Hip Arthroscopy Exercises: Recovery After Hip Scope Surgery

Hip arthroscopy treats conditions like femoroacetabular impingement (FAI), labral tears, and cartilage damage through small incisions. While minimally invasive, hip scope recovery is more involved than knee arthroscopy due to the hip's deep location and weight-bearing demands. Proper rehabilitation is crucial for achieving optimal outcomes.

Understanding Hip Arthroscopy

Common Procedures

• FAI correction (osteoplasty): Reshaping bone to reduce impingement
• Labral repair: Stitching torn labrum back to bone
• Labral debridement: Trimming damaged labral tissue
• Microfracture: Stimulating cartilage growth
• Loose body removal: Removing floating fragments
• Capsular repair: Tightening hip capsule if needed

Recovery Timeline

Labral debridement/simple procedures: 8-12 weeks Labral repair: 4-6 months FAI correction: 4-6 months Microfracture: 6-9 months

Your protocol depends entirely on what was done.

Weight-Bearing Restrictions

Typical Guidelines

Labral debridement: Weight-bearing as tolerated (WBAT) Labral repair: Partial weight-bearing 2-4 weeks, then progress FAI bone work: Partial weight-bearing 2-6 weeks Microfracture: Non or partial weight-bearing 6-8 weeks

Follow your surgeon's specific instructions.

Using Crutches

• Use as directed for duration specified
• Progress from two crutches to one (on opposite side)
• Wean when cleared and gait is normalized

Phase 1: Protection Phase (Week 0-4)

Goals

• Protect surgical repair
• Control swelling
• Maintain mobility within limits
• Prevent muscle shutdown

Ankle Pumps

Prevent blood clots:

1. Pump ankles up and down
2. Circle ankles
3. Do frequently throughout day

Perform: 20-30 reps, every hour

Quad Sets

Maintain quad activation:

1. Lie on back, leg straight
2. Push knee down, tighten quad
3. Hold 5-10 seconds
4. Relax

Perform: 20 reps, every 2-3 hours

Glute Sets

Maintain glute activation:

1. Lie on back
2. Squeeze buttocks together
3. Hold 5-10 seconds
4. Relax

Perform: 20 reps, every 2-3 hours

Heel Slides (Gentle)

Maintain hip flexion ROM:

1. Lie on back
2. Slide heel toward buttocks
3. Stay within allowed range (often 90 degrees initially)
4. Slide back to straight

Perform: 15-20 reps, 3-4 times daily

Passive Hip Rotation

Maintain rotation:

External Rotation:

1. Lie on back, knee bent
2. Let knee fall out gently
3. Stay within limits

Internal Rotation:

1. Similar setup
2. Rotate foot outward (knee inward)

Perform: 10-15 reps each, within allowed range

Stationary Bike (When Cleared)

Usually allowed early:

1. High seat, no resistance
2. Partial rotation if full circles difficult
3. Progress to full rotation
4. 10-20 minutes

CPM Machine

If prescribed:

• Use as directed (often 6-8 hours daily)
• Helps maintain motion
• Follow range limits set

Phase 2: Early Motion (Week 4-8)

Goals

• Progress range of motion
• Begin strengthening (gently)
• Normalize gait
• Wean from crutches

Progressive ROM

Active Hip Flexion:

1. Lie on back
2. Actively bend hip toward chest
3. Progress range as allowed

Standing Hip Extension:

1. Stand holding support
2. Extend leg backward
3. Keep back straight
4. Don't over-arch

Supine Hip Abduction:

1. Lie on back
2. Slide leg out to side
3. Keep toe pointed up
4. Return to center

Perform: 15-20 reps each, 3-4 times daily

Prone Lying

Stretch hip flexors:

1. Lie face down
2. Helps hip extension
3. Start with 5-10 minutes
4. Progress duration

Standing Exercises

Weight Shifting:

1. Stand with support
2. Shift weight side to side
3. Progress to more weight on surgical side

Mini Squats:

1. Hold support
2. Small knee bend (partial squat)
3. Keep weight even

Perform: 15-20 reps, 3 sets

Gait Training

Focus on normal walking pattern:

• Heel-toe pattern
• Equal stride length
• No limp or Trendelenburg
• Progress from two crutches to one to none

Stationary Bike (Progress)

• Lower seat for more motion
• Add light resistance
• 20-30 minutes

Phase 3: Strengthening (Week 8-16)

Goals

• Build hip strength
• Restore full ROM
• Progress functional activities
• Prepare for return to activity

Hip Strengthening

Bridges:

1. Lie on back, knees bent
2. Lift hips toward ceiling
3. Squeeze glutes at top
4. Lower slowly

Progress to single-leg bridges when ready

Side-Lying Hip Abduction:

1. Lie on non-surgical side
2. Lift top leg toward ceiling
3. Keep toe pointed forward
4. Lower slowly

Clamshells:

