Hip Arthroscopy Post-Op Protocol
HIP ARTHROSCOPY REHABILITATION PROTOCOL
Physiotherapy and compliance with exercises and physiotherapy post hip arthroscopy is crucial in ensuring a good outcome in patients who have had hip arthroscopy. The goals of rehabilitation are:
- Reduction in pain and swelling after hip arthroscopy.
- Restore and gradually improve range of movement of the hip.
- Restore hip muscle tone and strength.
- Improve and restore core muscle stability.
- Improve balance, proprioception, muscle balance and gait symmetry.
- Enable return to full function including day to day activities, physical/leisure activity of choice.
Rehabilitation after hip arthroscopy is individualised in that once the goals of each stage of rehabilitation has been achieved, then it is acceptable to move on to exercises in subsequent stages. It is crucial that your rehabilitation is supervised by an expert chartered physiotherapist. Broadly the stages of hip arthroscopy rehab are divided into 4 stages of approximately 4 to 6 weeks per stage;
Stage 1: Protected weight bearing stage.
This stage is the period between 4 to 6 weeks after hip arthroscopy. Patients should be mobilised using walking aids and this may last between 2 to 6 weeks depending on the level of surgical intervention, (e.g. if labral re-attachment, cam or pincer osteoplasty was performed and the extent of osteoplasty). Exercises during this stage are aimed at gradually restoring range of movement of the hip whilst maintaining muscle strength and function, allowing soft tissue structures around the hip to heal. The key at this stage of rehab is regular application of ice and active circumduction (rotation) of the hip within what is tolerated by the patient whilst allowing partial weight bearing. Patients are advised to ice the hip for 10 to 15 minutes, 6 to 7 times a day.
Stage 2: Intermediate exercises.
This is between typically 4 to 8 weeks after arthroscopy +/- 2 weeks where full weight bearing is permitted. Exercises should be commenced with the guidance of the treating physiotherapist. The aim should be to restore range of movement in the involved hip to 80 to 90% of the uninvolved side. Exercises taught at this stage are aimed at restoring range of movement of the hip, encouraging a normal pattern of gait, strengthening hip (esp. abductors) and core muscle strength.
Stage 3: Advanced exercises.
This is commenced around 8 to 12 weeks after surgery (+/- 2 weeks). Advanced exercises are commenced when full range of movement is obtained; walking is normal and pain free and muscle strength is greater than 30 % of the uninvolved side in all directions. The goals at this stage of treatment are restoring full muscle and cardiovascular fitness and improving proprioception and balance. Return to sporting activities is permitted at this stage.
Stage 4: Sports specific training.
This is commenced around 12 to 16 weeks after surgery (+/- 2 weeks). Those patients who participate in competitive sports would benefit from further strengthening and sports specific exercises. Training regimes for this stage is developed in conjunction with specialist physiotherapist or personal trainers.
For further information please refer to www.damiangriffin.org/rehabhtn