Bone Graft Harvest (Iliac Crest) — Complete Exercise Program

Looking for a shorter starting point? The Bone Graft Harvest (Iliac Crest) starter guide covers the first 8 exercises on a printable sheet.

A phase-by-phase exercise program used in recovery for bone graft harvest (iliac crest). Each movement includes what it's working on and how it's typically performed. Your own surgeon's or therapist's guidance always comes first.

Early Recovery

Weeks 0–2

Walking Program

Walking Program exercise illustration

Short, frequent walks build endurance and confidence.

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

  1. Take short walks at a comfortable pace.
  2. Increase your distance gradually as you feel able.

Tips:

  • Use your assistive device as directed.

Commonly done throughout the day.

Glute Squeezes

Glute Squeezes exercise illustration

Gently re-engages the buttock muscles.

What it helps: Wakes up the glutes — the big muscles that steady and support your hip. Getting them firing again is the first step toward a hip that feels stronger and carries you with less strain on the joint.

  1. Lie or sit comfortably.
  2. Squeeze your buttock muscles together.
  3. Hold a few seconds, then relax.

Commonly done as 2-3 sets of 10, a few times a day.

Ankle Pumps

Ankle Pumps exercise illustration

Improves circulation and helps reduce swelling.

What it helps: Keeps blood moving to reduce swelling and the risk of clots while you're less active — small, frequent, and important early on.

  1. Flex your foot up, pointing your toes toward the ceiling.
  2. Point your toes down, away from your body.

Tips:

  • Move slowly and with control.

Commonly done as 20 repetitions, several times a day.

Core Activation

Core Activation exercise illustration

Gentle core engagement to support posture and balance while you recover.

What it helps: Switches on the deep core muscles that stabilize your pelvis and spine, giving your hips a solid platform to move from.

  1. Lie or sit comfortably.
  2. Gently draw your belly button toward your spine.
  3. Hold a few seconds while breathing normally, then relax.

Tips:

  • Avoid holding your breath.

Commonly done as 2-3 sets of 10, daily.

Isometric Hip Abduction

A steady, held push outward that loads the side-hip muscles without any movement — often the gentlest way to start.

What it helps: Holding a steady contraction loads the side-hip tendons gently — it often eases pain while it begins rebuilding their strength. A calm, controlled first step before adding moving loads.

  1. Sit tall (or lie on your back) with a looped band around the outside of your knees — or simply use your hands on the outside of your knees for resistance.
  2. Press your knees gently outward against the band or your hands.
  3. Hold a firm but comfortable push — steady, no movement — then slowly relax.
  4. Rest a moment and repeat.

Tips:

  • You should feel the muscles on the side of the hip working — not your hip pain. Ease the effort if it provokes the sore spot.
  • Keep breathing normally through the hold; don't hold your breath.
  • Hold, don't bounce — the whole point is a steady contraction.

Commonly done as 4–5 holds sets of Hold 30–45 seconds, daily.

Quad Sets

Quad Sets exercise illustration

Re-activates the thigh muscle and supports knee control.

What it helps: Wakes up the quadriceps — the big thigh muscles that support and control your knee. Getting them firing is the foundation of a strong, steady leg.

  1. Sit or lie with your leg straight.
  2. Tighten the muscle on top of your thigh, pressing the back of your knee down.
  3. Hold briefly, then relax.

Commonly done as 2-3 sets of 10, a few times a day.

Flexibility Exercises

Flexibility Exercises exercise illustration

Maintains a comfortable range of motion.

What it helps: Keeps your joints and muscles moving through a comfortable range, so you stay supple and move with ease.

Commonly done most days.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

  1. Using light hand weights or a resistance band while seated, work through gentle arm and shoulder movements.

Tips:

  • Stay seated and supported while you're non-weight-bearing.

Commonly done a few times a week.

Building Comfort

Weeks 2–6

Progressive Walking Program

Progressive Walking Program exercise illustration

Keep building your walking distance and pace.

What it helps: Keep building your walking distance and pace — steady gains in endurance and confidence on your feet.

Commonly done daily.

Side-Lying Hip Abduction

Side-Lying Hip Abduction exercise illustration

Strengthens the muscles on the side of the hip.

What it helps: Loads the side-hip muscles a step harder, building the strength that keeps your hip level and takes pressure off the joint on stairs and longer walks.

  1. Lie on your side with the bottom leg bent for support.
  2. Keep the top leg straight and raise it toward the ceiling.
  3. Hold briefly, then lower slowly.

Tips:

  • Keep your toes pointing forward, not up.

Commonly done as 2-3 sets of 10-15, daily.

Standing Hip Abduction

Standing Hip Abduction exercise illustration

Strengthens the muscles on the side of the hip.

What it helps: Strengthens the outer-hip muscles that hold you steady whenever you're on one leg — which is every step you take. Stronger here, steadier hip.

  1. Stand holding a counter for support.
  2. Lift your leg out to the side, keeping it straight.
  3. Lower slowly.

Tips:

  • Keep your toes pointing forward.

Commonly done as 2-3 sets of 10-15, 1-2x daily.

Side-Lying Hip Rotation (Clamshell)

Side-Lying Hip Rotation (Clamshell) exercise illustration

Strengthens the deep rotators of the hip.

