This section applies to all patients.
No NSAIDS such as Advil, Motrin, ibuprofen, Naprosyn, and Aleve x 2 weeks
Pain: Tylenol for mild pain and if needed use mild narcotic provided
Driving restrictions: No driving until able to safely move foot from gas to brake if right hip,
and/or safely use clutch if left hip.
Work restrictions: Depends on duration of weight bearing restrictions
Exercise restrictions: 2 weeks relative rest followed by 4 weeks progressive PT. No running, jumping, or deep squats until 8 weeks.
The following may not apply to all patients. Your provider will complete this section, depending on your needs.
☐ Use Lumbar support brace for __________ days constant, _____ days PRN with increased activity
☐ Use crutches (partial weight bearing) until able to walk normally without limp
☐ Limit rotational movement of body/low and extension arching of the back for 4 days
☐ Avoid overhead work or lifting/weight bearing overhead for 1 week
☐ Avoid rotation motion with weight with for 1 week
☐ Use SI belt for 3-4 days continuously and then for 4-6 weeks with ambulation
☐ f/u for PT in 5-7 days
Activities: In general, with strength and activities, keep pain level below 4/10.
First 2 Weeks:
Strengthening/Motion: Isometrics always good. Non weight bearing and passive range of motion is good too. Try to get full range of motion by 2 weeks.
Walking: No hiking. May walk on flat ground initially for 10-15 minutes. If this goes well, may walk 5 minutes longer the next day.
Cycling: May gently ride stationary bike for 15 minutes after week 1. Exertion level 1-3/10
Swimming: May use pull buoy after week 1. No kicking.
-Strengthening/Motion: Start gentle low load closed chain concentric/eccentrics.
-Walking: May begin gentle hiking (no more than 30 minutes), watch hip angles.
-Cycling: May ride 30 minutes. No getting out of the saddle till after week 3. Exertion 4-6/10
-Swimming: May begin gentle kicking mixed with pull buoy. No more than 1⁄2 -1 mile.
Strengthening/Motion: Progress to moderate load, progressive strengthening.
Walking: May progress to longer hikes up to 60 minutes, still no big step-ups.
Cycling: May ride 60 minutes. May get out of saddle. Exertion 7-9/10 during intervals
Swimming: May swim up to 1-2 miles now. Still encourage breaks with buoy.