Advanced Hip Acute Injury Rehabilitation
A 20-week advanced program using knee braces, and therapy putty to aid in the recovery process.
Professional rehabilitation program designed for effective recovery and pain management.
Key facts at a glance
- Body part
- lower-limb · hip
- Injury type
- acute-injury
- Level
- advanced
- Duration
- 20
- Sessions/week
- 3
- Minutes/session
- 60
- Evidence level
- moderate
- ICD-10
- S72
- Cost tier
- moderate
Program Overview This is a 20-week, advanced rehabilitation plan for someone recovering from an acute hip injury. It combines supervised hands-on therapies with progressive exercise to rebuild hip strength, mobility, and confidence. Plan to attend three sessions per week, about 60 minutes each, with your treating clinician guiding the plan as you go.
Who This Program Is For and Its Goal This program is for people with an acute hip injury who are ready for a more demanding phase of rehabilitation, working with a clinician and using supportive equipment like a knee brace and therapy putty. The goal is to gradually restore hip strength, movement, and walking quality, then return you toward your normal activities as safely and confidently as possible.
Before You Start Before beginning, review this plan with your physical therapist or doctor. Make sure any braces or equipment are fitted correctly and that you understand which exercises you should do at home. Bring your outcome questionnaires to your first visit so you have a baseline to compare against later.
Safety Notes and When to Stop This program is not for you if you have severe pain right now; get that assessed first. Throughout, avoid overloading the hip, keep your spine in a neutral position during exercises, and stop any activity if your pain increases. Stop and contact your clinician promptly if you notice sharp or worsening pain, sudden swelling, inability to bear weight, numbness, or pain that keeps you awake at night.
Weekly Structure Each week includes three supervised sessions of roughly 60 minutes. Your equipment includes a knee brace and therapy putty, and your clinician may also use treatments such as shockwave therapy, therapeutic ultrasound, blood flow restriction training, aquatic therapy, and electrical stimulation. The plan moves through stages from early protection and pain control toward more advanced strengthening and function over the full 20 weeks.
How the 20-Week Plan Is Organized The program is divided into phases, starting with a phase focused on protecting the hip and controlling pain, then progressing toward strength, control, and functional tasks as you meet specific readiness markers. Your clinician decides when you move forward based on how you respond, not just on the calendar, so some people spend a little longer in one phase than others.
What a Typical Session Looks Like Sessions generally follow a warm-up, main exercise work, and cool-down. Your clinician will guide each part and adjust the mix as you progress through the phases.
Warm-Up, Main Work, and Cool-Down A session typically begins with gentle warm-up movements to prepare the hip and surrounding muscles. The main work may include strengthening exercises using therapy putty, balance and gait practice (sometimes with the knee brace for support), and any clinician-applied treatments listed in your plan. Cool-down involves gentle stretching and easy movement to help you settle, and your clinician will tailor each part to your stage.
Tracking Progress Your clinician will track your progress using outcome questionnaires (such as the Hip Outcome Score, Copenhagen Hip and Groin Outcome Score, and iHOT-33), hop tests, and strength measurements. These are repeated at intervals so you and your clinician can see how you are improving and adjust the plan. Keeping a simple daily note of pain and activity can also help.
How Progression Criteria Are Used Moving between phases depends on meeting readiness markers, such as pain staying low during daily activities, walking with a normal pattern, and gaining hip strength and movement without flare-ups. Your clinician reviews these along with your outcome measures to decide when you are ready for the next stage. The criteria guide decisions but are always interpreted alongside your individual situation.
Recovery and Self-Care Recovery happens between sessions too. Follow your clinician's advice on rest, activity pacing, and any home exercises. Use the knee brace and equipment as instructed, keep your spine neutral during exercises, and avoid pushing into pain. Good sleep and staying generally active within your limits support healing.
Pain Management Cautions and Red Flags Do not ignore increasing pain or rely on this guide for medication decisions; ask your clinician or pharmacist about pain relief. Rest when needed, but avoid long periods of complete inactivity unless advised. Seek prompt medical attention for severe or sudden pain, new swelling, fever, chest pain, or inability to bear weight, and always stop if pain increases during activity.
