Acetabular Labrum Tear edit
Rehabilition edit
With physical therapy, there is only a small amount of evidence on rehabilitation techniques for the acetabular labrum [1] It is even thought that physical therapy could be controversial due to there not being any evidence of a specific effective therapy routine [2] There are, however, some studies that report physical therapy could benefit the patient by bringing them back to “sports-ready” capabilities [3] It is advised that physical therapists keep up on the new findings and stay in close contact with the orthopaedic surgeon so they have the best idea of how to approach their patient’s case [4] Following surgery, crutches will be used for up to six weeks and there should be no expectation to return to activities such as running for at least a period of six months [5]
Some things to note when rehabilitation occurs is that it is important to know the size and placement of the tear. There are usually four phases in the rehabilitation process noted as: “Phase I – initial exercises (weeks 1-4), Phase II – intermediate exercises (weeks 5-7), Phase III – advanced exercises (weeks 8-12), and Phase IV – return to sports (weeks 12+)” [6] All physical therapy regimens should be individualized from person to person based on all adequate criteria [7]
In phase I of the rehabilitation process the first objective is to minimize the pain and inflammation. It is important to begin conducting small motion exercises that have up to 50% weight bearing capacity by the patient. A symmetrical gait pattern is imperative as not to create an imbalance in the muscles of the hip. Aquatic therapy is highly encouraged and looked upon due to its ability to help the patient move more freely without the pressure of gravity. To progress to phase “II” of the rehabilitation process patients should be able to complete straight leg raises while laying on their side to strengthen the sartorius and tensor fasciate latae muscles to build support in the leg.
In phase “II” the physical therapist should be trying to promote more flexibility in the soft tissue. There should be more emphasis on the beginning aspects of strength training while adding some resistance over time. In order to progress to phase “III”, the patient should be able to demonstrate a normal gait pattern and minimal pain with exercises like the single leg bridging to help strengthen the hamstring muscles to help with leg equality.
In phase “III” the focus is to begin building functional strength. Movements should include single leg exercises to build the muscle and challenge the strength of the hip.
In order to progress to phase “IV” the flexibility of the patient should be adequate. Phase IV is the final stage in which the physical therapist would assess and prescribe any further exercise up until the patient is ready to return to the sport [8]
Usually the therapist would start using complex movements like squatting, kicking, and running. The therapist would look for symmetrical movements on both sides of the body without pain. If the patient demonstrates the symmetrical movements without pain, the physical therapist would use their discretion for the patient’s clearance.
Some things to avoid from while rehabilitating are sitting with “knees lower than the hips, legs crossed where hip is rotated, and sitting on the edge of the seat and contracting the hip flexor muscles [9]
- ^ Garrison, Craig J., Osler, Michael T., Singleton, Steven B. (2007). Rehabilitation after Arthroscopy of an Acetabular Labral Tear. North American Journal of Sports Physical Therapy. 2(4), 241-250.
- ^ Groh, Megan M. & Herrera, Joseph. (2009). A comprehensive review of hip labral tears. Musculoskeletal Medicine. 2(2), 105-117.
- ^ Lewis, Cara L. & Sahrmann, Shirley A. (2006). Acetabular Labral Tears. Journal of the American Physical Therapy Association. 86, 110-121.
- ^ Garrison, Craig J., Osler, Michael T., Singleton, Steven B. (2007). Rehabilitation after Arthroscopy of an Acetabular Labral Tear. North American Journal of Sports Physical Therapy. 2(4), 241-250.
- ^ Clohisy, John C. & McClure, Thomas. (2005). Treatment of Anterior Femoroacetabular Impingement with Combined Hip Arthroscopy and Limited Anterior Decompression. Iowa Orthopaedic Journal. 2, 164-171.
- ^ Garrison, Craig J., Osler, Michael T., Singleton, Steven B. (2007). Rehabilitation after Arthroscopy of an Acetabular Labral Tear. North American Journal of Sports Physical Therapy. 2(4), 241-250.
- ^ Hunt, Devyani, Clohisy, John, Prather, Heidi. (2007). Acetabular Labral Tears of the Hip in Women. Physical Medicine and Rehabilitation Clinics of North America. 18(3), 497-520.
- ^ Garrison, Craig J., Osler, Michael T., Singleton, Steven B. (2007). Rehabilitation after Arthroscopy of an Acetabular Labral Tear. North American Journal of Sports Physical Therapy. 2(4), 241-250.
- ^ Lewis, Cara L. & Sahrmann, Shirley A. (2006). Acetabular Labral Tears. Journal of the American Physical Therapy Association. 86, 110-121.