Advanced Hip Rehabilitation for Nerve Injury

Pain level reduced to ≤3/10 at rest with weight-bearing activities,Hip ROM maintained with ≥70° flexion and ≥15° abduction without increased neurological symptoms,No exacerbation of nerve symptoms (paresthesia, burning) with gentle passive hip movements,Tolerance of prone lying for 10 minutes without increased hip or groin pain,Ability to perform independent transfers without assistive device or with single-point cane,Femoral nerve and sciatic nerve mechanosensitivity reduced on palpation and stretch testing

→ Advance to: Early Mobilization

Pain ≤2/10 with weight-bearing and transfers,Hip flexion ROM ≥85° with controlled pain response,Active straight leg raise without hip flexor compensation or increased nerve symptoms,Tolerance of pain-free stationary biking with low resistance for 10 minutes,Gluteal muscle contraction visible and palpable in side-lying position,Short sit tolerance ≥15 minutes without increased neurological symptoms

→ Advance to: Nerve Gliding and Early Strengthening

Completion of femoral nerve glide exercises without radiating symptoms,Hip abduction strength ≥3/5 against gravity in side-lying position,Hip flexion strength ≥3/5 in seated position without hip flexor tendinopathy symptoms,Single-leg stance time ≥10 seconds without compensatory trunk lean,Hip internal rotation ≥25° and external rotation ≥30° with neutral flexion,Tolerance of aquatic therapy with hip immersion to groin level

→ Advance to: Progressive Strengthening

Hip abduction strength ≥4/5 with resistance band,Hip extension strength ≥4/5 in prone position targeting gluteus maximus,Hip adduction strength ≥4/5 in side-lying against resistance,Pain-free gait pattern without antalgic compensations for distance of 200 meters,Hip flexion strength ≥4/5 in hook-lying position for iliopsoas,Piriformis and deep external rotator strength ≥3/5 without increased sciatic nerve tension

→ Advance to: Functional Training

Hip HOS (Activities of Daily Living subscale) ≥60% of normal,Functional squat to 45° knee flexion with symmetrical weight bearing,Step-up onto 15cm step with controlled descent without knee valgus,Single-leg squat to 30° knee flexion with maintained hip abduction control,Tolerance of elliptical trainer for 15 minutes at moderate intensity,Hip proprioception testing within 80% of contralateral side on star excursion balance

→ Advance to: Advanced Strengthening

Hip abduction strength ≥4+/5 with closed-chain resistance,Hip internal and external rotation strength ≥4/5 in seated position with resistance,Plyometric progression: double-leg hopping in place without increased hip pain,Running initiation at 50% speed on treadmill for 5 minutes without nerve symptoms,Single-leg stance on unstable surface (BOSU) for ≥15 seconds,Greater trochanteric bursa tolerance confirmed with resisted abduction without pain

→ Advance to: Sport-Specific Preparation

Full pain-free ROM in all hip planes including flexion to 120° and extension to 10°,Hip muscle endurance: side-lying hip abduction hold ≥45 seconds at 50% max effort,Running at 75% speed for 20 minutes without increased symptoms,Cutting and pivoting drills at 50% intensity without hip girdle pain,Lateral movement drills across hip without labral symptoms,iHot-12 score improvement of ≥15 points from baseline

→ Advance to: Return to Activity

Hip Outcome Score (Sports subscale) ≥65% of normal,Full sport-specific training volume without flare-up of nerve or joint symptoms,Hip strength ≥90% of contralateral side on handheld dynamometry,Functional movement screen (FMS) hip mobility score ≥2,No pain with end-range hip flexion combined with internal rotation (anterior labrum test),Patient-reported readiness to return to prior activity level with confidence in hip stability

→ Advance to: Maintenance