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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
FlexionExtensionExternal RotationInternal RotationAbduction
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
POST-OP DAY 1/INITIAL PHYSICAL THERAPY VISIT
CHECK LIST
Activity/InstructionFrequencyCompleted ?
Instructed in ambulation and stairs with crutches and 20# FFWB
Upright Stationary bike no resistance20 minutes daily
CPM usage4 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/caregiver20 minutes; 2 times each day
*Maintain restrictions for 3 weeks
Prone lying2–3 hours/day
Isometrics (quad sets, glut sets, TA activation)Hold each 5 seconds, 20 times each, 2x/day

PHASE 1

  • •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:Week123456
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 breathingdaily✓
Quadriped
-rocking, pelvic tilts, arm lifts		daily✓
Anterior capsule stretches: surgical leg off table/Figure 4daily✓
Clams/reverse clamsdaily✓
TA activation with bent knee fall outsdaily✓
Bridging progression5x/week✓
Prone hip ER/IR, hamstring curls5x/week✓

PHASE 2

  • •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:Week345678910
Progress off crutches starting week 3✓
Continuation of soft tissue mobilization to treat specific restrictions2x/week✓
Joint Mobilizations posterior/inferior glides2x/week✓
Joint Mobilizations anterior glides2x/week✓
Prone hip extension5x/week✓
Tall kneeling and ½ kneeling w/ core and shoulder girdle strengthening5x/week✓
Standing weight shifts: side/side and anterior/posterior5x/week✓
Backward and lateral walking no resistance5x/week✓
Standing double leg ⅓ knee bends5x/week✓
Advance double leg squat5x/week✓
Forward step ups5x/week✓
Modified planks and modified side planks5x/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 surgeryWeek8910111216
Continue soft tissue and joint mobilizations PRN2x/week✓
Lunges forward, lateral, split squats3x/week✓
Side steps and retro walks w/ resistance (begin w/ resistance more proximal)3x/week✓
Single leg balance activities: balance, squat, trunk rotation3x/week✓
Planks and side planks (advance as tolerated)3x/week✓
Single leg bridges (advance hold duration)3x/week✓
Slide board exercises3x/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 surgeryWeek1620242832
RunningIn 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

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

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