Intermediate Hip Acute Injury Rehabilitation

Pain at rest ≤2/10 on VAS scale,Trochanteric bursa tenderness decreasing with ice and NSAIDs,Hip flexion range 70-90° pain-free,Able to ambulate with assistive device (if needed) without increased pain,No active inflammation signs (heat, swelling, redness) at hip joint,Sleep quality improved with position modifications

→ Advance to: Phase 2: Early Mobility

Hip flexion range 90-110° with minimal pain,Hip external rotation 20-30° pain-free,Gluteal activation visible during hip abduction in side-lying,Pain with weight-bearing activities ≤3/10,Ischiofemoral ligament and hip capsule tolerance to gentle mobilizations,Able to perform basic hip stabilization exercises without flare-up

→ Advance to: Phase 3: Controlled Strengthening

Hip flexion 110-120° passive ROM,Hip abduction strength ≥4/5 (gluteus medius/minimus),Hip extension strength ≥4/5 (gluteus maximus),Adductor tendon tolerance to progressive loading without pain,No pain with stationary cycling at low resistance,Hip labrum stability: negative impingement tests with flexion

→ Advance to: Phase 4: Progressive Loading

Hip internal rotation 25-35° pain-free,Single-leg stance time ≥20 seconds without hip fatigue,Hip abduction strength ≥4+/5,Ischiofemoral ligament flexibility improved,Cartilage loading tolerance: able to tolerate 15-20 min weight-bearing activities,No night pain or pain at rest

→ Advance to: Phase 5: Advanced Strengthening

Hip ROM within 10° of contralateral side in all planes,Hip external rotator strength ≥4/5,Iliopsoas tendon tolerance to resisted hip flexion,Single-leg squat to 45° knee flexion without pain or valgus collapse,Hip adductor strength ≥4/5,Able to complete 3x10 hip stabilization exercises without fatigue

→ Advance to: Phase 6: Power Development

Hip flexion strength ≥5-/5,Gluteal strength ≥5-/5,Hop test tolerance: single-leg hop for distance ≥75% contralateral,Hip rotational strength symmetrical,Trochanteric bursa asymptomatic with side-lying exercises,Functional movement pattern screening score ≥18/24

→ Advance to: Phase 7: Sport/Activity Specific

Running progression: 10 min at comfortable pace without hip pain,Cutting/pivoting activities at 50% speed without symptoms,Hip power output ≥80% contralateral (isokinetic if available),Return to sport testing: FABER test negative,Ischiofemoral ligament and hip capsule full flexibility,Balance and proprioception: Y-balance test ≥90% limb symmetry

→ Advance to: Phase 8: Return to Activity Preparation

Full hip ROM equal to contralateral side,Complete sports-specific drill series without compensation,Fatigue index <15% after repeated sprint protocol,Subjective Hip Outcome Score ≥80/100,No pain during or after high-impact activities,Hip and core endurance: side-bridge test ≥60 seconds each side

→ Advance to: Phase 9: Full Return to Sport

Full training participation at 75% intensity,Cutting, pivoting, and deceleration at full speed without symptoms,Hip labrum stress test negative at end range,Subjective feeling of stability and confidence in hip,No flare-up after consecutive training days,Patient-specific functional outcome achieved

→ Advance to: Phase 10: Maintenance & Discharge

Full return to pre-injury activity level,Hip Outcome Score ≥85/100,Isokinetic hip strength >90% contralateral side,No restrictions on hip range of motion or loading,Independent home exercise program compliance confirmed,Patient discharged with maintenance protocol and follow-up plan

→ Advance to: Discharge