30 SECONDS OF THERAPY: Managing Hip Instability

START 1. Recognizing Instability Symptoms

a. Groin, lateral hip, or deep gluteal pain

b. Clicking, catching, or the feeling of the hip “giving out”

c. Difficulty with single-leg balance, stairs, or rotational tasks

d. History of frequent subluxations / dislocations 2. Understand Contributing Factors

a. Ligamentous laxity or joint hypermobility

b. Gluteal Maximus / Medius and Hip Internal and External Rotator Weakness

c. Poor neuromuscular control or proprioception deficits - Find specific ways to test this (reciprocal toe-tapping accuracy, Y balance Test)

d. Post-surgical labral repair, THR, PHR, other hip procedures. e. Biomechanical abnormalities like femoral version or pelvic tilt. 3. Strengthen the Hip Stabilizers

a. Focus on gluteus medius, gluteus maximus, and deep hip rotators to improve joint control.

         Exercises: 

Clamshells

Sidelying hip abduction

Single-leg bridges

STOP

1. Overstretching the Hip Muscles  a. Many patients think stretching will help, but excessive hip flexibility can worsen instability. Avoid aggressive stretching of the hip flexors and abductors.

2. Ignoring Core Stability a. The lumbo-pelvic complex plays a huge role in hip control. Weak core muscles lead to poor hip stability and compensatory movements. b. Correction: Strengthen the transverse abdominis, obliques, and lower back. (Show some exercises) PDF Core Control

3. Allowing Excessive Hip Internal Rotation and Adduction a. Movements like crossing legs, sitting in "W" position, or valgus knee positioning should be discouraged. These can place stress on the hip joint and worsen instability.
   

WHY

1. Prevent Joint Degeneration and Labral Tears a. Hip instability can lead to excessive joint wear, acetabular labral tears, and early-onset hip osteoarthritis. Early intervention helps preserve joint integrity and delay surgical interventions.

2. Enhance Patient Mobility and Functional Independence a. Without proper rehabilitation, patients may develop chronic pain, compensatory gait patterns, and decreased activity levels. Addressing instability leads to better quality of life and mobility longevity.

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