Regarding Kelly’s right hip labrum repair, it is very common for patients following this surgery to feel continued complications. This is primarily due to imbalances between the anterior chain and posterior chain and the fact that traditional physical therapy settings under-load patients and thus fail to build “real strength” which is necessary for proper joint mechanics. Our lifestyle of sitting in chairs at work, in car seats while driving, and on the couch at night creates tightness in the front of our bodies (hip flexors, quads, tensor fascia latae, etc.) and weakens our posterior musculature (glutes, hamstrings).
In the physical therapy world we call this lower crossed syndrome, a crossed pattern of tightness and weakness. In Kelly’s case, and so commonly, this leads to impingement in the front of the hip between the rim of the socket on the pelvis and the head of the femur. This impingement, if not addressed, can actually cause further complication to the labral tissue (including degenerative fraying and tearing).
The treatment for this condition is to identify tight and limiting tissue in the anterior portion of the hip and use dry needling, myofascial work, and joint mobilizations to loosen up tightness in the ligamentous hip capsule. This helps to better position the femoral head slightly back in the socket. Once we gain this position again we start to hard code it by performing deadlifts and other hip dominant exercises to strengthen the glutes and hamstrings.
Not only does this have positive impacts on posture, pelvic position, and improving hip mechanics, but hip dominant programming is also critical for return to sport activities and feeling explosive.
To measure Kelly’s progress, we used a system called Output which analyzes the velocity of the barbell, or in this case the hex bar, to calculate the power the athlete is producing during the lift. We like to use this with all of our clients to establish baseline strength, vertical leap, explosive power, and stability, so that we can track progress in real time.