Post-Operative Instructions:
Gluteal Repair

Pain Medications

  • In most cases local or regional nerve blocks will provide 8-12 hours of numbness. As soon as you start to feel the numbness wearing off, begin taking oral pain medication.

  • Take Tylenol 500mg one tab every 8 hours.

  • Take Aleve 220mg one to two tabs every 12 hours.

  • If you still have pain after Tylenol and Aleve, take one Norco tab (5mg/325mg).

  • If you still have pain after all of the above, take a second Norco tab.

  • Keep in mind Norco has Tylenol in it (325mg). If you take an extra Norco, then skip a dose of Tylenol.DO NOT exceed 3500mg of Tylenol over 24 hours. 

  • It is illegal to drive or operate machinery with narcotic medications. 

  • Do not combine alcohol or other sedatives with narcotic medications.

  • You do not need to take Tylenol or Aleve once you no longer have pain. You should stop Norco first (usually after a few days).

Other Medications

  • Take Aspirin 325mg one tab once a day for the first 4 weeks to prevent blood clots.

  • Take Zofran as needed for nausea (usually associated with anesthesia/narcotic meds).

  • Take an over-the-counter stool softener (Docusate/Senna/Miralax) as needed for constipation.

Activity

  • Use crutches to assist with ambulation.

  • You may bear 25% of your weight on your operative extremity with your foot flat on the ground.

  • Elevate your leg on pillows above the heart level as much as possible to decrease swelling.

  • Avoid prolonged periods standing to prevent excessive pain and swelling.

Recovery Equipment

  • You should wear the brace at all times (except for sleeping, exercises, CPM, and hygiene).

Cold Therapy

  • We recommend cold therapy use as much as possible in the first two weeks. 

  • Cold therapy units may be used continuously as instructed.

  • Ice packs should be applied 30 minutes at a time, with 30 minutes off between applications.

  • Do not apply ice directly to the skin to avoid burning.

Recovery Exercises

  • You may perform ankle exercises as instructed in your preoperative packet.

  • You should lie on your stomach to stretch the front of your hip for 1-2 hours per day.

  • Your motion goal should be to have 0-90 degrees of hip motion at your initial postoperative visit.

  • Begin physical therapy as soon as possible, ideally the day after surgery.

Diet: Please refer to your preoperative packet instructions.

Incision Care: Please refer to your preoperative packet instructions.

Emergencies: Please refer to your preoperative packet instructions.

Post-Operative Rehabilitation: 
Gluteal Repair

Therapy Plan: Twice per week for 0-3 months, once per week for 3-6 months

ROM Progression

Progress ROM as tolerated with the goal of symmetric full motion at 6-8 weeks EXCEPT ADDUCTION.

  • Do not start adduction stretching past neutral until after 6 weeks

Weight Bearing Progression

Initial weight bearing 0-6 weeks after surgery should be 25% body weight with the foot flat on the ground.

  • Progress weight bearing over weeks 6-8 with the goal of removing crutches at 8 weeks

  • Do NOT progress to one crutch - gait must be pain free and non-compensatory to remove both crutches

  • Brace should remain in place until strength is sufficient for gait stability

Initial Post-Operative Physical Therapy Visit

  • Correctly perform 25% body weight bearing with the foot flat on the ground with crutches

  • Instruct on upright (NO recumbent) stationary bike with NO resistance, pedal ONLY with opposite leg

  • Isometric exercises for core, glutes, quadriceps, hamstrings

Phase 1 Physical Therapy (0-6 weeks): protect the joint and avoid irritation

  • NO open-chain exercises

  • Manual therapy 20+ minutes per session, stationary bike 20-60 minutes/day (NO resistance)

  • Soft tissue mobilization, isometric exercises, core strengthening

Phase 2 Physical Therapy (6-10 weeks): non-compensatory gait and progression

  • Tactile and verbal cueing to enable non-compensatory gait patterning at 6 weeks

  • Progress gentle stretching for flexion-extension, adduction-abduction, and rotation

  • Soft tissue and joint mobilization, isometric exercises, core strengthening

  • Elliptical may begin at 8 weeks

  • Closed-chain strengthening and planks starting at 6 weeks advancing as tolerated

Phase 3 Physical Therapy (10-16 weeks): return to pre-injury level

  • Focus on functional exercises in all planes, advance only when fully controlled

  • Soft tissue and joint mobilization, closed-chain exercises, core strengthening

  • Strengthening: lunges, resisted side steps, planks

  • Slide board and hip rotation movements may begin at 10-12 weeks

Phase 4 Physical Therapy (16-32 weeks): return to sport

  • Full return may take a full 6-12 months or more and requires functional assessment prior to return

  • Soft tissue and joint mobilization, closed-chain exercises, core strengthening

  • Agility drills and pool (or Alter G) running may begin at 16 weeks

  • Straight running and cutting may begin at 20 weeks

  • Plyometric and sport-specific drills may begin at 24 weeks