1. Lie on side, knees bent
2. Open top knee (keep feet together)
3. Lower slowly

Perform: 15-20 reps each, 3 sets

Standing Strengthening

Standing Hip Abduction:

1. Stand on surgical leg
2. Lift other leg to side
3. Control movement
4. Progress to resistance band

Standing Hip Extension:

1. Stand holding support
2. Extend surgical leg backward
3. Keep trunk upright
4. Progress to band

Standing Hip Flexion:

1. Stand holding support
2. Lift knee toward chest
3. Lower slowly
4. Progress to band

Perform: 15-20 reps each, 3 sets

Functional Progression

Step-Ups:

1. Start with 4-inch step
2. Step up with surgical leg
3. Control descent
4. Progress step height

Step-Downs (Eccentric):

1. Stand on step
2. Lower opposite leg toward ground
3. Tap and return
4. Focus on control

Squats:

1. Progress depth gradually
2. Keep knees aligned
3. Don't go deeper than comfortable

Perform: 12-15 reps, 3 sets

Balance Training

Single-Leg Stance:

1. Stand on surgical leg
2. Hold 30-60 seconds
3. Progress: eyes closed, unstable surface

Perform: 3-5 reps, 30-60 seconds

Pool Exercises (If Available)

• Walking in water
• Hip ROM in water
• Reduces weight-bearing stress

Phase 4: Advanced Strengthening (Week 16+)

Goals

• Full strength
• Sport-specific preparation
• Return to activities
• Prevention strategies

Advanced Hip Strengthening

Single-Leg Squats (Partial):

1. Stand on surgical leg
2. Squat to 45-60 degrees
3. Keep knee aligned
4. Return with control

Lateral Band Walks:

1. Band around ankles
2. Squat position
3. Step sideways
4. Maintain tension

Monster Walks:

1. Band around ankles
2. Walk forward/backward
3. Keep feet wide

Perform: 12-15 reps each, 3 sets

Plyometrics (When Cleared)

Double-Leg Jumps:

1. Small hops in place
2. Progress to forward/lateral
3. Land softly

Single-Leg Hops:

1. Small hops on surgical leg
2. Progress distance
3. Stick landings

Box Jumps:

1. Low box initially
2. Land softly
3. Step down initially

Perform: 8-12 reps, 2-3 sets

Running Progression

Prerequisites:

• Full ROM
• Good single-leg strength
• No pain with walking
• Surgeon clearance

Progression: Week 1: Walk-jog intervals Week 2: Jogging 10-15 minutes Week 3: Increase duration Week 4: Add direction changes Week 5: Sport-specific movements

Procedure-Specific Considerations

After Labral Repair

• Protect rotation early: Often limited for 4-6 weeks
• Limit hip flexion with rotation: Position of stress
• Avoid deep flexion initially: May be limited to 90 degrees
• Progress slowly: Repair needs time to heal

After FAI Correction

• Bone takes time to heal: May have weight-bearing limits
• Avoid impingement positions: Deep flexion + internal rotation
• Progress gradually: Even though "just bone work"
• May have quicker motion return: Than labral repair

After Microfracture

• Extended non-weight-bearing: 6-8 weeks typically
• CPM often used: To nourish new cartilage
• Delayed strengthening: Protect new cartilage
• Longest timeline: 6-9 months to full activity

Positions to Avoid

Early Recovery (Varies by Procedure)

• Deep hip flexion (past 90 degrees)
• Hip flexion combined with internal rotation
• Excessive external rotation (if labrum repaired)
• Forced stretching

Long-Term (FAI)

• Positions that previously caused impingement
• May need permanent modifications for extreme positions

Sample Schedule (Week 10)

Daily

• ROM exercises: 2-3 times
• Stationary bike: 20-30 minutes

Monday/Wednesday/Friday

• Bridges: 3x15
• Side-lying abduction: 3x15
• Clamshells: 3x15
• Standing hip exercises: 3x15 each
• Step-ups: 3x12
• Single-leg balance: 3x45 sec

Tuesday/Thursday

• Stationary bike: 30 minutes
• Pool exercises if available
• Stretching routine

Weekend

• Active recovery
• Walking progression

When to Seek Help

Contact your surgeon if:

• Increasing pain
• New clicking, catching, or locking
• Hip gives way
• Signs of infection
• Numbness in leg that doesn't resolve
• Unable to progress with exercises

Key Takeaways

Hip arthroscopy recovery requires patience:

1. Procedure matters - Repair vs. debridement = different timelines
2. Protect the repair - Weight-bearing and motion restrictions vary
3. Hip muscles shut down - Active rehabilitation essential
4. Progress gradually - Hip bears significant load
5. Full recovery takes months - Don't rush the process

Hip arthroscopy outcomes are generally excellent, but they depend on proper rehabilitation. The deep hip muscles need systematic rebuilding, and the joint needs time to heal before returning to demanding activities.