Rehabilitation after hip surgery involves distinct phases of recovery. The goal is to allow the best environment for tissue healing while maximizing long-term function for return to as many of the activities you love as possible.
Your rehabilitation should be done under the guidance of a physical therapist, who can refer to our Post‐Operative Arthroscopic Hip Protocol for specific suggestions regarding rehabilitation progression.
This is merely an example of a typical recovery process, and should not be used to direct your rehabilitation after surgery. Each procedure and patient presents a unique set of circumstances, which is why the guidance of a physical therapist is essential to an effective recovery.
During Phase I, the goal is to provide maximal protection to the surgically repaired tissue while restoring basic range of motion (ROM) and strength. This phase includes passive ROM (using a rope or a helper to move your leg for you) and basic isometrics (tightening muscles in specific positions without moving the leg). The most important thing to focus on during this phase is getting the joint to simply calm down after surgery. You will be on crutches during this phase but the specific weight bearing restrictions depend on your exact procedure and will be determined at the time of your surgery.
During Phase II, the tissue fixation has become a little stronger but still requires protection. Active ROM (moving the leg on its own power) is recommended as tolerated. Hip flexor activation will often cause increased and unnecessary irritation so try to avoid lifting your leg straight up under its own power. Specific exercises to activate and strengthen the external rotators and abductors of the hip along with progressive weight bearing activities are also initiated during this phase. You will also be weaned off crutches as tolerated, although some procedures need extra time.
By Phase III the tissue should be well along in the healing process. This does not mean that it is completely secure, but it should require some sort of impact load to the tissue to cause damage. This includes running, jumping, and quick pivoting – these activities should continue to be avoided through Phase III. During this phase you will be off of your crutches and focused on regaining any remaining ROM deficits and trying to increase the overall strength of your entire leg. A systematic progression through increasingly challenging exercises while minimizing discomfort to your hip is ideal and should be performed under the guidance of a physical therapist.
By Phase IV, most repaired tissue should be very well affixed. During this phase your physical therapist will systematically test your tolerance of increasingly intense impact loads. Any discomfort will require modification of the activity. If tolerated, a progressive running program can be initiated also under the supervision of your physical therapist. Activities that you will be resuming after rehab is complete will be simulated in the clinic to test tolerance and to modify your program to address any remaining deficits you may have.
It is important to understand that this phase can be a three-month process in and of itself. Plan for six months of recovery before fully returning to high-level activities such as sports. You will often need to continue a consistent home program to maintain the highest level of function for years after surgery. Before undergoing surgery, it is also important to understand that the goal of the surgery is to maximize your function. It is not a guarantee that your hip will be perfect or "good as new". Occasional discomfort that is tolerable and manageable during activities is not uncommon long-term after surgery. Also, sometimes the irreparable damage that was already done to your joint prior to surgery may make certain activities very difficult to resume, if ever. Your surgeon and physical therapist can advise on this as you return to activities.