The Missing Link in Hip Rehabilitation

The Missing Link in Hip Rehabilitation

The Missing Link in Hip Rehabilitation — Evidence-Based Treatment for Hip Injuries

Patients who come to physio with pain in the hip have often been managed from a one-joint or soft tissue injury concept at another centre.

However, here at PhysiCo City, we firstly treat the hip joint itself – if there is any primary joint and bone pathology. Then, we assess and reduce neurological referred pain into the patient’s hip. Finally, we add the Gluteus Medius strengthening to ‘the holy trinity’ of a standard hip injury rehabilitation program.

You may ask – Is it enough? In a way, yes. It will reduce the pain and get you back to everyday life and exercise.

Is it the best approach?  Not always, because a good physio is not just here to get their patients back on their feet after injuries. We want to prevent the same injuries from happening over and over again.

To do so, we need to think outside of the box and look at how the patient’s body function as a whole. It’s important to understand the relationship between the lower back, pelvis, hip, and knee, and their relationship to the functional kinetic chain. In other words, we need to look above and below the hip for the weak link. Identifying, correcting, and conditioning the weak link is the key to a better treatment. This isn’t just treating the patient, but also successfully preventing the reoccurrence of the same injury.


So, what are these missing links in hip injuries:

‘My knee is not pointing straight when I run/walk”

The alignment from your foot and leg is often associated with a stiff, over-rotated foot and tight calf muscles. Next thing we know, the ankle starts to lock and the leg starts to turn inwards. This prevents the activation of the Gluteus Medius muscle and it becomes weak and prone to inflammation and micro tears. The patient makes compensations in their running/walking pattern until it is too painful to continue. That’s when they come to see their physio.

‘My pelvis is out of alignment’

Pelvis dysfunction is also frequently seen among the hip injuries. You may have heard people saying “Oh my Pelvic is out of alignment”. This is a common term for the pelvis, in particular, Sacroiliac joint (SIJ) dysfunction. The Pelvis serves as a functional link to transfer load from lower limbs to the spine, and vice versa. Any strains on the ligaments and imbalance/weakness in the muscles (especially Gluteas Maximus and Piriformis) can have negative impact on this link. Consequently, causing pain in the hip.

Core Muscles

‘Weak core and bad posture’

The core stability and strength is often forgotten or over looked in the rehabilitation of a hip injury. The core muscles are required to offset the powerful loads that are placed on the spine by the force that is generated in the hip and pelvic during mobilisation. The link among the legs, core, and upper body allows the power generated by these muscles to transmit through the body. This synchronises the motion of our body.


Eliminating the Missing Links

What can we do to eliminate those missing links that prevent you from full recovery? How can we keep you from coming back for the same hip injuries in a few week/months’ time?

The key is to go beyond the standard hip rehabilitation of the “holy trinity” and identify what is missing, and then to eliminate those weak links.


6 Step Program to Treat Hip Injuries

At PhysiCo City, we have a 6 steps to success program. This will help you to identify your missing links, treat any issues related to your hip injuries, and guide you through with a personalised rehabilitation program based on your hip condition.

  1. Functional Examination and differential diagnosis
  2. Address the biomechanics elsewhere in the kinetic chain
  3. Functional Joint mobilisation and soft tissue release to free up the symptomatic and overloaded structures
  4. Functional muscle activation and strengthening in the hip region to address the imbalance between muscle groups
  5. Core strength conditioning
  6. High intensity strength and functional activity program


If you’re looking to receive treatment for a hip injury from one of our expert physiotherapists, you can BOOK ONLINE today. Otherwise, you can give us a call on 9267 3775 or fill out one of our enquiry forms and we’ll get in touch with you 🙂