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
