Hip Abductor Repair

Physical Therapy Protocol

Precautions

• No flexion beyond 90° and no adduction past midline for the first 6 weeks post-op.
• No passive external rotation (PROM ER) until week 4.

Phase I – Immediate Post-Surgical Phase (Weeks 0–4)

Goals:

• Protect the repair
• Control pain and inflammation
• Prevent muscle atrophy
• Maintain core and surrounding joint mobility

Precautions:

• Flat foot weight bearing (FFWB), no more than 20 lbs
• No active hip abduction

Interventions:

• Biking: Limit to 20 minutes per session
• Isometric quad and hamstring activation
• Open kinetic chain quad/hamstring strengthening
• Pelvic clock drills
• Begin extension and adduction isometrics at 2 weeks post-op

Phase II – Progressive Weight Bearing Phase (Weeks 5–11)

Goals:

• Gradual return to weight bearing
• Protect healing tissues
• Improve neuromuscular control and core engagement

Precautions:

• Progress weight bearing by adding 25% body weight each week
• Transition to full weight bearing (FWB) by week 8

Interventions:

• Progress PROM to full
• Restore full AROM by end of this phase
• Initiate concentric hip adduction
• Begin isometric hip abduction
• Core strengthening focus (e.g., planks, dead bugs)
• Bridging exercises (double-leg → single-leg progression)

Phase III – Strengthening and Proprioception (Weeks 12–15)

Goals:

• Normalize gait
• Eliminate Trendelenburg pattern
• Improve proprioception and hip stability

Interventions:

• Initiate concentric abduction strengthening
• Proprioceptive training:
  • Double-leg and single-leg stance
  • Progress to unstable surfaces as tolerated
• Progress from open-chain to closed-chain abduction

Phase IV – Return to Sport and Higher-Level Function (Week 16+)

Goals:

• Prepare for athletic activity or high-level daily function
• Restore dynamic hip strength and coordination

Interventions:

• Begin running progression
• Incorporate plyometric training
• Sports-specific drills and agility work