Recovery phases
Pain at rest less than 3/10 on visual analog scale,Weight bearing as tolerated with normal gait pattern without Trendelenburg sign,Hip flexion range of motion greater than 90 degrees without exacerbation,No acute inflammation signs of greater trochanteric bursa or iliopsoas bursa,Passive hip external rotation within 30 degrees of contralateral side,Able to perform isometric contractions of gluteus medius and hip adductors without increased pain
→ Advance to: Phase 2: Early Mobilization and Gentle Strengthening
Pain with activities of daily living less than 3/10,Single leg stance time greater than 10 seconds without compensations,Hip abduction strength manual muscle testing grade 3/5,No catching or clicking reproduced by hip flexion with adduction (anterior hip impingement test negative),Able to ascend and descend stairs with rail assistance only if needed,Sternal sleep position maintained to avoid hip flexion greater than 90 degrees
→ Advance to: Phase 2: Early Mobilization and Gentle Strengthening
Pain with walking 15 minutes less than 3/10,Hip internal rotation greater than 15 degrees without anterior groin pain,Full passive hip flexion to 120 degrees,No pain with palpation of ischial tuberosity (ischial bursitis resolved),Hip extension within 10 degrees of contralateral side,Able to perform supine hip bridges without hip labrum symptoms
→ Advance to: Phase 2: Early Mobilization and Gentle Strengthening
Pain at night less than 2/10,Functional movement screen hip mobility score improved,Hip abduction strength 3+/5 on dynamometry greater than 50% contralateral,Negative impingement sign (hip flexion 90 degrees with adduction and internal rotation),Able to sit for 45 minutes without hip discomfort,No hip flexor tendon tenderness at lesser trochanter
→ Advance to: Phase 2: Early Mobilization and Gentle Strengthening
Pain with resisted hip flexion less than 3/10,Hip abduction strength greater than 4/5,Active hip external rotation against gravity without pain,Single leg squat to 45 degrees knee flexion without pelvic drop,Hip flexion strength 4/5 on affected side,Able to perform clamshell exercise without hip tendon pain
→ Advance to: Phase 3: Progressive Strengthening and Stability
Walking distance 20 minutes without increased pain,Hip internal rotation strength 3+/5,Squat to 45 degrees without hip labrum clicking or catching,Single leg stance eyes closed greater than 10 seconds,Hip extension strength approaching 4/5,No pain with passive hip distraction maneuver
→ Advance to: Phase 3: Progressive Strengthening and Stability
Functional movement assessment score greater than 14/21,Hip adductor strength greater than 4/5,Treadmill walking 15 minutes at 4 mph without antalgic gait,Hip circumduction pattern eliminated during gait,Negative FABER test for hip joint versus sacroiliac,Gluteus medius endurance greater than 30 seconds per side
→ Advance to: Phase 3: Progressive Strengthening and Stability
Pain with light jogging less than 3/10,Hip external rotator strength 4/5,Single leg hop for distance greater than 50% contralateral leg,Hip flexion to 125 degrees,Single leg deadlift to horizontal without loss of pelvic control,Able to perform hip hikes without hip joint symptoms
→ Advance to: Phase 3: Progressive Strengthening and Stability
Pain with jumping less than 2/10,Hip abduction strength greater than 85% contralateral on dynamometry,Running distance 1 mile without increased symptoms,Single leg squat to 90 degrees knee flexion with proper femoral alignment,Hip abduction strength ratio greater than 70% compared to adduction,No hip flexor tendon pain with resisted hip flexion
→ Advance to: Phase 4: Advanced Strengthening and Sport-Specific Training
Hip flexion strength greater than 85% contralateral,Double leg hop test symmetry greater than 85%,Hip external rotation strength greater than 80% contralateral,Lunge forward distance symmetry greater than 80%,Hip extension flexibility within 5 degrees of contralateral,Piriformis and deep external rotator tenderness resolved
→ Advance to: Phase 4: Advanced Strengthening and Sport-Specific Training
Stair climbing without hip joint symptoms,Hip abduction endurance ratio greater than 1.0 (side-to-side),Single leg balance reaches within 10% of contralateral,Running pace 6 mph for 20 minutes without pain flare,Hip internal rotation strength greater than 80% contralateral,No femoral acetabular impingement symptoms with end-range flexion
→ Advance to: Phase 4: Advanced Strengthening and Sport-Specific Training
