Download Hip Arthroscopy Rehab Protocol

Weeks 1- 6:

Phase 1 – Rehabilitation Goal: Protect the joint and avoid irritation

ROM Restrictions:
* Perform PROM in patient’s PAIN FREE Range

FLEXION: Limited to: 90 degrees x 2 weeks (may go higher in the CPM)

EXTENSION: Limited to: 0 degrees x 3 weeks

EXTERNAL ROTATION: Limited to: *30 degrees @ 90 degrees of hip flexion x 3 weeks

*20 degrees in prone x 3 weeks

INTERNAL ROTATION: Limited to: *20 degrees @ 90 degrees of hip flexion x 3 weeks
*No limitation in prone

ABDUCTION: Limited to: 30 degrees x 2 weeks

Weight Bearing Restrictions:

20% FOOT FLAT Weight Bearing-for 2-3 weeks (non-Micro-fracture)

Gait Progression:

  • Begin to D/C crutches at 3 weeks. Do NOT progress to one crutch
  • Patient may be fully off crutches and brace once gait is PAIN FREE and NON-COMPENSATORY

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


  • 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.


  • Stationary bike (20 min, Increase time at week 3 as patient tolerates) Daily, Weeks 1-6
  • Soft tissue mobilization (specific focus to the adductors, TFL, Iliopsoas, QL and Inguinal ligament) Complete daily 20-30 minutes per session, Weeks 1-6
  • Isometrics-quad, glutes, TA, Daily, Weeks 1-2
  • Diaphragmatic breathing, Daily, Weeks 1-2
  • Quadruped-rocking, pelvic tilts, arm lifts, Daily, Weeks 1-3
  • Clams/reverse clams, Daily, Weeks 1-3
  • TA activation with bent knee fall outs. Daily, Weeks 1-3
  • Anterior capsule stretches: prone hip ER, Daily, Weeks 3-6
  • Bridging progression 5x/week, Weeks 2-6
  • Prone hip ER/IR, hamstring curls 5x/week, Weeks 2-6

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


  • Progress off crutches starting Week 3
  • Continuation of soft tissue mobilization to treat specific restrictions 2x/week, Weeks 3 – 10
  • Joint Mobilizations posterior/inferior glides 2x/week, Weeks 5-10
  • Joint Mobilizations anterior glides 2x/week, Weeks 7-10
  • Prone hip Extension, 5x/week, Weeks 3-5
  • Tall Kneeling and 1/2 kneeling with core and shoulder girdle strenghtening, 5x/week, Weeks 3-6
  • Standing weight shifts: siide/side and anterior/posterior, 5x/week, Weeks 3-4
  • Backward lateral walking, no resistance, 5x/week, Weeks 3-4
  • Standing double leg 1/3 knee bends 5x/week, Weeks 4-6
  • Advanced double leg squat, 5x/week, Weeks 6-10
  • Forward Step ups, 5x/week, Weeks 6-10
  • Modified plans and modified side plans, 5x/week, Weeks 6-10
  • Elliptical (begin 3 min as tolerated) 3x/week, Weeks 6-10

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


  • Continue soft tissue and joint mobilizations PRN, 2x/week, Weeks 8-12
  • Lunges forward, lateral, split squats, 3x/week, Weeks 8-10
  • Side steps and retro walks with resistance (begin with resistance more proximal) 3x/week, Weeks 8-16
  • Single leg balance activities: balance, squat, truck rotation, 3x/week, Weeks 8-16
  • Planks and side planks (advance as tolerated) 3x/week, Weeks 8-16
  • Single leg bridges (advance hold duration) 3x/week, Weeks 8-16
  • Slide board exercises, 3x/week, Weeks 10-16
  • Agility drills (if pain free) 3x/week, Week 16
  • Hip rotation activities (if pain free) 3x/week, Weeks 10-16

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


  • Running, Week 16, in alter G, then Weeks 20-32
  • Agility, Weeks 16-32
  • Cutting, Weeks 20-32
  • Plyometrics, Weeks 24-32
  • Return to sport specifics, Weeks 24-32

Please note that these instructions are general guidelines to be followed; however, any written or verbal instructions provided by Dr. Nwachukwu supersede the instructions below and should be followed.