An Adventurer’s Guide to Hip Replacement

On a physically challenging trip through Italy, two travel writers learned important lessons about how to maximize their new hips

Paul Greenberg, with Betsy Andrews,

AARP

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Published January 23, 2026

an illustration of people biking on an Italy hillside

Travel writers Paul Greenberg and Betsy Andrews, both in their 60s, share their advice for anyone who’s had a hip replacement and wants to return to their formerly active lifestyle.

Jones & Company

Betsy Andrews and I are friends and adventure travel writers, both hovering around the age of 60. The third thing we have in common is betrayed only by airport metal detectors: Neither of us is walking on our original hips.

That’s what arthritis will do to you. When our hips started to crap out, we tried it all: acupuncture and Pilates, turmeric and glucosamine. But in the end, there was only one solution: Swap out the old for newer models constructed from titanium and porcelain.

In 2019, at age 57, Betsy had her left hip replaced at New York’s Hospital for Special Surgery (HSS). She returned there in 2023 to switch out her right. When it was my turn for a simultaneous bilateral replacement at HSS the following year, Betsy served as my consigliere of the hips, assuring me, “You’ll be walking in no time.” And fishing and swimming and skiing and climbing sheer cliffs, doing all the sporty things that by dint of our profession we are compelled to do.

Was Betsy correct? As my new hips approached their one-year anniversary, when the bones had finally grown into their artificial joints and strengthened them past the point of a fall-injury risk, we decided to test her optimism with a trip. Where to? Of course, Italy: epicenter of elegant design and, coincidentally, home to the manufacturer of Betsy’s replacement hardware. But also a hilly, challenging landscape in which to do a bike tour. We met in Le Marche, a region of ancient hilltop villages with vineyards, abundant seafood and a tradition of fine craftsmanship, especially in shoes. Wedged between the Adriatic Sea and the Apennine Mountains, Le Marche is the type of lesser-traveled place that travel writers love to explore. Blissfully free of the crowds that plague more popular Italian destinations, it was a charming locale for our prosthetically enhanced adventure. Based on what we learned, here’s our advice for anyone who’s had a hip replacement and wants to return to their formerly active lifestyle:

a woman and man posing for a picture while wearing biking gear on an overlook

Paul and Betsy take a break while biking on the road from the Hotel Monteconero down to the coast near Porto Nuovo, Italy, in 2025.

Courtesy Paul Greenberg

1. Take your physical therapy on the road

My orthopedic surgeon believes in physical therapy. Betsy’s bone doctor does not. But given our own experiences, we agree that PT is a must. We both packed elastic straps and stretching gear so we could keep up with our strengthening exercises in our hotel rooms. The muscle-relaxing steam room at Pesaro’s beachfront Excelsior Hotel and the sauna with a view at Hotel Monteconero, atop one of the Adriatic coast’s highest mountains, didn’t hurt, either.

2. Beware the inflammation

Plane cabins are pressurized, but at the heights that planes travel, that pressure is still much lower than we normally experience on the ground. So the gases in your body expand when you’re flying. That’s why many surgeons say you shouldn’t fly for at least six weeks after your hip replacement. Betsy’s surgeon prescribed anti-inflammatories for the first couple of flights she took on her new hips. My own doctor didn’t mention them, so I’d already flown a good 20,000 miles before learning this from Betsy. Everybody’s different. Ask your orthopedist what’s best for you.

3. Fire up those glutes!

One way to keep pressure off your hips is to make sure you’re engaging your butt muscles. Betsy had come from Sicily, where she was completing the dives for her PADI Advanced Open Water Diver certificate in Taormina. To maximize her aerodynamism in the water, her scuba instructor taught her the trim position. He laid on his stomach on the boat deck to demonstrate, forming a convex curve with his body by lifting his shoulders and raising his thighs with bent knees. To do so, he said, “You have to squeeze your buns.”

