Week 4 Lecture 4A - Phases of Recovery (Hip) Flashcards
Work on GAIT, crutches initially. Try to get them moving again
Got it
Got it
Got it
Can do these day 1.
Start with knee flexion, knee abduction, log roll – hip IR and ER. Circumduction feels good for the pt = pt likes to move hip after surgery.
Prone – IR/ER hip rotation in 90, RF stretch.
Week and a half – quadruped heel sits – work on flexion in a stable position – provides stability to the joint bc they are WB.
Got it
GOTIT
GOT IT
Can start sidelying earlier than in supine
got it
Delayed – don’t know if delay causes groin pain or vice-versa. Either way have to address it. Have to work on the core regardless.
got it
Abdominal
Draw
In
Mover – this is just an isometric contraction of the abs
Got it
Don’t want to do a lot of hip (flexion/rotation) early on after surgery – irritating. Position of the hip flexor – 12-3 of the labrum will be irritated if they did some work with the labrum.
flexion;
Got it
Gotit
Overhead things with weights, therabands, palloff presses, overhead theraband, moving into hip adduction (bent knee fall out)
Go tti
Use stabilization on the foam, bosu, challenge their balance. Can do push/pull wit cable columns.
Got it
Activate core when doing glute strengthening.
Got it
Movement stabilization of the hip for proprioceptive feedback
Clam shells with the ball on the wall
Got it
MWM – Mobilization with movement – can move into flexion if they don’t have that motion, or ER/IR as well
Got it
If they have surgery, those tissues can stuck together so they have to move early. Have to get them on the bike asap, just don’t want adhesions early on.
Got it
G
O
Adductors are typically a sore spot
Got it
Extend the knee and drop into abduction
GOT
Working on step up and step downs – working on NM control .
Want front planks, make sure no hip flexion irritability with that.
Got it`
Got it
gi
Good for direction change, precursor for change of direction drills
Have band around ankles and then tap each direction for the arrow.
GI
Got it
Got it
Gi
gi
Isometric contra fall out – abducted leg is the nonop leg.
Gi
gi
gi
gi
gi
Hip Flexor Progressions
Precaution: (early/SLOW) progression to hip flexion activity
Early: Do not create (anterior/posterior) hip pain
(Do/Avoid) active straight leg raise
(including any type of trunk curl with the hip flexion such as a sit up)
Start this week 4-6 if everything is going well. If getting a lot of pinching and it is irritated, bring the hip flexor progression a little bit more slowly.
SLOW; anterior; Avoid
Eccentric hip flexion – they are moving the trunk to create engagement of the hip flexors in an eccentric manner. Her hand is on his adductors/hamstrings to make sure they aren’t too activated – want to focus on the hip flexors.
gi
This is a progression
Sidelying hip flexion to eliminate gravity.
Ball can assist hip flexion
Got it
If the femoral head is misshaped they’ll do it this way.
gi
Surgical hip dislocation
TTWB / crutches
Hip dislocation precautions:
No flexion above _
No Excessive (IR/ER / adduction)
Abduction precautions – trochanteric osteotomy No passive (add/abd) No active (add/abd)
Flex, IR, pop out the back is how people dislocate their hip.
90; IR/ER; add; abd;
Watched video in class
Folds who don’t have enough coverage – shallow hip socket. Center edge angle is small. They can create an overhang with the PAO by cutting out the acetabulum and moving it to where they want it.
Intense surgery and pts do really well.
https://www.hss.edu/no-index/animation-PAO-periacetabular-osteotomy.htm
gi
More overhang in the postop pic on the right. Typically done to people in their late 20s early 30s who have had pain. They return back to high level activity.
Got it
PAO- Peri Acetabular Osteotomy
TTWB - weeks
No active hip (extension/flexion)
No active hip (adduction/abduction)
(not a contra indication but might be painful early)
After 8 weeks Rehab similar to hip FAI surgery
Won’t do hip flexion and abduction because they are not too stable and weak so it doesn’t feel good.
Slower progression compared to hip FAI.
6-8; flexion; abduction;
They cut the femur and turned it. They turned the femoral shaft so it wasn’t so anteverted.
gOT
Pincer and cam can lead to hip damage – won’t have a good congruent joint, will wear out quicker.
If the cartilage is too far gone/damaged, can only do so much.
Bony correction – surgeon has to take out the right amount of bone - too little – still impingement – too much – unstable
gOTI
Doesn’t fix their strength, core control, etc
Look up and down the kinetic chain to find limitations.
All hip rehab – need a stable core to have success.
Got itq
