Hip Arthoscopy Rehabilitation

Labral repair with or without treatment of FAI (femoral acetabular impingement)

GENERAL PRINCIPALS

    Weeks 0-4

  • Protected weight bearing – 30-40 lbs. for 4 weeks
  • Limited rotation – 20°
  • Passive motion pendulums for hip
  • Protect hip flexor – pain Level 2-3/1

    Second 4 weeks (weeks 4-8)

  • Progress to weight bear as tolerated
  • ROM as tolerated
  • Progress strengthening
  • Add exercise bike/elliptical
  • All within pain scale of 2-3/10

    Third month (weeks 8-12

  • Add sport specific drills
  • Begin distance running

    Fourth month

  • Progress athletics to tolerance
  • Submaximal sports” with progressive return

PHASE I – Early Healing

    Weeks 0-4

  • Partial weight bear gait training – 30-40 lbs.
  • AROM hip flexion to 90 °, external rotation to 20°
  • PROM to 20° external rotation
  • Hip flexor stretch within pain level 2-3/10
  • Log rolling to pain level 2-3/10 only
  • Pelvic tilts, Glut sets, Quad isometrics
  • Squats to 45° hip flexion using body weight
  • Hip isometrics except flexion
  • Hip pendulum on stair 1-2 min 3x/day 0-2 weeks
  • Exercise bike minimal resistance after week 2

LATE PHASE I

  •  At 3 weeks wean off crutches, weight bearing as tolerated if pain free
  • Begin to increase external rotation toward 40°
  • ITB stretch
  • Standing squats to 60°
  • Exercise bike, 20-30 minutes
  • Core strengthening isometrics/planks
  • Local active tissue release

PHASE II  (week 4-8)  Late healing

    Modalities

    ROM

  • ROM as tolerated with stretch in rotation to pain level 2-3/10
  • Bike/elliptical to increase w/resistance as tolerated – daily
  • Add FABER/FADIR stretch – pain 2-3/10
  • Prone rotation int/ext
  • Hip ilipsoas stretch
  • Water walk if available
  • Treadmill at 6 weeks  20-30min
  • Balance drills

    Strengthening

  • Continue Phase I
  • Hip isotonics to include hip flexion 2-3/10 pain maximum
  • Progress quad and glut strengthening with squat press – high rep, low resistance
  • Core strengthening
  • Hip PRE’s except Hip flexion
  • Side step theraband
  • Pulley system

PHASE III  WEEK  8-12

        Strengthening

  • Progress hip flexor PRE’s
  • Progress glut/quad PRE’s
  • Begin Plyometrics
  • Continue core strengthening

        ROM

  • Continue ROM to tolerance within pain level 2-3/10
  • Glut, hip flexor, quad, hamstring stretch

        Begin jog on treadmill

        Sport Specific drills

   PHASE IV WEEK 12-16

  • Add jog/run
  • Add max plyometrics
  • Begin agility/sprint drills
  • Potential return to sports

        RETURN TO SPORTS

  • Able to jog/run/sprint pain 2/10 max
  • Squat/jump
  • Single leg hop test
  • Strength at 90% involved hip/let