I, on the other hand, had come from fighting massive amberjack in Texas for a fishing story, but I was given similar butt-clenching advice when fighting the big ones. It was a lesson we kept reminding each other of as we hiked up hills and staircases: Squeezing your buns engages your glutes, so they do the work, taking the pressure off your hip joints.

4. Focus on balance

It was pouring when we stopped in Urbino, and the uneven cobblestones of this walled Renaissance city were slick with rain. As we traipsed up and down inclines, we locked arms if we needed extra support. We saw those bumpety, slippery roads as a welcome challenge. They sharpened our focus, honed our balance and improved our functional skills. An exercise my physical therapist recommended played a role in helping us stay upright: 60 seconds of one-legged stands per day on each leg. The more you practice, the more stable you’ll be.

5. Take the stairs whenever you can

Federico da Montefeltro, the 15th-century duke of Urbino, lost his right eye and a chunk of his nose in a jousting tournament, so portraits show him in left profile, his schnoz a precipitous slope. That didn’t stop him from waging the wars that brought the wealth to build his palace. Returning from battle, his horses would clomp up the palace’s shallow marble stairs. If horses can do it, so can you, we thought as we climbed.

It’s good to get that practice because elevators are scarce in older European buildings. We had to drag our suitcases up a flight to our rooms at Hotel Monteconero. A history of always taking the stairs whenever possible helped both of us manage the ups and downs without injury.

6. Ride the (hand)rails

Handrails exist for a reason, so there’s no shame in grabbing onto one when you’re walking up or down stairs. The marble handrails in the Palazzo Ducale di Urbino are over 500 years old. They felt cool and smooth to our grip, and we enjoyed thinking of the generations that had grasped them before us.

7. Allow yourself time

Stairs weren’t the only heights we scaled in Le Marche. At a hillside vineyard planted in Verdicchio by the winery Umani Ronchi, Betsy scrambled up the log ladder to a platform that had been built for shooting wild boars (the animals would otherwise devour the grapes).

But my own climbing abilities were far more compromised: I could barely manage a four-limbed scramble the first time I attempted to board the vintner’s jeep. When you’re only recently sturdy, you retain a fear of falling from your hip’s weakened past, and you worry that if you do fall you’ll ruin your surgeon’s handiwork. We supported each other through that drama so we could enjoy the ultimate challenge of our trip. It might be a humbling experience, but taking on physical challenges builds confidence over time. The second time I mounted the jeep, I did so in one mostly fluid step.

8. Don’t be afraid of adventure

I am a longtime cyclist, a veteran of several American Century rides and cross-country rides through Crete and Portugal. So I insisted on a pedal. The bikes were electric. But, except on the steepest inclines, we challenged ourselves to default to the lowest setting, so using our hips was a must. Giorgio Vecchiola, our guide from Chrono Italia, was an inspiration at 76 years old. He led us with aplomb, pounding mountain bike trails and zooming along corkscrew roads from the summit of Monte Conero more than 1,800 feet down to the sea, then back up again.

Throwing a leg over the bar of a bicycle proved far more easy with new hips, and pedaling furiously, we felt like we earned those phenomenal Adriatic views. Of course, biking is breezier when the ride is electric. But even on the highest setting, we had to pump like hell to keep the bikes pushing up those inclines. Afterward, a sense of bliss. So let this be your power assist: Your new hips are made for adventure.

In conclusion

Hip replacement is at first humbling but later empowering. No one likes to admit that a natural body part has failed. But there is absolutely no reason a person with technologically enhanced hindquarters can’t embrace the joys of travel after the work has been done. Careful planning builds confidence and should take you many miles down the road.

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Paul Greenberg is the James Beard Award–winning author of the New York Times bestseller Four Fish and six other books. His Goodbye Phone, Hello World has just been published in Italy as Bye Bye Smartphone.
Betsy Andrews is an award-winning food, drink and travel writer. She is a contributing editor at Food & Wine and SevenFifty Daily and, most recently, the coauthor of Coastal: 130 Recipes From a California Road Trip.