Rehabilitation

Rehabilitation after hip surgery involves distinct phases of recovery. The goal is to allow the best environment for tissue healing while maximizing long-term function. The guidance of a physical therapist, in consultation with your physician, is essential to an optimal recovery.

View our Rehabilitation Guidelines (PDF).

Immediate Post-Operative Phase
(Post Op Weeks 1-4)

Goals of Phase
  • Protect osteotomy sites, control pain and edema, minimize atrophy
Precautions
  • Partial flat-foot weight bearing (~20 .lbs) for 6 weeks
  • Avoid hip flexion >90 degrees
  • Avoid long lever LE exercises

*Depending on procedure other ROM restrictions may apply

Frequency: 1x / 1-2 weeks

Suggested Interventions
  • Bilateral lower extremity circulation and muscle activation
  • Specific gluteal/abdominal muscle activation and retraining
  • Gait training per weightbearing precautions
  • Supine bent knee fall ins/outs within protected ROM (<20ยบ)
  • Pain free gentle circumduction PROM
  • Cryotherapy/compression
Criteria to Progress to Intermediate Phase of Rehab
  • Good tolerance to low level interventions
  • Pain well controlled ( <3 /10 on 11 point pain scale )

Early Post-Operative Phase
(Post Op Weeks 4-6)

Goals of Phase
  • Protect osteotomy sites, control pain and edema, minimize atrophy, restore ROM
Precautions (continue per Phase 1)
  • Continue foot flat protected weightbearing (<20 lbs. weightbearing)
  • No flexion >90 with exercise
  • Avoid active hip flexion
Recommended Exercises
  • Continue interventions from Phase I as appropriate
  • Submaximal isometrics adduction/abduction in hook lying position
  • Short lever pain free A/AAROM within protected ROM
  • Short arc knee extension
  • Standing hip abduction within pain-free ROM
  • Pool walking in chest deep water once incision fully healed
    • Begin with 10 minutes progressing x 5 min as tolerated
Frequency: 3 days/week with rest day between sessions until tolerance improves

Criteria to Progress to Intermediate Phase of Rehab
  • Physician clearance to begin WBAT
  • Pain well-controlled (<3/10 on 11-point pain scale) free ROM

Intermediate Phase
(Post Op Weeks 6+)

Goals of Phase
  • Increase hip A/PROM, improve hip and LE strength, improve balance, improve proprioception, normalize gait pattern without AD
Precautions
  • Monitor for joint and soft tissue inflammation
  • Criteria to d/c crutches for community ambulation:
    • >/= 30 seconds of SLS balance without loss of pelvic height
    • 10 repetitions of correctly performed prone hip extension test
    • Score of 0-1 on active hip abduction test
Frequency: 1-2x/week

Suggested Interventions
  • Low resistance upright bike
  • Hip and LE strength progression (bilateral to single leg)
  • Core stability progression (utilizing transitional positions)
  • Gait training
Example Exercises
  • Prone hip extension
  • Bridges
  • Standing TKE
  • Leg press
  • Clamshells with resistance
  • Quadruped hip extension
  • Single leg balance
  • Chop/lift patterns in half kneeling
  • Step up/step downs
  • Double and single leg squats with suspension trainer
  • Single leg deadlift
Criteria to Progress to Late Phase of Rehab
  • Negative Trendelenberg Test
  • Pain free with ADLs
  • Normalization of gait pattern without AD
  • Community ambulation without fatigue or symptoms

Late Postoperative Phase

Goals of Phase
  • Control body in multiple planes and tolerate low impact plyometric activities, asymptomatic with recreational activity
Precautions
  • Avoid provocation of symptoms with exercise progression
Frequency: 2x / week

Suggested Interventions
  • Multi-directional hip and lower extremity strengthening progression
  • Progression of core stabilization
  • Low impact plyometrics
  • Structured walk-jog interval program
  • Low intensity agilities
Example Exercises
  • Single-leg mini squats with multi-directional LE reach
  • Reduced weight bearing hopping on shuttle
  • Side shuffle
  • Progressive hopping drills
Criteria to Progress to Return to Sport Phase of Rehab
  • Full and pain-free strength
  • Full and pain-free ROM
  • No reactive pain or inflammation with therapeutic interventions
  • Pain-free sport specific activities
  • Ability to perform unilateral functional activities without compensatory patterns or deviations