Steve Stalzer MSPT Michael Wahoff FT Molly Scanlan Mspt Ocs

Howard Head Sports Medicine Center, 181 West Meadow Drive, Vail, CO 81657, USA

The management of hip injuries has evolved significantly in recent years with the advancement of arthroscopic techniques. The application of minimally invasive surgical techniques has facilitated relatively rapid returns to sporting activity in both recreational and elite athletes [1]. These recent surgical advances require establishment of rehabilitation guidelines that consider the constraints of soft tissue healing while advancing patients as rapidly and safely as possible.

Although rehabilitation guidelines following hip arthroscopy continue to evolve, the overall goal remains to return the patient to a preinjury level of activity. This involves restoration of normal range of motion, gait, and strength to allow return to functional activity. In the athlete, the rehabilitation program must also focus on restoration of power, speed, and agility for optimal return to competition.

Repaired tissue must be properly protected to allow healing and to prevent excessive stress on tissue. However, prolonged immobilization is not desired because of the numerous deleterious effects, including muscle atrophy, articular cartilage degeneration, ligament strength loss, and excessive adverse collagen formation [2-9]. Rehabilitation protocols need to follow several basic principles: (1) consideration of soft tissue healing constraints, (2) control of swelling and pain to limit muscular inhibition and atrophy, (3) early range of motion (ROM), (4) limitations on weight bearing, (5) early initiation of muscle activity and neuromuscular control, (6) progressive lower extremity strengthening and proprioceptive retraining, (7) cardiovascular training, and (8) sport specific training.

We have divided postoperative hip rehabilitation protocols into four phases. Progression through each phase is based on clinical criteria and time frames as appropriate.

* Corresponding author. E-mail address: [email protected] (S. Stalzer).

0278-5919/06/$ - see front matter © 2006 Elsevier Inc. All rights reserved.

doi:10.1016/j.csm.2005.12.008 sportsmed.theclinics.com

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