Intermediate Hip Acute Injury Rehabilitation
A 21-week intermediate program using rowers, 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
- intermediate
- Duration
- 21
- Sessions/week
- 5
- Minutes/session
- 60
- Evidence level
- moderate
- ICD-10
- S72
- Cost tier
- moderate
Program Overview — Intermediate Hip Acute Injury Rehabilitation This is a 21-week, five-days-a-week, 60-minute-per-session rehabilitation guide for someone recovering from an acute hip injury at an intermediate level. It combines supervised strengthening and mobility work with equipment you may use in a clinic or at home, including a rower and therapy putty, alongside treatments your clinician may apply such as ultrasound, electrical stimulation, shockwave, aquatic therapy, and a hip brace or compression garment. The plan moves you gradually from protecting the healing hip toward stronger, more confident daily movement. Every step is adjusted to how your hip responds.
Who This Program Is For and Its Goal This program is for people past the earliest days of an acute hip injury who are ready to build strength, range of motion, and tolerance for everyday activity. The goal is to steadily reduce pain, restore hip movement, and rebuild hip abductor and extensor strength so you can walk, climb stairs, and return toward higher-level activity safely. Progress is guided by how you feel and by milestone checks, not by rushing. Your clinician will tailor the details to your body, your injury, and your response.
Before You Start Please review this plan with your physical therapist or doctor before beginning, and at each phase change. It is general education, not a personal prescription. If you have severe osteoporosis, certain manual techniques, loading, or equipment use may not be right for you, so your clinician must approve and modify the program. Tell your care team about all your health conditions, medications, and any implanted devices before electrical stimulation or other modalities are used.
Safety Notes and When to Stop Follow the precautions of keeping a neutral spine, warming up before activity, and avoiding overloading the hip. Stop and call your clinician if you have sharp or worsening hip pain, new groin or buttock pain, swelling, numbness, or weakness; if you cannot bear weight; if you develop chest pain, shortness of breath, or calf pain and swelling; or if pain at rest or at night is increasing. These could signal a problem that needs prompt attention. Never push through pain that clearly worsens during or after a session.
Weekly Structure Expect five sessions of about 60 minutes each week for 21 weeks, with rest or lighter days built in as your clinician advises. The plan is organized into phases. Early weeks focus on protection and pain control: gentle movement, protected weight-bearing, and calming irritated tissues. Middle weeks build range of motion and begin strengthening the hip abductors and extensors. Later weeks add endurance, functional tasks, and higher-level control using the rower and putty, always within limits your clinician sets.
How the 21 Weeks Are Organized The 21 weeks are grouped into phases that advance only when you meet simple milestone checks, such as comfortable pain levels, improving hip movement, and tolerating weight-bearing without assistive devices. Sessions blend warm-up, mobility, strengthening, and cool-down. You will use the rower for gentle endurance work and therapy putty for grip, upper-body, and light resistance tasks. Your clinician may add modalities like ultrasound, electrical stimulation, shockwave, aquatic therapy, or a brace during specific phases to support healing and comfort.
What a Typical Session Looks Like A typical session follows a predictable pattern: a warm-up to prepare your hip and body, the main work of mobility and strengthening, then a cool-down to settle things down. Your therapist may apply treatments such as ultrasound, electrical stimulation, or shockwave before or after exercise, and may recommend aquatic sessions or a brace during higher-level activities. The rower and putty are tools within this flow, used at a level that keeps your spine neutral and your hip comfortable throughout.
Warm-Up, Main Work, and Cool-Down Begin with a gentle warm-up such as easy walking or light rowing at a comfortable pace, followed by controlled hip and leg movements to prepare the joints. The main work includes range-of-motion exercises, hip abductor and extensor strengthening, and functional tasks; use therapy putty for light resistance and grip work, and the rower for steady, low-impact endurance while keeping a neutral spine. Finish with a cool-down of slow, gentle stretches and relaxed breathing to help your hip settle.
Tracking Progress Keep a simple log of your pain before and after sessions, how far you walked or rowed, which exercises you completed, and how your hip felt the next day. Your clinician will use these notes plus milestone checks to decide when you are ready to advance. Outcome measures such as the Hip Outcome Score, iHOT-33, Harris Hip Score, Single Leg Stance Test, and Functional Movement Screen help show your overall progress and guide adjustments over the 21 weeks.
