Hip injuries are common in sports and daily activities. Specific sports where hip injuries occur are ballet, runners, soccer, golfers, and contact sports. Numerous common lesions of the hip are either considered Intraarticular or Extraarticulate lesions.
Intraarticular lesions are for example; acetabular labral tears, Osteoarthritis, instability, FAI (cam, pincer), capsular sprain, loose bodies, and more. Extraarticular lesions are Snapping Iliotibal tendon, muscle strain like hamstring strain, Hip pointer, Lumbar radicular pain, and more. Physical Therapists complete a thorough examination including subjective history, physical exam of the hip, gait assessment, spine exam, knee exam, foot and ankle exam, leg length, and pelvis alignment.
The goals of Physical Therapy rehabilitation include restoring the range of motion (ROM) of joint capsule mobility and muscular flexibility, reducing joint capsular inflammation and pain, reestablishing muscular strength, and correcting biomechanics before returning to sports or daily activities.
Therapy is not the same for all hip injuries and is personalized to the patient from completing the examination and if post-surgical working with rehabilitation protocols with the surgeon. Hip stretches will be instructed often for hip flexors, TFL/ITB, Hamstrings, and hip adductor muscles. Joint mobilizations will be completed by your Physical Therapist including long-axis traction, caudal glides, lateral distraction (often using a mobilizing belt), and anterior and posterior glides.
Strengthening will often include hip internal and external rotation, hip flexors, hip extensors, and hip abductors. Specific glute medius exercises depending on where you are in the course of rehabilitation may include lateral step up/down and single-leg exercise progressions. Core stabilization with a plank progression from a stable surface to an unstable one.
Functional drills depending upon your sport like resisted golf swing exercises. A functional warm-up will be instructed like: skip drills, power steps, carioca, backpedal, and high knees. Dynamic flexibility drills like knee hugs, side lunges with adductor stretch, walk lunges with arms overhead, cross lunges in front or behind, and hurdle stepovers.
In the end, the criteria for full return has many aspects but the main focus is the full range of motion, hip strength equal to the uninvolved side, single leg pick up with level pelvis, ability to perform sports-specific drills at full speed without pain, and completion of a functional sports test.
If you are an athlete or not and have hip pain or need to rehabilitate after injury or surgery, see my website and call/text or email to schedule.
Karen Baltz Gibbs, PT, DPT, CSCS, CMP, LMT, Owner of Garage Training & Rehab Gym
Phone/Text: 971-719-3162
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