HIP ARTHROSCOPY LABRAL REPAIR
Overall Goal: Brief rehabilitation with education on signs and symptoms of overuse and
modification of activity to avoid pain.
This protocol is based on a goal oriented progression. Each patient is different and should be treated
according to their tolerance in therapy.
Impact activity should not begin until at least 12 weeks postoperative (i.e. running, jumping,
stairmaster) and should be started only when the patient exhibits a nearly full passive and active
range of motion of the hip. Particular attention should be paid to the improvement of passive and
active internal rotation of the hip. The patient may be nonweight bearing, toe touch weight bearing,
flat foot weight bearing for up to 2-4 weeks following the procedure.
No active external rotation for 4 weeks
Passive motion of hip with bike encouraged immediately
Seen 1x/week first month and 2-3x/week for next 1-2 months
I: Initial Phase:
Goals: Regain range of motion within tolerance, decrease swelling and pain, avoid muscle atrophy.
A: Day of surgery begin isometric gluteal sets and ankle pumps.
B: Postoperative day 1-7:
Toe touch/flat foot weight bearing, crutch ambulation.
1. Isometric quad sets, gluteal sets, hamstring sets, abductor sets.
2. Active assisted range of motion in all planes without pain. Limits include flexion
to 90 degrees, internal rotation to 30 degrees, careful external rotation to 20 degrees for the
first month, unless otherwise noted
3. Hip mobilization is beneficial in decreasing pain and increasing range of motion
with straight distraction.
4. Inferior glide and posterior glide, open chain abduction, adduction with
resistance.
5. Pool exercises; water resisted toning, swimming, and walking drills.
6. Avoid early straight leg raises until at least 3 weeks postoperative.
7. Gentle toning exercises can begin as early as week 1 as long as the patient
is pain free and remains pain free throughout exercises.
II: Early Phase:
Goals: improve strength and normalize joint arthrokinematics.
A: Postoperative weeks 2-3:
1. Continue to progress range of motion with gradual end range
2. stretch within tolerance and surgical limits placed.
3. Begin progressive resistive exercises as tolerated. Closed chain single leg
bridging.
4. Open chain above knee resistive Theraband or pulley exercise in abduction,
adduction, and hamstring curl as tolerated.
5. Bike if tolerated for up to 5-10 minutes.
6. Pool exercises as tolerated.
7. No Impact or repetitive twisting activities.
III: Intermediate Phase:
Goals: Improve functional strength and endurance, without high impact.
A: Postoperative weeks 4-6:
1. Begin gradual progressive weight bearing as tolerated.
2. Continue flexibility exercises.
3. Continue progressive resisted strengthening and functional strengthening
exercises.
4. Closed chain exercises as tolerated, multi-hip strengthening, hamstring curls,
knee extension.
5. Open chain activities.
6. Begin biking (recumbent ideal at first experience)
IV: Advanced Phase:
Goals: Return to functional activity in sports specific motions.
A: Postoperative weeks 7-12:
1. Begin progression to functional activities. Pivoting and rotational (high impact
activities gradually introduced)
2. No pain. Predicated on normal range of motion prior to institution of
activities.
V: Return to Full Activities by weeks 8-12 as tolerated.
VI: Full sports Activities by 12-16 weeks.