Gluteus Medius / Abductor Repair Rehab Protocol

Arthroscopic or open repair — therapist reference

Physical Therapy Protocols · From Dr. Allred · Transcribed from the printed sheet · 9 sections

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If you have questions about a protocol or a specific patient, call the clinic where the surgery was performed.

After hours & emergency numbers → Weekdays, business hours.

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Precautions (First 6 Weeks)

  • No active abduction; no passive adduction. Limit passive IR/ER for 6 weeks to protect the repair.
  • Weight bearing: touchdown (foot-flat) only for 6 weeks with brace and crutches; normalize gait.
  • Manage portal-site scarring; watch for hip-flexor tendinitis, trochanteric bursitis, and synovitis. PT begins post-op day 1–3, then ~1×/week from week 3, progressing to 2–3×/week.

Phase 1 · Weeks 0–4

  • Stationary bike 20 min/day (no resistance); scar massage; modalities; gait training with assistive device.
  • Hip PROM: flexion and abduction as tolerated, log roll, quadruped rocking. No passive ER until 4 weeks, no adduction until 6 weeks.
  • Hip isometrics (add extension/adduction/ER at 2 weeks); hamstring isotonics; pelvic tilts; NMES to quads with short-arc quads.

Phase 2 · Weeks 4–6

  • Stool rotations IR/ER (~20°); supine bridges; isotonic adduction.
  • Begin sub-maximal, pain-free hip-flexion isometrics; quadriceps strengthening.
  • Progress core strengthening (avoid hip-flexor tendinitis); continue scar massage.

Phase 3 · Weeks 6–8

  • Advance to full weight bearing by 8 weeks; begin weaning crutches.
  • Progress ROM: passive ER/IR (stool rotation → BAPS → prone hip ER/IR); hip joint mobilizations if needed.
  • Continue core progression.

Phase 4 · Weeks 8–10

  • Wean off crutches (2 → 1 → 0) without a Trendelenburg gait.
  • Strengthen: hip-abduction isometrics → isotonics, bilateral leg press, isokinetic knee flexion/extension; progress core.
  • Begin proprioception/balance (balance board, single-leg stance); aqua therapy; elliptical.

Phase 5 · Weeks 10–12

  • Progress hip strengthening: hip PREs/machine, unilateral leg press, hip hiking, step-downs.
  • Stretch hip flexors, glute/piriformis, IT band; progress balance (bilateral → unilateral → foam → dynadisc); treadmill and Thera-Band side-stepping; StairMaster hip hiking (week 12).

Phase 6 · Weeks 12+

  • Progressive ROM/stretching and LE/core strengthening; hip endurance and dynamic balance.
  • Treadmill running program; sport-specific agility drills and plyometrics.

Discharge Criteria (Re-Evaluate at 3–6 Months)

  • Pain-free or a manageable level of discomfort.
  • Manual muscle testing within 10% of the uninvolved leg.
  • Biodex quadriceps/hamstring peak torque within 15% of the uninvolved leg.
  • Passes step-down test.

References

  • Gluteus Medius Repair Physical Therapy Protocol. American Hip Institute.
  • Return to Activity After Gluteus Medius Repair. PMC, 2021.

Streamlined and de-duplicated from the prior version (the earlier Weeks 8-10 section repeated the Weeks 6-8 text). Weight-bearing status, repair precautions, and criterion-based discharge testing align with current gluteal-repair rehabilitation practice.

Questions about this sheet? Call the clinic where the surgery was performed. I'm happy to talk through the plan. Numbers are at the top of this page, and every after-hours line is on the emergency numbers page.