Intermediate Hip Rehabilitation Program for Chronic Conditions

Pain level reduced to ≤3/10 on VAS at rest and ≤5/10 during weight-bearing activities,Hip flexion range of motion maintained at ≥90 degrees without increased symptoms,Ability to ambulate with assistive device (if prescribed) for household distances,No increase in night pain or resting pain following treatment sessions,Trochanteric and iliopsoas bursa tenderness reduced on palpation,Hip capsule mobility assessment shows no worsening of capsular restrictions

→ Advance to: Phase 2: Early Mobility and Muscle Activation

Pain level reduced to ≤2/10 at rest, ≤4/10 during walking,Hip abduction strength ≥3/5 on manual muscle testing,Absence of pain with passive hip flexion to 90 degrees in supine,Gluteus medius tendon palpation tenderness decreased by ≥30%,Ability to perform gentle hip pendulum exercises without increased symptoms,Sleep quality improved with reduced hip discomfort at night

→ Advance to: Phase 2: Early Mobility and Muscle Activation

Pain level ≤2/10 at rest, ≤3/10 with light activities,Hip internal rotation range of motion improved by ≥10 degrees,Single leg stance maintained for ≥10 seconds without compensatory hip hiking,Acetabular labrum symptoms (deep groin pain, clicking) stable or improved,Ischial bursa pain with sitting reduced,Full weight-bearing ambulation achieved without assistive device

→ Advance to: Phase 2: Early Mobility and Muscle Activation

Hip flexion range of motion ≥110 degrees,Hip external rotation ≥30 degrees without pain,Hip abduction strength ≥4/5 on MMT,Ability to perform clam shells without hip or buttock pain,Gluteus minimus tendon activation without compensatory hip hiking,Pain-free hip circles and figure-4 stretches

→ Advance to: Phase 3: Strengthening and Functional Training

Hip adduction strength ≥4/5,Hip extension range of motion within 10 degrees of contralateral side,Single leg squat to 45 degrees knee flexion without pain or valgus collapse,Iliopsoas tendon tension reduced; hip flexion strength ≥4/5,No reproduction of labral symptoms with hip internal rotation and flexion,Functional步行距离达到10分钟无明显疼痛

→ Advance to: Phase 3: Strengthening and Functional Training

Hip internal rotation ≥25 degrees in prone position,Hip flexion strength ≥4/5,Walking tolerance 15-20 minutes at moderate pace,No audible or palpable clicking with hip movement,Cartilage loading tolerance improved; pain-free weight-bearing activities,Single leg stance ≥20 seconds with good pelvic control

→ Advance to: Phase 3: Strengthening and Functional Training

Hip abduction strength ≥4+/5 with good endurance,Hip external rotation strength ≥4/5 in side-lying position,Single leg squat to 60 degrees knee flexion without compensation,Ability to perform lateral step-downs without hip adduction collapse,No reproduction of acetabular labrum symptoms with provocative maneuvers,Hip flexion strength ≥5-/5

→ Advance to: Phase 4: Advanced Strengthening and Return to Activity

Hip extension strength ≥4+/5,Hip adduction strength ≥4+/5,Single leg bridge for 30 seconds without hip fatigue,Functional hop testing initiated without pain,Hip rotation strength balanced side-to-side,Return to low-impact recreational activities (cycling, swimming)

→ Advance to: Phase 4: Advanced Strengthening and Return to Activity

Hip abductor endurance test ≥90 seconds per side,Single leg squat depth ≥70 degrees without valgus or trunk lean,Hip and core integration exercises completed without compensation,No recurrence of trochanteric or iliopsoas bursa symptoms,Proprioceptive training: unstable surface balance ≥30 seconds,Pain-free running initiation at slow pace

→ Advance to: Phase 4: Advanced Strengthening and Return to Activity

Hip strength ≥90% of contralateral side on isokinetic testing,Running progression: 15-20 minutes at comfortable pace without symptoms,Cut squat test negative for hip instability,Single leg hop for distance ≥90% of contralateral side,Hip flexion with abduction and external rotation (FABER test) negative,Return to sport-specific training initiated

→ Advance to: Phase 4: Advanced Strengthening and Return to Activity

Agility training: 45-degree cuts, figure-8 runs without pain,Plyometric training: double leg hops progressing to single leg,Hip instability tests (anterior impingement test) negative,Functional Movement Screen score ≥17,Patient-reported outcome measures improved from baseline,Return to full training with team

→ Advance to: Phase 4: Advanced Strengthening and Return to Activity

Full return to competitive sports without restrictions,Hip Outcome Score ≥80% of normative values,Single leg hop test ≥95% of contralateral side,No hip fatigue with prolonged activity (≥60 minutes),Patient satisfaction ≥8/10 with functional outcomes,Maintenance program established with home exercise compliance

→ Advance to: Discharge and Maintenance