REHAB PROTOCOL · HIP

Hip Arthroscopy & Labral Repair Rehab Protocol

By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA

The written protocol Dr. Kelly provides to his patients and their physical therapists in the Tri-Cities. Time frames are guidelines — progression is criteria-based, and your own post-op instructions always govern.

⬇ Printable protocol (PDF)Request an appointment →

Educational information, not medical advice. This is not a substitute for the specific instructions Dr. Kelly and your physical therapist give you. Your timeline depends on your surgery, your body, and your progress. Follow your own care team's directions. In an emergency, call 911.

PHASE 1

PHASE 2

Phase 3

Phase 4

ROM RESTRICTIONS

•Perform PROM in patient’s PAIN FREE Range

Flexion	Extension	External Rotation	Internal Rotation	Abduction
Limited to: 90 degrees x 2 weeks	Limited to: 0 degrees x 3 weeks	Limited to: 30 degrees @ 90 degrees of hip flexion x 3 weeks 20 degrees in prone x 3 weeks	Limited to: 20 degrees @ 90 degrees of hip flexion x 3 weeks No limitation in prone	Limited to: 30 degrees x 2 weeks

WEIGHT BEARING RESTRICTIONS: GAIT PROGRESSION

20# FOOT FLAT Weight Bearing
-for 3 weeks (non-Micro-fracture)
-for 6 weeks (with Microfracture)

Begin to D/C crutches at 4 weeks (6 wks if MicroFracture is performed).
Patient may be fully off crutches and brace
once gait is PAIN FREE and NONCOMPENSATORY

PATIENT PRECAUTIONS

##INLINE1##NO active lifting of the surgical leg (use a family member/caretaker for assistance / utilization of the non-operative leg) for approximately 4 weeks
##INLINE2##NO sitting greater than 30 minutes at a time for the first 3 weeks; DO NOT push through pain

POST-OP DAY 1/INITIAL PHYSICAL THERAPY VISIT

CHECK LIST

Activity/Instruction	Frequency	Completed ?
Instructed in ambulation and stairs with crutches and 20# FFWB
Upright Stationary bike no resistance	20 minutes daily
CPM usage	4 hours/day (decrease to 3 hours if stationary bike used for 20’)
Instruction on brace application/usage
PROM (circumduction, abduction, log rolls) instructed to the family/caregiver	20 minutes; 2 times each day

*Maintain restrictions for 3 weeks
Prone lying	2–3 hours/day
Isometrics (quad sets, glut sets, TA activation)	Hold each 5 seconds, 20 times each, 2x/day

##INLINE3##

##INLINE4##Goal: Protect the Joint and Avoid Irritation

PT POINTERS

•Goal is symmetric ROM by 6–8 weeks; NO Active open chain hip flexor activation; emphasize proximal control
•Manual Therapy to be provided 20–30 minutes/PT session

Date of surgery:	Week	1	2	3
Stationary bike (20 min, Increase time at week 3 as patient tolerates)	Daily	✓
Soft tissue mobilization (specific focus to the adductors, TFL, Iliopsoas, QL and Inguinal ligament)	Daily (20–30 minutes each session)	✓
Isometrics -quad, glutes, TA	daily	✓
Diaphragmatic breathing	daily	✓
Quadriped -rocking, pelvic tilts, arm lifts	daily	✓
Anterior capsule stretches: surgical leg off table/Figure 4	daily			✓
Clams/reverse clams	daily	✓
TA activation with bent knee fall outs	daily	✓
Bridging progression	5x/week		✓
Prone hip ER/IR, hamstring curls	5x/week		✓

##INLINE7##

##INLINE8##Goal: Non-Compensatory Gait and Progression

PT POINTERS

•Advance ambulation slowly without crutches/brace as patient tolerates and avoid any compensatory patterns
•Provide tactile and verbal cueing to enable non-compensatory gait patterning
•Advance exercises only as patient exhibits good control (proximally and distally) with previous exercises
•If MicroFracture was performed, Hold all weight bearing exercises until week 6

Date of Surgery:	Week	3	4	5	7
Progress off crutches starting week 3		✓
Continuation of soft tissue mobilization to treat specific restrictions	2x/week	✓
Joint Mobilizations posterior/inferior glides	2x/week			✓
Joint Mobilizations anterior glides	2x/week				✓
Prone hip extension	5x/week	✓
Tall kneeling and ½ kneeling w/ core and shoulder girdle strengthening	5x/week	✓
Standing weight shifts: side/side and anterior/posterior	5x/week	✓
Backward and lateral walking no resistance	5x/week	✓
Standing double leg ⅓ knee bends	5x/week		✓

Advance double leg squat	5x/week	✓
Forward step ups	5x/week	✓
Modified planks and modified side planks	5x/week	✓
Elliptical (begin 3 min, ↑ as tolerated)	3x/week	✓

Phase 3

•Goal: Return the Patient to Their Pre-Injury Level

PT POINTERS

•Focus on more FUNCTIONAL exercises in all planes
•Advance exercises only as patient exhibits good control (proximally and distally) with previous exercises
•More individualized, if the patients demand is higher than the rehab will be longer

Date of surgery	Week	8	10
Continue soft tissue and joint mobilizations PRN	2x/week	✓
Lunges forward, lateral, split squats	3x/week	✓
Side steps and retro walks w/ resistance (begin w/ resistance more proximal)	3x/week	✓
Single leg balance activities: balance, squat, trunk rotation	3x/week	✓
Planks and side planks (advance as tolerated)	3x/week	✓
Single leg bridges (advance hold duration)	3x/week	✓
Slide board exercises	3x/week		✓
Agility drills (if pain free)	3x/week		✓
Hip rotational activities (if pain free)	3x/week		✓

Phase 4

•Goal: Return to Sport

PT POINTERS

•It typically takes 4–6 months to return to sport, possible 1 year for maximal recovery
•Perform a running analysis prior to running/cutting/agility
•Assess functional strength and obtain proximal control prior to advancement of phase 4

Date of surgery	16	20	24
Running	In Alter G	✓
Agility		✓
Cutting			✓
Plyometrics			✓
Return to sport specifics			✓

Return to Sport & Discharge Criteria

•Non-compensatory gait; pain-free ADLs; symmetric hip ROM
•Hip/core strength ≥90%; functional testing passed
•Return to sport when cleared by Dr. Kelly

Time frames are guidelines — progress when phase goals are met, per Dr. Kelly and the treating therapist.

Procedure variants — printable protocols

⬇ Patient Guide (First 2 Weeks) (PDF)

When to call

Increasing pain, numbness, redness, drainage from the wound, or fever/chills — call (509) 460-5588. After hours, the answering service can reach Dr. Kelly. If your issue feels emergent, call 911 or go to the nearest emergency department.

Physical therapists

Treating one of Dr. Kelly's patients? Download the printable protocol for your clinic, and call (509) 460-5588 with questions about an individual patient's progression.

⬇ Protocol PDF

Related protocols

HIPTotal Hip Replacement KNEEACL Reconstruction KNEEMeniscus Surgery

Back on the field starts with a plan.

Fellowship-trained sports medicine care in Kennewick, Richland & Pasco.

Request an Appointment