By: Ken Knox

Therapeutic
Intervention Design
Introduction
Sex: Female
Sport: Basketball
Ethnicity: Caucasian
Injury: Hip Labral Tear
Medical History: No prior history
Demographics

Most common on the anterior

portion of the labrum
More common in women
Acetabular labral tears are much
more common than once thought
Mechanism of Injury

Secondary to traumatic injury

Repetitive trauma
Structural abnormalities of the
acetabulum or femoral head
Direct trauma
Dysplasia
Femoroacetabular impingement
Tight muscles
Diagnosis of Injury
Signs & Symptoms:
Anterior groin pain worsening with weight bearing activities
Stiffness or ROM
Clicking, locking or catching with hip motion
Groin pain with FABER Test, Hip Scouring Test and Straight
Leg Raise
Hypermobility
Secondary Diagnosis
Degenerative changes to the acetabular articular surface
Osteoarthritis
Surgery

Preoperative Diagnosis:
Labral tear with CAM
impingement on the right
Postoperative Diagnosis:
Labral tear with CAM
impingement chondral defect
(superolateral) of the
acetabulum with pincer
impingement
Prehab
Sample TI to meet goals:
Bike for 10 minutes
BW Squats on hard side of Bosu
Ball 3x12
Lateral box step ups w/ 10 lb ankle
weight 3x12
Inverted hamstring exercise w/ 5 lb
ankle weight
Glute bridge w/ ball squeeze 3x20
second hold
Plank 3 x 30 seconds each side
Hip, Quad and Hamstring stretches

Goals:
Reduce pain
Strengthen surrounding structures
ICF Disablement Model

Health Condition

Body Function Environmental Personal

Activities Participation
& Structures Factors Factors
Phase 1 (1 3 Weeks)
Physiology of tissue healing
Phase goals
Sample TI to meet goals
4 Way Ankle exercises (Red TheraBand) 3x12
50 Heel Slides
Seated Ball Squeezes 10x15 secs
Seated Leg Extensions 3x12
Glute Bridges 3x12
Hamstring and Quad Stretches
Criteria to progress
Phase 2 (4 6 Weeks)
Physiology of Tissue Healing
Phase Goals
Sample TI to Meet Goals:
Stationary Bike (10 Mins)
4 Way Ankle exercises (Grey TheraBand) 4x10
50 Heel Slides (Compare hip/knee flexion prior)
Seated Ball Squeezes 10x20 secs
Standing Mini Squats 4x10
Glute Bridges 4x10 (2 second hold)
Hamstring and Quad Stretches
Criteria to Progress
Phase 3 (7 9 Weeks)
Physiology of Healing Tissue
Phase Goals
Sample TI to Meet Goals:
Full Squats
Lunges
Box Step-Ups
Single Leg Balance (Firm to Soft Surface)
Criteria to Progress
Phase 4 (3 5 Weeks)
Physiology of Tissue Healing
Phase Goals
Sample TI to Meet Goals:
Sport Specific
Agility
Stationary Bike w/ resistance
Running
Criteria to Progress
Challenges & Successes

Challenges:
Prehab to Rehab
Schedule
Activity Level
Shyness
Successes:
Experience
Progress
Personal Insights

Longer duration
Schedule conflicts
Less activity
More information
References
http://restoremyjoint.com/pdfs/post-op-hip-arthroscopy.pdf
http://www.western-
ortho.com/WesternOrtho/media/WesternOrtho/Rehab%20and%20P
ost-Op%20Instructions/Dr.%20White/White%202013/Hip-Protocol-
for-Dancers-10-2013.pdf?ext=.pdf