaimer. I’m not a doctor, and I’m not a physical therapist. I can’t even stand the sight of blood. If you feel the need to see a doctor or physical therapist, please do so.

I’ve worked with physical therapists extensively over the years, especially during my initial recoveries. Everything I’m sharing here is based on what I learned from professionals and what I’ve tested on myself over time.
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Let me set the stage.
You’ve had your surgery, you’ve recovered, and maybe you felt pretty good for a while. Then, months or years later, aches and pains start creeping in. Or maybe you’re still in recovery and feel like you’ve plateaued.

You start thinking, Something went wrong. My hips don’t feel right. My legs or back hurt. Did the surgery fail?

I’ve been there.

I had a long recovery and did a lot of physical therapy. But between being very active at times — and not active enough at other times — these aches and pains have shown up over the years.
So let’s talk about them.
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These are in no particular order.

1. Tightness and aching in the front of the hips
The front of my hips can get extremely tight and achy. From what I’ve learned, forward motion — walking, running, biking, golfing — compresses the front of the hip. Over time, the muscles tighten and lose elasticity.

My solution has been to stretch the front of the hips and legs — especially the quadriceps — and strengthen the back side. This balances things out.

Sitting too long can also cause this tightness. If you sit at a desk or on the couch for long periods, those muscles will tighten up.

I had an anterior approach for both surgeries, meaning the surgeon entered from the front of the hip. That may play a role here.

If this sounds familiar, focus on stretching the front and strengthening the back. A physical therapist can give you great guidance.
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2. IT band pain along the side of the leg
This one was the most painful.
Several years after surgery, I developed sharp pain along my IT band — so sharp that I thought I had broken my leg or damaged the implant.

After consulting trainers and physical therapists, it became clear this was a stretching issue, especially given how much cycling, walking, and golfing I was doing.
Stretching the IT bands consistently solved it.
Another unexpected factor was my office chair. The sides of the chair pressed into my legs and aggravated the issue. I now rotate between different chairs weekly and avoid sitting in one position too long.

If you have sharp pain on the side of your leg, stretch your IT bands and evaluate how and where you sit.
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3. Hip pain on the longer leg
4. Knee pain on the shorter leg
After surgery, I developed a small leg-length difference — about four millimeters. That may sound minor, but it matters.

If I don’t correct it, the hip on my longer side aches and the knee on my shorter side starts hurting. It feels like my shorter leg is standing in a hole.

I address this with a shoe insert in my shorter leg. I’ve experimented with different insoles to find what works best.

If I walk barefoot, wear worn-out shoes, or change footwear without correcting the difference, the pain comes back.

If this sounds familiar, talk with your surgeon or physical therapist about measuring leg length and appropriate correction.
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5. Heel and ankle pain on the shorter side
This is the most recent issue I’ve experienced. I believe it’s caused by gait changes and ankle rotation on the shorter leg.

The fix for me has been more consistent stretching, mobility work, and strengthening the muscles around the leg.

When I stay consistent, the pain stays away. When I don’t, it creeps back in.
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Over the years, I’ve learned that I can largely control these aches and pains through stretching, movement, and awareness.

If I ignore them, they get worse. If I address them, they improve.
I try to do something every day — stretch, move, stay active — so I can live a full, active, and mostly pain-free life.
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I wanted to share this episode so you don’t panic if aches and pains show up months or years after surgery. It doesn’t automatically mean something is wrong with your hip.
Often, it’s about understanding the source and addressing the surrounding muscles and movement patterns.
In the next episode, I’ll talk about the tools and techniques I use to manage these aches and pains.

Thanks so much for listening to The Hip Replacement Podcast. Until next time, I wish you the best recovery possible.

Take care.
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Episode 6 - Top 5 Aches and Pains After a Hip Replacement

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