Rehabilitation guidelines following hip arthroscopy have been presented in the literature with common themes consisting of initial protection, restoration of lumbo-pelvic stability, neuromuscular re-education, and return to sport training. The purpose of this review is to present hip arthroscopy guidelines in 4 phases and to address common pitfalls that may delay the rehabilitative process. The goal of phase 1 should be to protect healing tissues through activity modifications. Phase 2 intends to return the patient to pain-free community ambulation without compensation or irritation. A review of hip muscular actions during gait is presented to guide exercise progressions during this phase. Phase 3 should reestablish neuromuscular control through strength and endurance training to provide the foundation for return to functional activities or sports training progressions. The last phase of rehabilitation is dedicated to reestablishing power, speed, agility, and skill for advanced sports and advanced functions.
The 4-Element Movement System Model describes primary elements (motion, force, motor control, and energy) essential to the performance of all movements. The model provides a framework or scaffolding which allows for consistent processes to be used in examination and intervention decisions. The process starts with task identification followed by a systematic observation of control, amount, speed, symmetry, and symptoms during movement. Testable hypotheses are generated from the observations which inform the examination and the interventions. This commentary describes the use of the 4-Element Movement System Model in entry level and post-graduate residency educational programs and in clinical care with three common sports-related diagnoses.
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