Physiotherapy
Physiotherapy can be used with purely conservative treatment to change the gait pattern and strengthen the muscles.However, since surgery is performed in most cases, physiotherapeutic therapy usually takes place in the post-operative phase. In the first 2-4 weeks, or up to 6 weeks if parts of the cartilage had to be fixed (labrum refixation), walking is only allowed with crutches and the leg is only partially loaded. The use of a bicycle ergometer and the movement of the leg by the physiotherapist are also recommended.
Up to 10 weeks, training in a closed chain (e.g. leg press or knee bend) is allowed and also crosstrainer and aqua gymnastics may be used. It is important that no overloading takes place and that training is only done in the pain-free area. From the 10th week onwards, up to 70% load can be applied to the leg.
Increased strength, coordination and endurance training should also be part of the therapy plan. From the 4th month onwards, in most cases, full weight-bearing can be resumed without pain. At the beginning after a surgical intervention on the hip impingement, it is important that the hip joint is not overloaded.
Therefore, careful training on a bicycle ergometer or crosstrainer is recommended at the beginning. Later, you can also train on the treadmill or in the swimming pool. Full strain on the leg should be avoided as a matter of urgency.
If (for the time being) no operation is performed, stretching exercises are a central component. The large gluteus maximus muscles must be stretched. To do this, stand up straight and pull one leg upwards as if you were marching.
The knee is grasped by both hands and pulled towards the abdomen. It should pull in the corresponding cheek. The second exercise is also done standing up.
While standing one leg and the upper body is brought into a horizontal position and the arms are stretched out to the side. Try to hold this for about 30 seconds. Besides stretching muscles, this exercise is helpful for developing coordination and strength.
The third exercise is done in the supine position. While lying on your back, one leg is angled on the floor and the other is grasped at the knee with both hands and pulled towards the stomach. In doing so, you push yourself off the floor with the other leg, so that you build a bridge.
This is done alternately with both legs and is repeated several times. On the one hand, the deep-seated muscles are stretched and on the other hand, they are also strengthened. The fourth exercise takes place in a lateral position.
Both knees lie on top of each other. A mini-band is stretched between them – this is a teraband that is continuous, like a big strong elastic band. Now the upper leg is lifted slowly and calmly from the one below against the pull of the band and then lowered again.
This is repeated 8-12 times and then the leg is changed. Further stretching exercises to stretch the front hip muscles and the adductors can also be used. Squats can also be useful, but should be performed in a controlled manner, as incorrect performance can increase hip impingement.
