Introduction
Phase 1 - Rehabilitation Goal: Protect the joint and avoid irritation (Approximately Weeks 1-6)
PT Pointers:
- Provide patient with education on initial joint protection to avoid joint and surrounding soft tissue irritation
- Begin initial passive range of motion within post operative restrictions
- Initiate muscle activation and isometrics to prevent atrophy
- Progress range of motion promoting active range of motion and stretching
- Emphasize proximal control of hip and pelvis with initial strengthening
- Initiate return to weight bearing and crutch weaning
- Normalize gait pattern and gradually increase weight bearing times for function
PRECAUTIONS:
- NO Active lifting of the surgical leg (use a family member/care taker for assistance/ utilization of the non-operative leg) for 3 weeks
- DO NOT push through pain
- Pivoting or rotating hip during ambulation / NO open chain or isolated hip muscle activation, unless isometric.
Phase 2 - Rehabilitation Goal: Non-compensatory gait and progression (Approximately Weeks 4-10)
PT Pointers:
- Return the patient to community ambulation and stair climbing without pain using normal reciprocal gait pattern
- Continue to utilize manual techniques to promote normal muscle firing patterns and prevent soft tissue irritation
- Progress strengthening exercises from double to single leg
- Promote advanced strengthening and neuromuscular re-education focusing on distal control for complex movement patterns
- Progress the patient to phase 3 rehabilitation with appropriate control and strength for sport specific activities
Phase 3 - Rehabilitation Goal: Return to pre-injury level (weeks 10-18)
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
Phase 4 - Rehabilitation Goal: Return to Sport (weeks 16-32)
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
