Return to running after arthroscopic hip surgery: literature review and proposal of a physical therapy protocol

The number of hip arthroscopy procedures has significantly increased in the last several years, thereby necessitating individualized rehabilitation protocols for patients following hip arthroscopy. The purpose of this article is to review the literature on rehabilitation protocols for patients following hip arthroscopy and to describe a new protocol specifically designed for patients to return to running following hip arthroscopy. A search of PubMed was performed through October 2016 to locate studies of rehabilitation protocols for patients wishing to return to sport/general activity following hip arthroscopy. Patients at our institution who desired to return to running following hip arthroscopy underwent 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 distance running. Rehabilitation 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 pain-free return to sports. 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. There is an overall lack of published outcomes based on patients adhering to various post-hip arthroscopy rehabilitation protocols.