What it helps: Strengthens the deep rotators of the hip that steady the joint and control the leg.

  1. Lie on your side with knees bent and stacked.
  2. Keeping your feet together, lift the top knee like a clamshell opening.
  3. Lower slowly.

Tips:

  • Keep your hips stacked; don't roll backward.

Commonly done as 2-3 sets of 10-15, daily.

Hip Flexor Stretch

Loosens the muscles at the front of the hip that can pull the low back into an arch.

What it helps: Tight hip flexors tip your pelvis and pull your low back into an arch. Loosening them lets your back settle into a more open, comfortable position and takes strain off the spine.

  1. Kneel on the leg you want to stretch, with the other foot planted in front (a half-kneeling lunge). Use a cushion under the knee.
  2. Gently tuck your tailbone under (a small posterior pelvic tilt) so your low back flattens slightly.
  3. Keeping tall and your core gently braced, ease your weight forward until you feel a comfortable stretch across the front of the kneeling hip.
  4. Hold, breathing easily — never push into back or leg pain. Switch sides.

Tips:

  • The stretch should be felt at the front of the hip/thigh, not in the back.
  • Keep the gentle tailbone-tuck the whole time — letting the back arch defeats the purpose.
  • A standing version (one foot up on a chair, ease the hips forward) works if kneeling is uncomfortable.

Commonly done as 2–3 each side sets of Hold 30 seconds, daily.

Core Strengthening

Core Strengthening exercise illustration

Supports posture and overall stability.

What it helps: Builds the core that holds your trunk steady, supporting your posture, your back, and everything you do on your feet.

  1. Perform gentle core exercises as directed.

Commonly done a few times a week.

Sit-to-Stand

Sit-to-Stand exercise illustration

Builds the strength and confidence to rise from a chair.

What it helps: Trains the exact strength you use to rise from a chair, a toilet, or a car. Stronger here means more independence and less of a struggle on tough days.

  1. Sit at the edge of a sturdy chair.
  2. Lean slightly forward and stand up.
  3. Lower yourself back down with control.

Tips:

  • Use your arms for support as needed.

Commonly done as 2-3 sets of 8-10, once or twice a day.

Stationary Bike

Stationary Bike exercise illustration

Builds motion and endurance with low impact.

What it helps: Keeps the joints moving and nourished while you build endurance — all with no pounding. One of the gentlest ways to stay active when a joint is sore.

  1. Set the seat so pedaling is comfortable.
  2. Pedal at an easy pace.
  3. Increase your time gradually.

Commonly done as directed.

Return to Normal

Weeks 6–26

Resistance Band Hip Strengthening

Resistance Band Hip Strengthening exercise illustration

Builds hip strength in all directions with a band.

What it helps: Builds hip strength in every direction with light resistance, rounding out the support that keeps the joint steady.

  1. Anchor a resistance band and loop it around the surgical leg.
  2. Move the leg out to the side, backward, and forward against the band.
  3. Return slowly each time.

Tips:

  • Keep your trunk steady and the motion controlled.

Commonly done as 2-3 sets of 10-15, daily.

Strength Training

Strength Training exercise illustration

Maintains and builds long-term strength.

What it helps: Builds and maintains long-term strength to keep you active, resilient, and independent.

Commonly done a few times a week.

Functional Strength Training

Functional Strength Training exercise illustration

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

  1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
  2. Add resistance gradually.

Tips:

  • Quality of movement first, then load.

Commonly done several times a week.

Standing Hip Extension

Standing Hip Extension exercise illustration

Strengthens the muscles behind the hip.

What it helps: Strengthens the muscles behind the hip that power you forward with each step and help you stand tall — the engine of a strong, even stride.

  1. Stand holding a counter.
  2. Move your leg straight back without arching your back.
  3. Lower slowly.

Commonly done as 2-3 sets of 10-15, 1-2x daily.

Mini Squats

Mini Squats exercise illustration

Builds leg strength through a comfortable range.

What it helps: Builds hip and leg strength through a comfortable range, so everyday moves — sitting, standing, bending — take less out of your joints.

  1. Stand holding a counter.
  2. Bend your knees a small amount, keeping them behind your toes.
  3. Return to standing.

Commonly done as 2-3 sets of 10, once or twice a day.

Progressive Strengthening

Progressive Strengthening exercise illustration

Gradually increases strength as you recover.

What it helps: Gradually raises the challenge as you get stronger, so your body keeps adapting and improving rather than plateauing.

Commonly done as directed.

Cycling

Cycling exercise illustration

Low-impact endurance and motion.

What it helps: Low-impact endurance that keeps the joints moving smoothly while you build fitness — easy on the body, good for the long run.

Commonly done as able.

Low-Impact Recreational Activities

Low-Impact Recreational Activities exercise illustration

Enjoyable activities that protect your joint.

What it helps: Getting back to the activities you enjoy in ways that are kind to your joints — the whole point of building this strength.

Commonly done as you like.

Recovery reading

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These are general exercise guides, not a personal prescription. The repetitions and frequency shown are what's commonly used — your own surgeon or therapist may advise something different, and their guidance comes first.