Pre Operative Hip Program

This program is designed for people who have hip joint pain due to degenerative changes, impingement (FAI), and labral tears. It is meant to provide guidelines for this population to build strength, flexibility, and endurance prior to any surgical procedure as well as those who have decided not to have surgery. All exercises are shown for the involved hip. If time permits it is always beneficial to work the other side as well.

If time permits it is always beneficial to work the other side as well.


Click here to download the Pre-Operative Hip Program.


Warm Up/ Cardio

Non Impact exercise such as stationary cycling and elliptical machines are great ways to keep the joint moving and maintain cardiovascular health. It is important to keep all exercise pain free and only work in pain free range of motion. While cycling keep the seat high to avoid pinching at the hip. High impact activities such as running and jumping should be avoided to prevent irritating the joint surfaces. Swimming is also a good non impact activity but, be careful with strokes like the breast stroke where the kick may cause pain in the hip joint.


Flexibility

Foam rolling is a great way to decrease pain and improve flexibility at the hip joint. The following pictures illustrate the proper technique for using the foam roller. For each muscle group find the most painful spot in that muscle and hold for 30 seconds. Repeat 3 x.

Piriformis

TFL (Hip Flexor)

ITB

Hip Adductor


Stretching

Below are a group of stretches that address the muscles of the hip joint. There are multiple versions for certain muscle groups so use the one that is most comfortable for you or feel free to use them all. Remember, during these stretches no sharp pain in the joint should be felt. You should move into a position where there is a mild pulling in the muscle to be stretched and hold this position for 20¥30 seconds. Repeat 3x.

Hip Flexor (Kneeling)Kneeling on the ground (pad). Tighten your buttocks and lunge forward until a stretch is felt in front of the hip. Hip Flexor (Thomas)Lying on a bed, bring one knee towards your chest. Allow the other leg to drop off the edge of the bed as in the picture. Stretch should be felt in front of the hip that is off the bed.
*If you feel pain in the hip that is pulled in towards your chest, DO NOT perform this stretch.
Hip Rotator (Piriformis)Lying on back. Bring one knee towards your chest then, pull your foot towards your opposite shoulder. Stretch should be felt in buttock.
Hip Flexor (Kneeling with arm overhead)Kneeling on the ground (pad). Tighten your buttocks and lunge forward then, lean away from the hip being stretched. Stretch should be felt in front of the hip. HamstringLying on back with feet flat on table. Straighten one knee and with both hands behind your knee pull your leg towards your chest. Keep a slight bend in the knee at all times. Stretch should be felt in the back of the thigh. Hip AdductorStanding with feet wide apart and hands on hips. Bend one knee and lunge away from the leg being stretched. Stretch should be felt in the inner thigh of the straight leg.

Hip Strengthening

These exercises are designed for strengthening the muscles that support the hip joint. It is important to perform these exercises in a slow controlled manner. We have intentionally left out straight leg raises because they may aggravate symptoms of hip pain and the benefit is not worth the risk of worsening hip pain.

Side Leg Lift (abduction) Lying on your side, lift leg upward as in picture. Hold for 2 seconds. Repeat 15x. Hip ExtensionStart on your hand and knees as shown in the picture. Lift one leg backward with knee bent. Hold 2 seconds. Repeat 15x. Single Leg BridgeLying on your back with one foot on the ground and the other in the air. Lift your buttock off the ground as shown. Hold 2 seconds. Repeat 15x.
Clam ShellLying on your side with both knees bent. Lift the knee of the top leg. Hold for 2 seconds. Repeat 15x. Elastic band may be used around knees as exercise gets easy. Fire HydrantStarting on hands and knees. Lift one knee out to the side while maintaining a flat back. Hold 2 seconds. Repeat 15x. Elastic band may be used around the knees as exercise gets easy. Lateral SteppingWith elastic band around ankles step to the side as far as comfortable. Make sure feet remain straight ahead throughout the exercise. Repeat 15 steps.

Core Strengthening & Functional Exercises

PlankSupport your body weight with your elbows and toes while lying face down on a mat. Maintain this position for 30 seconds. Repeat 3x. Do not allow your body to move during this exercise. Side Plank Support your body weight with one elbow and foot while in side lying. Maintain this position for 30 seconds. Do not allow your body to move during this exercise. Single Leg CurlWhile balancing on the involved leg perform an arm curl. Repeat 15x.
Single Leg pressWhile balancing on the involved leg perform a shoulder press. Repeat 15x. Leg Curl with BallLying on back with ball positioned under your ankles. Lift buttock off the floor, maintaining this position bring your knees towards your chest and return to starting position slowly. Repeat 15x. Knee Tuck with Ball Start in a push up position with lower legs resting on the ball. Bring knees to your chest and return to starting position slowly. Repeat 15x. As exercise gets easier you can perform a push up between repetitions.
Warm Up/ Cardio

Non Impact exercise such as stationary cycling and elliptical machines are great ways to keep the joint moving and maintain cardiovascular health. It is important to keep all exercise pain free and only work in pain free range of motion. While cycling keep the seat high to avoid pinching at the hip. High impact activities such as running and jumping should be avoided to prevent irritating the joint surfaces. Swimming is also a good non impact activity but, be careful with strokes like the breast stroke where the kick may cause pain in the hip joint.



