Gluteus Medius Repair Protocol

WEEK 1-4:

Weight Bearing

  • Touch Down Weight Bearing with crutches (about 20 lbs. of force)

Brace

  • Wear brace at all times except for exercises and hygiene
  • Wear brace at night

ROM

  • Avoid pinching feeling with ROM
  • No active abduction or internal rotation
  • No passive external rotation or adduction
  • Flexion: 0-90°
  • Extension: 0° (avoid hyperextension)
  • Abduction: as tolerated

Therapeutic Exercise

  • Exercise bike without resistance immediately (POD#1 if possible) 20 minutes per day (can be 2x per day)
  • Gait training PWB with crutches
  • Isometrics: Quad setting, gluteal setting, hamstring digs with knee support, plantarflexion/ dorsiflexion, eversion/inversion strengthening
  • Prone lying
  • STM mobilization, scar massage
  • No joint/capsular mobilizations

WEEK 4-6:

Weight Bearing

  • Continue Touch Down Weight Bearing with crutches (about 20 lbs. of force)

Brace

  • Wear abduction brace when ambulatory, remove for exercises and hygiene
  • May remove brace at night and when non-ambulatory

ROM

  • Progress with passive hip flexion beyond 90 degrees
  • Passive range of motion as tolerated within pain free range

Therapeutic Exercise

  • Avoid straight leg raises (flexion) to prevent post-operative hip flexor tendonitis
  • Continue to protect repaired tissue, avoid joint/capsular mobilizations
  • Restore hip ROM
  • Hamstring isometrics

WEEK 6-12:

Weight Bearing

  • Full

Brace

  • None

ROM

  • Full

Therapeutic Exercise

  • Continue previous phase exercise
  • Begin straight leg raises (flexion)
  • Continue to protect repaired tissue, avoid joint/capsular mobilizations
  • Stationary bike with resistance
  • Gluteal Isometrics
  • Hamstring isometrics
  • Avoid side-lying abduction against gravity until 12 weeks

WEEKS 12+:

Weight Bearing

  • Full

Brace

  • None

ROM

  • Full

Therapeutic Exercise

  • Treadmill walking, progressing to running when abductor strength is equal to contralateral side
  • Single leg squats
  • Lunges
  • Side planks
  • Plyometrics
  • Sport Specific Training if hip strength 80% of contralateral side
  • Return to sport 4-6 months if cleared by MD

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