How Progression Criteria Work You move to the next phase when you meet the milestone checks your clinician reviews, such as comfortable pain levels, improving hip flexion and abduction range, and tolerating weight-bearing and stairs. These checks are a guide, not a strict timetable, so a phase may take longer and that is okay. Outcome measures add a broader picture of how your hip is functioning in daily life and sport, helping your care team decide whether to progress, hold steady, or adjust the program.
Recovery and Self-Care Recovery happens between sessions as much as during them. Get consistent sleep, stay hydrated, and eat well to support healing. Use rest and gentle movement on sore days, and apply ice or heat only as your clinician advises. Wear the brace or compression garment as directed during higher-level activity. Keep your spine neutral during exercise, warm up before each session, and avoid overloading the hip. A steady, patient approach usually serves you better than pushing hard.
Pain Management, Rest, and Red Flags Follow your clinician's guidance on any pain relief, and do not add or change medications on your own. Some mild, short-lived soreness after activity can be normal, but pain that builds, lasts, or wakes you at night is a signal to ease off and check in. Rest when you need it, and seek urgent care for severe pain, sudden inability to bear weight, chest pain, breathing trouble, or leg swelling and warmth — these are red flags that need prompt evaluation.
Recovery phases
Pain at rest ≤ 2/10 on visual analog scale,Weight-bearing tolerance to tolerance as tolerated with assistive device,Hip range of motion: flexion to 70 degrees, abduction to 20 degrees without increased pain,Ability to perform stationary ankle pumps without hip pain reproduction,No night pain or pain at rest indicating acute inflammation,Greater trochanteric bursa tenderness decreasing on palpation
→ Advance to: Phase II
Pain with functional activities ≤ 3/10,Hip flexion range of motion improved to 85 degrees,Hip abduction improved to 30 degrees,No increase in pain with gentle passive hip range of motion,Iliopsoas tendon tension tolerance without severe pain reproduction,Able to perform supine hip sets with 3/5 muscle activation
→ Advance to: Phase II
Pain ≤ 2/10 with weight-bearing activities,Hip flexion range of motion to 90 degrees,Hip external rotation to 20 degrees without pain,Ischial bursa tolerance for seated activities,Stationary ambulation without assistive device in home environment,No reactive synovitis signs including morning stiffness less than 15 minutes
→ Advance to: Phase II
Pain ≤ 1/10 at rest,Hip flexion range of motion to 100 degrees,Hip abduction to 40 degrees,Full weight-bearing without assistive device,Ascending stairs with alternate foot pattern,Hip labrum provocation tests negative or significantly improved
→ Advance to: Phase II
Hip flexion range of motion to 110 degrees,Hip external rotation to 30 degrees, internal rotation to 20 degrees,Hip abductor strength 3/5 on manual muscle testing,Pain ≤ 2/10 with activities of daily living,Single leg stance time 10 seconds without hipTrendelenburg sign,Gluteus medius activation without compensatory hip hiking
→ Advance to: Phase III
Hip flexion to 115 degrees with minimal discomfort,Hip adductor strength 3/5,Hamstring tendon flexibility allowing 80 degree straight leg raise,Iliopsoas tendon length sufficient for functional activities without snapping,Walk 20 minutes continuous at self-selected speed without increased pain,Greater trochanteric bursa non-tender to palpation
→ Advance to: Phase III
Hip internal rotation improved to 25 degrees,Hip extension range of motion to 0 degrees from neutral,Hip abductor strength 3+/5,Single leg squat to 45 degrees knee flexion without compensation,Functional movement pattern without antalgic gait,Cartilage loading tolerance with low-impact activities
→ Advance to: Phase III
Hip range of motion within 10 degrees of contralateral side,Hip external rotation strength 3/5,Hip flexor strength 3+/5,Descend stairs with control using railing,Stand from seated without upper extremity assistance,No reproduction of labral symptoms with hip flexion combined with internal rotation
→ Advance to: Phase III
Hip abductor strength 4/5,Hip abduction to 45 degrees against gravity,Single leg stance 20 seconds without fatigue,Hip external rotator strength 3+/5,Functional ambulation on uneven surfaces,Iliopsoas tendon load tolerance without iliopsoas syndrome signs
