GALLAND/KIRBY HIP ARTHROSCOPY POST-SURGICAL REHABILITATION PROTOCOL

POST-OP DAYS 1 – 7

•   Crutches – weight bearing as tolerate (WBAT), D/C when gait is normal

•   All exercises must be performed in pain-free range

•   Heel slides, AAROM, PROM – Limit flexion to 90 degrees

•   Calf pumping

•   Electrical stimulation in full extension with quad sets

•   Quad sets, Co-contractions quads/hamstring

•   Short arc quads

•   Glut sets

•   Adductor isometric sets (squeeze pillow between legs)

•   Abductor isometric sets (belt around thighs, push out)

•   Stationary bike for range of motion (ROM) – No Resistance

GOALS

•   Pain control

•   Hip ROM 0-90 degrees flexion

DAYS 7 – 14

•   Crutches – D/C if gait is normal

•   Continue appropriate previous exercises

•   All exercises must be performed in pain-free range

•   AAROM, AROM through full range as tolerated

–   Rocking to heel in quadruped position

–   Prone lying and gentle prone press ups

•   Standing Straight leg raise (SLR) x 4 directions

•   Weight shifts and Mini-squats in parallel bars

•   Heel raises – Double leg to single leg

•   Core stabilization exercise

–   Double leg bridging exercises – neutral pelvis

–   Transverse abd contractions

•   Stationary bike for ROM – Minimal resistance

•   Pool therapy – Chest deep running, aqua-jogger

GOALS

•   Full hip ROM

•   Normal gait

WEEKS 2 – 4

•   Continue appropriate previous exercises

•   SLR x 4 on mat

•   Wall squats, Total gym

•   Forward, retro and lateral step downs (2-4” step)

•   Leg press (up to ¼ body weight)

•   HS curls – Closed chain (carpet drags or rolling stool)

•   Proprioception ex – Double to single leg BAPS

•   Core stabilization exercises

–   Single-leg bridging (on affected side)

–   Crunches

•   Stationary bicycle for progressive resistance and time

•   Elliptical trainer

•   Pool therapy – Waist deep running

•   Stretches – Hamstring, Hip Flexors, ITB

GOALS

•   No pain with stair climbing

•   Walk 1 mile at easy pace

WEEKS 4 – 6

•   Continue appropriate previous exercises

•   Standing SLR x 4 with Theraband bilaterally

•   Hamstring curls weight machine

•   Knee extension weight machine

•   Leg press (up to ½ body weight)

•   Proprioception exercise – Single leg ball toss and body blade

•   Core stabilization exercise

–   Side bridging

–   Plank (hold push-up position on elbows)

•   Treadmill – Walking progression program

•   Stairmaster

•   Pool therapy – Unrestricted

GOAL

•   Walk 2 miles at easy pace

WEEKS 6 – 8

•   Continue appropriate previous exercises with progressive resistance

•   Forward, retro and lateral step downs (med to large step)

•   Hip weight machine x 4 directions

•   Hip rotation in weight bearing (closed chain) with hip machine, cables/cord

•   Functional training – Fitter, slide board

•   Treadmill – Walking progression approaching 15 min/mile pace

•   Quad stretches

GOAL

•   Walk 2 miles at 15 min/mile pace

MONTHS 2 - 3

•   Continue appropriate previous exercises

•   Advanced core stabilization exercise

–   Sit backs

–   Quadruped swimmer

–   Double leg lower

–   Physioball

•   Push-up progression

•   Treadmill – Running progression program

•   Pool – Begin swimming laps

GOAL

•   Run 2 miles at easy pace

MONTHS 3 – 4

•   Continue appropriate previous exercises

•   Sit-up progression

•   Agility drills / Plyometrics

•   Transition to home / gym program

GOAL

•   Return to all activities

*NO CONTACT SPORTS UNTIL 6 MONTHS POST-OP*

DEVELOPED BY:                                                                                                                     ADAPTED FROM:

Mark Galland, MD                                                                                                                     Physical Therapy Section

Kenneth Kirby, PT, DPT                                                                                                            William Beaumont Army Medical Center