Flexibility

Foam rolling is a great way to decrease pain and improve flexibility at the hip joint. The following pictures illustrate the proper technique for using the foam roller. For each muscle group find the most painful spot in that muscle and hold for 30 seconds. Repeat 3 x.

Piriformis


TFL (Hip Flexor)


ITB


Hip Adductor


Stretching

Below are a group of stretches that address the muscles of the hip joint. There are multiple versions for certain muscle groups so use the one that is most comfortable for you or feel free to use them all. Remember, during these stretches no sharp pain in the joint should be felt. You should move into a position where there is a mild pulling in the muscle to be stretched and hold this position for 20¥30 seconds. Repeat 3x.

Hip Flexor (Kneeling)
Kneeling on the ground (pad). Tighten your buttocks and lunge forward until a stretch is felt in front of the hip.
Hip Flexor (Thomas)
Lying on a bed, bring one knee towards your chest. Allow the other leg to drop off the edge of the bed as in the picture. Stretch should be felt in front of the hip that is off the bed.
*If you feel pain in the hip that is pulled in towards your chest, DO NOT perform this stretch.
Hip Rotator (Piriformis)
Lying on back. Bring one knee towards your chest then, pull your foot towards your opposite shoulder. Stretch should be felt in buttock.
Hip Flexor
(Kneeling with arm overhead)
Kneeling on the ground (pad). Tighten your buttocks and lunge forward then, lean away from the hip being stretched. Stretch should be felt in front of the hip.
Hamstring
Lying on back with feet flat on table. Straighten one knee and with both hands behind your knee pull your leg towards your chest. Keep a slight bend in the knee at all times. Stretch should be felt in the back of the thigh.
Hip Adductor
Standing with feet wide apart and hands on hips. Bend one knee and lunge away from the leg being stretched. Stretch should be felt in the inner thigh of the straight leg.

Hip Strengthening

These exercises are designed for strengthening the muscles that support the hip joint. It is important to perform these exercises in a slow controlled manner. We have intentionally left out straight leg raises because they may aggravate symptoms of hip pain and the benefit is not worth the risk of worsening hip pain.

Side Leg Lift (abduction)
Lying on your side, lift leg upward as in picture. Hold for 2 seconds. Repeat 15x.
Hip Extension
Start on your hand and knees as shown in the picture. Lift one leg backward with knee bent. Hold 2 seconds. Repeat 15x.
Single Leg Bridge
Lying on your back with one foot on the ground and the other in the air. Lift your buttock off the ground as shown. Hold 2 seconds. Repeat 15x.
Clam Shell
Lying on your side with both knees bent. Lift the knee of the top leg. Hold for 2 seconds. Repeat 15x. Elastic band may be used around knees as exercise gets easy.
Fire Hydrant
Starting on hands and knees. Lift one knee out to the side while maintaining a flat back. Hold 2 seconds. Repeat 15x. Elastic band may be used around the knees as exercise gets easy.
Lateral Stepping
With elastic band around ankles step to the side as far as comfortable. Make sure feet remain straight ahead throughout the exercise. Repeat 15 steps.

Core Strengthening & Functional Exercises
Plank
Support your body weight with your elbows and toes while lying face down on a mat. Maintain this position for 30 seconds. Repeat 3x. Do not allow your body to move during this exercise.
Side Plank
Support your body weight with one elbow and foot while in side lying. Maintain this position for 30 seconds. Do not allow your body to move during this exercise.
Single Leg Curl
While balancing on the involved leg perform an arm curl. Repeat 15x.
Single Leg press
While balancing on the involved leg perform a shoulder press. Repeat 15x.
Leg Curl with Ball
Lying on back with ball positioned under your ankles. Lift buttock off the floor, maintaining this position bring your knees towards your chest and return to starting position slowly. Repeat 15x.
Knee Tuck with Ball
Start in a push up position with lower legs resting on the ball. Bring knees to your chest and return to starting position slowly. Repeat 15x. As exercise gets easier you can perform a push up between repetitions.