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Return to play: Hip

Categories
  • Education
  • Hip
  • Return to play
Tags
  • Hip rehabilitation
  • rehabilitation
  • Return to play
Hip

Rehabilitation Principles related to the Hip

  1. Consult your professional/s for treatment and rehabilitation as these are academic principle guidelines only and not prescriptive.
  2. ASSIC does not dispense medical and/or exercise advice.
  3. Consult your professional regarding exercise, treatment and rehabilitation exercise regimes and medical advise.
  4. The contents of the following web page are principle guidelines and must be utilized under the supervision of a relevant medical and/or exercise professional.

Download ASSIC Performance Fingerprint / Strength and Conditioning now to
access exercise and rehab guideline routines

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Rehabilitation principles are similar but differ depending on the injury in question. The basic tenants of functional progression in rehabilitation would be to begin with reducing pain and swelling, restore range of motion, build basic strength followed by neuromuscular proprioception. Once these parameters have been achieved, the re-establishing of motor pathways and finally return to practice before match play. It is also prudent to start with skill training for the sport concerned, as rehabilitation may happen over extended periods of time.

    • After a hip injury, depending on the specific injury, and how long will the rehabilitation programme last, will dictate at what level of fitness the player will be, in order to return to play. In most cases hip injuries rehabilitation can take between 2 to 8 weeks of rehabilitation depending on the grade of injury.
    • It is imperative, that rehabilitation process start as soon as possible in order to reduce the recovery time, however, it depends of the wiliness of the player
    • An analysis of the players movements during competition is important so that specific rehabilitation techniques could be used to have an effective rehabilitation programme
    • Once the swelling, pain and tenderness has been abated, then the improvement of functional stability should be tackled and rehabbed

Finally there are a number of factors that influence the rate of recovery of the player. These are type of injury and it’s severity, sport code, contact or non-contact, how far into the season, did the injury occur and the mental toughness of the player. The final decision to return to practice will be an assessment done by a multi-disciplinary team for the green light to be given to the play.

A few examples of generic exercises for second phase rehabilitation is listed below:

Flexibility Exercises:

Hip Flexor stretch

Hip Flexor stretch

Hamstring stretch

Hamstring stretch

Perform Piriformis stretch and Gluteal stretch

Perform Piriformis stretch and Gluteal stretch

Iliotibial band stretch

Iliotibial band stretch

Strengthening Exercises:

Hip extension exercise

Hip extension exercise

Hip Abductors

Hip Abductors

Hip Adductors

Modified push ups

Closed Chain exercises:

Squats - Quads and Hamstrings

Squats – Quads and Hamstrings

Leg Curl-Quadriceps-Extension

Leg Curl-Quadriceps-Extension

Leg Curl-Hamstrings-Flexion

Leg Curl-Hamstrings-Flexion

Lateral Step-Ups

Lateral Step-Ups

Hamstring leans

Hamstring leans

Plyometric Exercises:

Jump on and off box

Jump on and off box

High Knee Lifts

High Knee Lifts

Core Using Slider technique by application below foot

Core Using Slider technique by application below foot

Lateral Slide to Right then Left

Lateral Slide to Right then Left

Return to practice then match play after hip Injury

Return to practice or play is usually determined by a multi-disciplinary team, taking all factors into account. These guidelines depends on a number of factors, including, how long did the rehabilitation period last, which will indicate level of deconditioning. The players psychological state of mind during the injury and during rehabilitation and if the player was in rehabilitation for longer than 8 weeks, then the level and intensity of training should be commence at pre-season stage. Another factor to be taken into account is how far into the season will the player join the team. If the season is almost over, then it is suggested that the player sit out till the next pre-season training.

  • Different parameters of fitness testing will differ from sport to sport, e.g. a gymnast will focus on greater flexibility and strength and agility, whereas a soccer player will focus on aerobic, anaerobic, agility and speed
  • A comprehensive fitness testing programme is required and compared to pre-season testing results
  • The basic testing parameters would be flexibility, aerobic, anaerobic, speed, agility and muscular strength and endurance, as related to the hip injury
  • Once a score of 95% of pre-injury levels are achieved, the player is ready to go back to practice
  • During the first two weeks of practice, the rehabbed player should only train at an intensity of 50% of the teams intensity, then following that 60% , 70% and finally join the team at same intensity, then the player would be ready for match play

Download ASSIC Performance Fingerprint / Strength and Conditioning now to
access exercise and rehab guideline routines

apple app store  google play store

References:

  1. Prentice, W.E. (2000) Rehabilitation Techniques in Sports Medicine. McGraw Hill. New York.
  2. Mellion, M.B. (1994) Sports Medicine Secrets. Mosby. Boston.
  3. Bruckner, P and Khan, K. (2007) Clinical Sports Medicine. McGraw Hill. New York.

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