Phase Iiintermediate Rehabilitation


• Protect integrity of repaired tissue

• Restore full ROM

• Restore normal gait pattern

• Progressively increase muscle strength


• No ballistic or forced stretching

• No treadmill use

• Avoid hip flexor/joint inflammation

Criteria for Progression to Phase III

• Full range of motion

• Pain-free/normal gait pattern

• Hip flexion strength >60% of the uninvolved side

• Hip add, abd, ext, IR, ER strength >70% of the uninvolved side

Fig. 5. Double one third knee bends.

Fig. 6. Side supports.

Fig. 7. Single leg stance on Dyna-disc (Exertools Novato, California).
Fig. 8. Advanced bridging.


The intermediate phase of rehabilitation is typically started between 4 and 6 weeks postoperatively, dependent upon the surgical procedure and weight-bearing restrictions. The second phase of rehabilitation includes a progression of ROM/stretching, gait training, and strengthening. PROM and stretching exer-

Fig. 9. Single leg cord rotations.

Fig. 10. Sidestepping with resistance.

cises should be continued as needed to achieve full ROM. Gait training should take place both in the pool and on land as the patient is progressed off of crutches. Intermediate strength exercises include double one third knee bends (Fig. 5), side supports (Fig. 6), stationary biking with resistance, swimming with fins, single leg stance on a Dyna Disc (Exertools, Novato, California) (Fig. 7), advanced bridging (Fig. 8), single leg cord rotations (Fig. 9), Pilates skaters, sidestepping with resistance (Fig. 10), and single knee bends (Fig. 11). Cardiovascular training is achieved with the use of an elliptic machine or stairclimber during this phase. Once the goals of phase II have been met, patients are progressed to the advanced phase of rehabilitation.

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