top of page

 Hip Arthroscopy Surgical Rehabilitation

Phase I (Surgery to 2-6 weeks postoperative)

Appointments

  • Home exercise program will begin after surgery – 2 weeks

  • 1-2 visits per week with HEP instruction

Rehabilitation Goals

  • Protection of the post-surgical hip through limited weight bearing and education on avoiding pain with range of motion exercises

  • Restore normal hip range of motion

  • Normalize gait

  • Restore leg control

Precautions

  • Use crutches for normal gait with straight leg—may allow full WB early, otherwise, follow:

    Week 0-2: 30% weight bearing
    Week 2- 50% with progression to 75%
    Week 3- progress to full weight bearing as tolerated Week 4- discontinue crutches

  • Avoid active hip flexion past 90 degrees and avoid passive range of motion that causes pinching pain

  • Avoid exercises that engage the iliopsoas

  • Avoid passive unilateral extension until 3 weeks postoperative

Suggested Therapeutic Exercise

Weeks 0-2:

  • Stationary bicycle without resistance- no pain

  • Gluteal sets, quad sets, heel slides, calf pumps

  • Passive range of motion of hip avoiding ER and emphasize IR

  • Isometric strengthening- transverse abdominus, hip abduction

    and adduction

  • Uninvolved knee to chest, piriformis stretching without ER

  • Supine hip roll IR, standing hip IR, quadruped rocking

    Weeks 2-6:

  • Continue all exercises above

  • Add light resistance to stationary bike

  • SLR 4 directions

  • Side-lying clams, bent knee fall outs, short lever hip flexion

    (seated)

  • Weight shifts with progression to single leg proprioception

  • Double leg bridging

Cardiovascular exercise

• Upper body circuit training or upper body ergometer (UBE)

Progression Criteria

  • Normal gait with assistive device with FWB (pain free)

  • Good leg control at low velocity

  • Functional range of motion (pain free)

 

Phase II (weeks 6 – 3 months)

Appointments

• Rehabilitation appointments are 1-3 times per week

Rehabilitation Goals

  • Improve muscular strength and endurance

  • Good control and no pain with sport and work specific

    movements

Precautions

  • Post activity soreness should resolve within 24 hours

  • No ballistic or forced stretching

  • Avoid post-activity swelling or muscle weakness

  • Be cautious with repetitive hip flexion activities

Suggested Therapeutic Exercise

  • Continue above exercises

  • Kneeling hip flexor stretch, manual long axis distraction,

    manual A/P mobs, double 1/3 knee bends, cord resisted

    standing double leg IR and ER

  • Swimming with fins, bounding, plyometric

  • Mini-squats and wall slides

  • Toe raises with weights, step ups

  • Trunk strength- transverse abdominus, side supports, trunk

    and low back stabilizers

Cardiovascular exercise

  • Seated rowing, elliptical, stair climber

  • Swimming as stated above

Progression Criteria

• Normal gait, dynamic neuromuscular control without pain or swelling

 

Phase III (3-4 months)

Appointments

• Rehabilitation appointments are once every 1-2 weeks

Rehabilitation Goals

  • Improve muscular strength and endurance

  • Good control and no pain with sport and work specific

    movements

Precautions

  • Post activity soreness should resolve within 24 hours

  • No ballistic or forced stretching

• Avoid post-activity swelling or muscle weakness

Suggested Therapeutic exercises

  • Continue all above exercises

  • Dynadisc, advanced bridging, side supports, cord resisted

    single leg standing IR/ER, skaters/side stepping, Pilates or slideboard, single knee bends, single leg windmills, lunges, side to side lateral agility, forward/backward running with cord

  • Closed chain exercises including leg press, step ups, mini- squats, and hamstring curls

Cardiovascular exercise

• Jump rope exercises, jogging on even ground (no treadmill)

Criteria for Progression

• Normal gait, dynamic neuromuscular control without pain or swelling

 

Phase IV (4-6 months)

Appointments

• Rehabilitation appointments are once every week

Rehabilitation Goals

  • Development of strength, power, and endurance

  • Begin gradual return to functional activities

Precautions

• No active reactive swelling or joint pain that lasts more than 12 hours

Suggested Therapeutic exercises

  • All previous exercises as appropriate

  • Begin advanced strengthening with weights including leg

    press, squats, leg curls and lunges

  • Initiate plyometric program

  • Functional training exercises including fast straight running,

    backward running, cutting, cross overs, carioca

  • Gradual return to previous sport and activities under

    controlled conditions

Cardiovascular exercise

• Continue as above

Progression/ return to sport

  • Normal muscle strength in the involved lower extremity

  • Jog and full speed run without a limp

  • Full range of motion

  • Satisfactory clinical examination

bottom of page