Hip Dysplasia: The Non-Surgical Solution [Evidence Based Guide]

By dpope2020

September 12, 2025

adult hip dysplasia, dan pope, developmental hip dysplasia, fitness pain free, hip dysplasia, hip dysplasia causes, hip dysplasia diagnosis, hip dysplasia exerciese, hip dysplasia exercises, hip dysplasia in adults, hip dysplasia surgery, hip dysplasia symptoms, hip dysplasia treatment, hip dysplasia treatment options, hip pain, orthopedic surgery, pao surgery, periacetabular osteotomy, physical therapy for hip dysplasia, signs of hip dysplasia, treating hip dysplasia

Hip Dysplasia: The Non-Surgical Solution [Evidence Based Guide]

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In today's video we go over: Hip Dysplasia: The Non-Surgical Solution [Evidence Based Guide] - FPF Show Episode 179

  • 0:00 Introduction
  • 0:04 Why should we care about hip dysplasia?
  • 1:40 Are there any RCTs looking at physical therapy for dysplasia or comparing surgery (PAO) vs. conservative management?  
  • 8:10 Step 1: Activity modification to help unload the hip and allow it to calm down
  • 9:51 Step 2: Therapeutic exercise.  Should we use exercise and how do we introduce and advance it?
  • 19:45 Should we train the hips flexors in these patients or will we just aggravate them?
  • 28:51 Should we stretching our patients with hip dysplasia?
  • 35:45 Step 3: How we should be introducing and advancing cardiovascular fitness in our patients with hip dysplasia
  • 39:52 Step 4: How should we introduce return to running programs in our patients with hip dysplasia?
  • 45:37 How should we introduce plyometric training in our patients with hip dysplasia?
  • 50:46 When can hip dysplasia patients return to sport after an onset of pain?
  • 54:50 Return to sport criteria for getting back to sport and activity
  • 58:39 Step 5: When to refer back to the physician if not progressing.
  • 59:56 Should patients with more severe hip dysplasia (<20 degrees LCEA) be sent back to the surgeon faster?
  • 1:03:19 Diagnosing Hip Dysplasia: What Every PT Needs to Know

Think We Fixed Those Hips...

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Jacobsen, J.S., Evans, R., Morgan, K. et al. An exercise and patient education intervention to reduce pain and physical limitations in adults with acetabular dysplasia: study protocol for a process evaluation integrated within a randomised controlled trial (the MovetheHip trial). Trials 25, 411 (2024). https://doi.org/10.1186/s13063-024-08262-y

  2. Disantis AE, Martin RL, Enseki K, Spaid V, McClincy M. Non-Operative Rehabilitation Principles for Use in Individuals with Acetabular Dysplasia: A North American Based Delphi Study. Int J Sports Phys Ther. 2023 Dec 2;18(6):1331-1345. doi: 10.26603/001c.89265. PMID: 38050551; PMCID: PMC10693488.

  3. Reimer LCU, Jakobsen SS, Mortensen L, Dalgas U, Jacobsen JS, Soballe K, Bere T, Madsen JE, Nordsletten L, Risberg MA, Mechlenburg I. Efficacy of periacetabular osteotomy followed by progressive resistance training compared to progressive resistance training as non-surgical treatment in patients with hip dysplasia (PreserveHip) - a protocol for a randomised controlled trial. BMJ Open. 2019 Dec 23;9(12):e032782. doi: 10.1136/bmjopen-2019-032782. PMID: 31874882; PMCID: PMC7008423.

Image References:

  1. Hip Labrum: Image Source, License, Attribution: OpenStax College – Edited by Fitness Pain Free LLC
  2. Lateral center edge angle: Source: https://upload.wikimedia.org/wikipedia/commons/b/bf/Center-edge_angle_of_Wiberg.jpg  attribution: Article authors: Ruiz Santiago, Fernando; Santiago Chinchilla, Alicia; Ansari, Afshin; Guzmán Álvarez, Luis; Castellano García, Maria del Mar; Martínez Martínez, Alberto; Tercedor Sánchez, Juan, CC BY 4.0 <https://creativecommons.org/licenses/by/4.0>, via Wikimedia Commons
  3. Tonnis Angle: Source: https://upload.wikimedia.org/wikipedia/commons/d/d9/T%C3%B6nnis_angle_of_the_hip.jpg   attribution: Article authors: Article authors: Ruiz Santiago, Fernando; Santiago Chinchilla, Alicia; Ansari, Afshin; Guzmán Álvarez, Luis; Castellano García, Maria del Mar; Martínez Martínez, Alberto; Tercedor Sánchez, Juan, CC BY 4.0 <https://creativecommons.org/licenses/by/4.0>, via Wikimedia Commons
  4. Normal Hip Image source: https://upload.wikimedia.org/wikipedia/commons/e/e3/Biomechanik-H%C3%BCftdysplasie-Normalstellung.svg  Attribution: Original: Redlinux Vector:  Anka Friedrich, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons
  5. Dysplasia Hip Image source: https://upload.wikimedia.org/wikipedia/commons/6/65/Biomechanik-H%C3%BCftdysplasie-dysplastisch.svg Attribution: Original: Redlinux Vector:  Anka Friedrich, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons 
  6. PAO Source: https://upload.wikimedia.org/wikipedia/commons/b/bd/PAO_after.jpg  attribution: Hip2PAOFO, Public domain, via Wikimedia Commons
  7. PAO picture: Source: https://upload.wikimedia.org/wikipedia/commons/1/16/Acetabuloplastik-Schritt2.svg attribution: Hk kng nach Vorlage von de:Benutzer:OrthoPat, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons
  8. Coxa Valga: Image source: https://upload.wikimedia.org/wikipedia/commons/6/62/Coxa-valga-norma-vara-000.png  Attribution: Addingrefs, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons