Orthopaedics Rehabilitation After Hip Arthroscopy By UPMC Orthopaedic Care, December 19, 2016 Hip arthroscopy has become an increasingly popular surgical option for younger, active patients experiencing non-arthritic hip pain. While the surgery is often minimally invasive, rehabilitation (rehab) following hip arthroscopy is imperative to recovery. Your physician will work with your physical therapist to develop a personalized rehab plan to help you return to your sport. According to Keelan Enseki, PT, MS, ATC, orthopaedic physical therapy residency director at UPMC Centers for Rehab Services, rehab will advance in phases and many patients are able to return to full-activity and their sport in three to four months. Here is what you can expect during rehab: One to Four Weeks After Hip Arthroscopy Following surgery, weight bearing precautions vary depending upon your procedure. In minimally invasive cases, there is typically a short period of partial weight bearing, often two weeks or less, in which you will be required to use crutches and/or a brace to support your hip. During this time, your physical therapist also will develop a personalized rehab plan for you, which will include a timeline to meet functional goals. Before you leave the hospital, your physical therapist will demonstrate exercises for you to start as soon as you get home; however, your physical therapy visits will begin two to three days after surgery. It is important to stay committed to therapy. Phase One and Early Range-of-Motion (ROM) To prevent postoperative joint stiffness during phase one, your physical therapist will recommend exercises to restore normal joint motion, maintain flexibility, and build strength. These exercises typically start immediately after surgery and may include: Circumduction motion Stretches The goal of phase one is to restore functional motion of the hip and to prepare your muscles to begin walking again. Your ROM will continue to be evaluated by your physical therapist as you progress to the next phase of rehab, as you will need to meet specific criteria before beginning phase two. Keelan mentions that progression of intensity or volume of exercises prematurely can cause increased inflammation, pain, and delayed recovery. Four to Eight Weeks After Hip Arthroscopy By this point, most patients have returned to walking normally and driving again. You will likely experience very little discomfort other than some stiffness or tightness, and your physical therapist will continue to prescribe exercises to help you achieve full ROM. Phase Two and Soft-Tissue Mobilization During phase two, your physical therapist may also perform soft tissue mobilization to help relax your muscles and reduce scar tissue. You may also begin hip and leg muscle strengthening. Exercises during this phase typically include: Increased time on an upright bike Leg presses or squats Advanced stretching to improve flexibility Balance exercises Eight to 12 Weeks after Hip Arthroscopy During this time, most patients will begin phase three of their rehab plan. Your physical therapist will work with you so that you establish a full range of motion in order to prepare you to meet your return to sport criteria. Patients should not expect to reach full activity until they have completed at least three full months (12 weeks) of rehab. Phase Three and Returning to Your Sport Your hip strength and motion will likely be fully restored during this phase. When you are pain-free, your physical therapist will advance you to running and jogging exercises. To help you reach your desired level of function in your sport, your physical therapist will typically recommend plyometric and functional exercises. During this phase you also will: Advance to the treadmill and/or elliptical Increase weight and repetition of exercises Complete stretching so that tightness is resolved Depending on the demands of your sport, you may need to continue rehab beyond 12 weeks, as some athletes require four to five months of structured rehabilitation. Your physical therapist will alter your personalize your rehab plan based on how you progress through each phase. For more information on physical therapy following hip arthroscopy, visit the UPMC Sports Medicine website for call 1-855-93-SPORT (77678).