→ Advance to: Phase IV
Hip adductor strength 4/5,Hamstring strength 4/5,Forward lunge to 90 degrees hip flexion,Step-up forward 8-inch step without compensation,No hip joint effusion on examination,Hip cartilage loading progression to moderate-impact activities
→ Advance to: Phase IV
Hip flexor strength 4/5,Single leg squat to 60 degrees knee flexion with good mechanics,Side-lying hip abduction against resistance without hip flexor substitution,Walk 30 minutes at 4 mph without increased symptoms,Functional movement screening hip mobility score adequate,Ischial bursa tolerance for prolonged sitting
→ Advance to: Phase IV
Hip internal rotation strength 4/5,Hip extension strength 4/5,Single leg balance 30 seconds with eyes closed,Double leg hop for distance within 80% contralateral side,Descending stairs without pain,Acetabular labrum stress test negative
→ Advance to: Phase IV
All hip muscle groups strength 4/5,Hip range of motion within 5 degrees of contralateral side,Single leg hop for time within 90% contralateral side,Carioca running pattern without hip pain,Pigeon pose or hip internal rotation stretch achieving symmetry,No pain with functional loading activities
→ Advance to: Phase IV
Hip abductor endurance 4/5,Functional movement assessment score 17 or greater,Timed up and go test within normal limits,Single leg stance functional reach test within normal limits,Hip pain with maximal loading less than 2/10,Cartilage tolerance to impact loading progression
→ Advance to: Phase IV
Hip muscle strength 4+/5 all directions,Running progression at 50% speed without pain,Single leg squat without compensatory patterns,Agility testing without hip symptoms,Full hip range of motion including internal rotation in flexion,Greater trochanteric bursa fully rehabilitated
→ Advance to: Phase V
Running at 75% speed for 20 minutes,Lateral shuffles without hip pain,Crossover cutting maneuvers without hip symptoms,Hip plyometric progression tolerance,Single leg vertical hop within 85% contralateral side,Ischiofemoral ligament and ischial bursa tolerance for loading
→ Advance to: Phase V
Running at 90% speed without symptoms,Unplanned cutting and pivoting without pain,Hip power output 85% contralateral side,Sport-specific movement patterns without compensation,Pubofemoral and iliofemoral ligament stability confirmed,No hip joint clicking or catching indicative of labral pathology
→ Advance to: Phase V
Full speed running without symptoms,Return to sport drill progression completed,Hip endurance equal to contralateral side,Functional movement assessment return to sport criteria met,Completes sport-specific conditioning without flare-up,Cartilage loading at full sport demands
→ Advance to: Phase V
Full sport participation without restrictions,Hip strength 5/5 or 95% contralateral side,No hip fatigue with sport-specific activities,Complete return to competition without modifications,Patient subjective outcome rating 8 or greater,All hip special tests negative
→ Advance to: Discharge
Sustained full training load without setbacks,Hip performance metrics within normal limits,No recurrence of symptoms with high-level activities,Confidence in hip stability during athletic maneuvers,Functional hip score at pre-injury level,Ischial bursa and surrounding soft tissues fully adapted
→ Advance to: Discharge
Complete return to competition,Maintenance program established,Hip joint proprioception optimal,No ongoing hip joint inflammation,Patient discharged with home exercise program,Follow-up scheduled for 3-month monitoring
→ 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 21Weight-bearing tolerance increased by ≥ 25% from previous baseline
Precautions
- maintain-neutral-spine
- warm-up-before
- avoid-overloading
Contraindications
- severe-osteoporosis
Pain management
- Ice therapy applied to greater trochanteric region for 15-20 minutes post-exercise
- Non-steroidal anti-inflammatory medication as prescribed for bursitis management
- Hip joint mobilization with grades I-II for pain modulation
- Positional release techniques for iliopsoas and hip adductor tension
- Soft tissue mobilization to hip flexors, abductors, and tensor fasciae latae
Equipment & modalities
Frequently asked questions
How hard should I push during exercise?
Why do I need so many weeks?
Can I skip the modalities like ultrasound or shockwave?
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