Multidisciplinary Management and Proposed Criteria for a Return to Competitive Crossfit Following a Hip Resurfacing: A Case Study

Research Objectives: To highlight a multidisciplinary approach in the successful return to CrossFit following a hip resurfacing. A secondary goal is to propose a criteria based progression assisting in decision making for determining readiness of the individual’s return to high level CrossFit activities.

Design: Retrospective case study

Setting: The setting includes outpatient physical therapy center at the Hospital For Special Surgery and a community CrossFit center

Participants: The study involves an adult male referred to physical therapy following a hip resurfacing.

Interventions: Interventions included standard of care, with progressive strengthening of the lower extremities. Functional training and high level plyometric motion replicating his desired sport were included and progressed.

Main Outcome Measures: Outcome measurements utilized included a numeric pain scale, hip passive range of motion, hand held dynamometer strength and knee extension strength measured via biodex. Patient reported outcomes included the HOOS jr. and Lower Extremity Functional Scale. Functional and high level plyometric motions were observed for symmetry, deviations and overall performance.

Results: Numeric pain scale 0/10. Hip passive range of motion was near symmetrical: He was demonstrating 92.3%, 120.3%, 89.2%, 46.6% and 125% strength indexes for hip flexion, extension, abduction, external rotation and internal rotation respectively. His quad index was 86% and 91% at 30 degrees and 60 degrees respectively. He demonstrated high level plyometric motion with observed symmetry. His Lower Extremity Functional Scale score was 64% and HOOS jr. score was 92.34.

Conclusions: The patient was returned to competitive CrossFit in less than 6 months while demonstrating at least a 89% strength index in all hip motions aside from hip external rotation. Symmetrical hip range of motion and an ability to demonstrate high level plyometric motion with appropriate control. As a result, we propose criteria based progression for an individual's ability to safely return to Crossfit to include symmetrical range of motion, at least 89% strength indexes for hip and quad strength and symmetrical plyometric performances. However, further research needs to be conducted in order to establish baseline requirements for an individual’s return to high level sporting activities.

Author(s) Disclosures: Authors have nothing to disclose