Hip Rehab after Surgery

Success of hip arthroscopic surgery is strongly associated with a thorough rehabilitation protocol. It is essential to achieve adequate range of motion, and local hip muscle activation early in the rehabilitation process. Restoration of basic movement patterns with good biomechanics and progressive increases in load management or speed development as appropriate, are necessary for functional activities or return to sport.

The rehabilitation protocol consists of 5 stages and allows for return to sport around 6 months after surgery. Throughout the rehabilitation protocol, it is important to respect individual pain triggers and potential surgical restrictions to minimize pain flare ups and ensure optimal functional results. Criterion based progression relies on the achievement of determined milestones before advancing to the next phase. The intent of this protocol is to provide guidelines for the patient’s therapy progression.

Although the rehabilitation protocol is milestone driven, the timeline provided should be used as a guide. Each athlete will have a unique journey and should be treated on an individual basis; therefore, some criteria might not be fully met prior to progressing onto the next phase. The rehabilitation specialist should use their clinical reasoning skills and shared decision making with the athlete to guide the process. Ideally, ALL milestones are achieved before advancing to the next rehabilitation phase.

The first phase of rehabilitation is centered on regaining hip mobility and regional muscle activation. Ensuring adequate early mobility, without being overly aggressive on joint mobilizations and respecting pain are paramount for the initial phases of rehabilitation. When in doubt, rehabilitation should err on the side of protecting the integrity of the repaired tissue in the first 3-6 weeks post op.

After this initial postoperative period, the rehabilitation protocol then progresses to developing hip muscle strength, equal and effective weight bearing tolerance, re-establishing core muscle control plus building up basic movement patterns. Together, this will provide a platform for athletic progression.

Optimal muscle activation with pelvis and trunk control will ensure better biomechanics during movements with speed and power. This will reduce the stress on the repaired tissues and enhance postoperative outcomes. It is therefore essential to follow specialized rehabilitation protocols throughout the 6 - 9 month post-operative window. This should be continued until the patient is able to demonstrate base proficiency in the testing outlined at the end of phase 4 and is cleared to return to unrestricted activities or sports.

Hip Arthroscopy Protocol - Physio .pdf

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