Download For Open Gluteus Medius Repair Rehab Protocol

Provide patient with home exercise program

Weeks 1-4:

  • Bike for 20 minutes/day (can be 2x/day)
  • Scar massage
  • Gait training PWB with assistive device
  • Hip PROM
    • Hip flexion to 90 degrees, abduction as tolerated
    • No active abduction and IR
    • No passive ER or adduction (6 weeks)
  • Quadruped rocking for hip flexion
  • Hip isometrics
    • Extension, adduction, ER at 2 weeks
    • Hamstring isotonics
    • Pelvic tilts
    • NMES to quads with SAQ

Weeks 4-6

  • Continue with previous therapy
  • Gait training PWB with assistive device
    • 20 pounds through 6 weeks
  • Progress with passive hip flexion greater than 90 degrees
  • Supine bridges
  • Isotonic adduction
  • Progress core strengthening (avoid hip flexor tendonitis)
  • Progress with hip strengthening
    • Start isometric sub max pain free hip flexion(3-4 wks)
  • Quadriceps strengthening
  • Aqua therapy in low end of water

Weeks 6-8

  • Continue with previous therapy
  • Gait training: increase WBing to 100% by 8 weeks with crutches
  • Progress with ROM
    • Passive hip ER/IR
  • Supine log rolling Stool rotation Standing on BAPS
  • Hip Joint mobs with mobilization belt (if needed)
  • Lateral and inferior with rotation
    • Prone posterior-anterior glides with rotation
  • Progress core strengthening (avoid hip flexor tendonitis

Weeks 8-10

  • Continue previous therapy
  • Wean off crutches (2 – 1 – 0)
  • Progressive hip RO
  • Progress strengthening LE
  • Hip isometrics for abduction and progress to isotonics
  • Leg press (bilateral LE)
  • Isokinetics: knee flexion/extension
  • Progress core strengthening
  • Begin proprioception/balance
  • Balance board and single leg stance
  • Bilateral cable column rotations
  • Elliptical

Weeks 10-12

  • Continue with previous therex
  • Progressive hip ROM
  • Progressive LE and core strengthening
  • Hip PREs and hip machine
  • Unilateral Leg press
  • Unilateral cable column rotations
  • Hip Hiking
  • Step downs
  • Hip flexor, glute/piriformis, and It-band Stretching – manual and self
  • Progress balance and proprioception
    • Bilateral – Unilateral – Foam – Dynadisc
    • Treadmill side stepping from level surface holding on progressing to inclines
    • Side stepping with theraband
  • Hip hiking on stairmaster (week 12)

12 Weeks and Over:

  • Progressive hip ROM and stretching
  • Progressive LE and core strengthening
  • Endurance activities around the hip
  • Dynamic balance activities
  • Treadmill running program
  • Sport specific agility drills and plyometrics

Other:

  • Modalities
    • Electric Stimulation Ultrasound Heat before/after Ice before/after

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.