HOOS score improvement greater than 15 points from baseline,Hip extension strength greater than 85% contralateral,Copenhagen hip and groin outcome score greater than 70%,Single leg hop for time less than 110% contralateral,Hip flexion to 130 degrees with proper femoral head tracking,Greater trochanteric bursa non-tender to palpation
→ Advance to: Phase 4: Advanced Strengthening and Sport-Specific Training
Plyometric progression without hip pain,Squat strength greater than 90% contralateral,Running sprint intervals without hip symptoms,Hip abduction power greater than 80% contralateral,Single leg hop for distance greater than 90% contralateral,Negative hip impingement test post-activity
→ Advance to: Phase 5: Return to Full Activity and Sport
Cutting and pivoting activities without hip pain,Hip flexor power greater than 80% contralateral,Return to sport training progression phase 2 completed,Hip adductor strength greater than 90% contralateral,Y-balance test anterior reach within 5% of contralateral,No hip joint effusion on clinical examination
→ Advance to: Phase 5: Return to Full Activity and Sport
Full training participation without restrictions,Hip power measures greater than 85% contralateral,Functional Movement Screen score greater than 17/21,Single leg vertical hop height greater than 85% contralateral,Hip external rotation to internal rotation strength ratio normalized,Subjective hip outcome score greater than 80%
→ Advance to: Phase 5: Return to Full Activity and Sport
Sports-specific agility drills completed without compensation,Hip abduction to adduction power ratio 1.0 or greater,Running economy within 10% of pre-injury baseline,Hip and groin outcome score greater than 80%,Patient-specific functional scale goals achieved,No iliopsoas tendon pain with resisted hip flexion against resistance
→ Advance to: Phase 5: Return to Full Activity and Sport
Full sport participation at competition intensity,Isokinetic hip flexion peak torque greater than 90% contralateral,Isokinetic hip extension peak torque greater than 90% contralateral,Return to sport assessment passed,Hip labral function tests negative for symptoms,No hip cartilage symptoms with high-impact activities
→ Advance to: Maintenance and Discharge Planning
Unrestricted return to athletic competition,Single leg hop battery symmetry greater than 95%,Hip abduction endurance greater than 45 seconds,No recurrence of greater trochanteric bursitis symptoms,Hip joint play mobility normal,Patient satisfied with functional outcomes
→ Advance to: Maintenance and Discharge Planning
Completed graduated return to sport protocol over 2 weeks,Hip strength 95% or greater of contralateral side,Full training load tolerated without flare,Hip outcome measures at discharge goals met,No hip flexor or adductor tendon dysfunction,Functional confidence score returned to pre-injury level
→ Advance to: Maintenance and Discharge Planning
Final functional assessment within 5% of pre-injury baseline,HOOS score greater than 90%,Completed return to sport progression,Hip joint stability tests negative,Patient education on maintenance program completed,Discharge criteria met with independent home exercise program
→ Advance to: Discharge
Return to activity milestones
Pain-free basic activities of daily living
Week 6Ankle dorsiflexion adequate for normalised gait pattern over heel
Light functional activities and conditioning
Week 9Weight-bearing tolerance increased by ≥ 25% from previous baseline
Moderate activity and sport-specific conditioning
Week 12Able to ascend and descend 4 stairs with reciprocal pattern, no rail
Full return to sport, occupation, and recreation
Week 20Weight-bearing tolerance increased by ≥ 25% from previous baseline
Precautions
- avoid-overloading
- maintain-neutral-spine
- stop-if-pain-increases
Contraindications
- severe-pain
Pain management
- Non-steroidal anti-inflammatory medication as prescribed for hip joint or bursa inflammation
- Ice therapy to greater trochanteric region and anterior hip for 15-20 minutes post-exercise
- Hip flexion positioning avoidance (sitting greater than 90 degrees) to reduce anterior impingement
- Activity modification to avoid repetitive hip flexion with adduction and internal rotation
- Gentle hip distraction manual therapy techniques for pain modulation
Equipment & modalities
Frequently asked questions
How much pain is acceptable during exercise?
Can I skip sessions if I feel better?
What if I miss a phase milestone?
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed October 6, 2026. · Read our editorial policy