Recovery

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 effective recovery.

Typical Recovery Process

This is an example of a typical recovery process, and should not be used to direct your rehabilitation after surgery. Each procedure and patient presents a unique set of circumstances, and progressions should be based on your individual responses, exam findings, and progress.

Immediate Post-Operative Phase

Overall Goals
  • Protect osteotomy sites, control pain and edema, minimize atrophy
Precautions
  • Partial flat-foot weight bearing (~20 #) for 4-8 weeks
  • Avoid hip flexion >90 degrees
  • Avoid long lever LE exercises

*Depending on procedure/approach other ROM restrictions may apply

Frequency: 1x / 1-2 weeks

Suggested Interventions
  • Short-lever, pain free AROM excluding flexion
  • Gluteal/abdominal activation
  • Midrange submaximal isometrics
  • Gait training per WB precautions
  • Cryotherapy/compression
Example Exercises
  • Supine bent knee fall ins/outs within protected ROM (<20ยบ)
  • Submaximal isometrics adduction/abduction in hook-lying position
  • Short arc knee extension
  • Prone knee flexion/quad flexibility
  • Prone terminal knee extension
Criteria to Progress to Intermediate Phase of Rehab
  • Physician clearance to begin WBAT (weight bearing as tolerated)
  • Pain well controlled ( <3 /10 on 11 point pain scale)

Immediate Phase

Overall Goals
  • 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: 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 Phase

Overall Goals
  • 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 LE strength progression
  • Core stability progression
  • Low impact plyometrics
  • Step-wise walk-jog 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 Late 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