Return to running after arthroscopic hip surgery- literature review and proposal of a physical therapy protocol Commentary
Hip arthroscopy is an increasingly utilized surgical treatment option for patients presenting with pain and limited function. As surgical techniques have increasingly developed, so too have the rehabilitation protocols designed specifically for each patient. In high-impact sports that cause overuse injuries, such as running, a carefully designed protocol is needed to ensure a successful return to sport following surgery. Currently established rehabilitation programs are generally focused on returning patients to sports without any specificity as to which sport patients are returning. Furthermore, there is an overall lack of published outcomes based on patients adhering to various post-hip arthroscopy rehabilitation protocols.
To address this, this study reviewed the literature on rehabilitation protocols for patients following hip arthroscopy and describe a new protocol specifically designed for patients to return to running. Currently utilized rehabilitation protocols vary in timing in that some include a timeline with each phase taking a certain number of weeks while others are based on goal achievement. These protocols for patients following hip arthroscopy frequently use a four-phase system in which Phase I focuses on regaining hip range of motion and protection of surgically repaired tissues, and Phase IV involves a return to sports. From experience, the authors established a set of return to running guidelines which are based on goal achievement within a three-phase system that begins with a walking program and finishes with return to pain-free distance running. Rather than specifying when patients may return to functional activities at certain time-points, the proposed protocol in this article allows for gradual activity progression based upon the comfort level of the patient and their ability to accomplish the prior protocol phase without injury or significant.
