Hip Manual Therapy: Evidence Based Guide for PTs

By dpope2020

October 17, 2025

dan pope, FAI, FAI manual therapy, femoroacetabular impingement treatment, fitness pain free, hip caudal glide, hip distraction mobilization, hip joint mobilization, hip manipulation, hip manual therapy, hip medial glide, hip mobility exercises, hip OA mobilization, hip osteoarthritis treatment, hip pain, hip pain relief, hip posterior glide, manual therapy, Mulligan hip belt technique, physical therapy, post-op FAI rehab, stiff hip treatment

Hip Manual Therapy: Evidence Based Guide for PTs

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In today's video we go over: Hip Manual Therapy: Evidence Based Guide for PTs

Do you struggle to see consistent, short-term improvement in your hip pain patients, especially those with OA or FAI? Feeling limited by basic techniques or unsure how to safely apply mobilizations in tricky post-op cases?

You know exercise and education are the "heavy hitters," but you also know that adding the right manual therapy can be the crucial difference-maker in that initial, painful phase.

If you've ever felt:

❌ Unconfident applying mobilizations (like the posterior glide) on sensitive patients with FAI or hip arthritis, fearing you'll increase their pain.

❌ Frustrated trying to generate effective, global hip distraction or difficult medial glides without the right setup or leverage (especially with heavier patients!).

❌ Limited in your technique variations, sticking to just one or two safe options instead of having a complete, evidence-based toolkit.

❌ Unsure how to properly position yourself and the patient to mobilize along the plane of the acetabulum for maximal effect....then this is the video for you!

In this comprehensive video, we'll dive deep into essential, evidence-based manual therapies for the hip, perfect for treating common conditions like Hip Osteoarthritis (OA) and Femoral Acetabular Impingement (FAI), and for post-op stiffness/pain.

What you'll master:

✅ Posterior Hip Glide: Learn careful application to improve flexion and IR—crucial tips for avoiding provocation in sensitive joints.

✅ Lateral Distraction (Mulligan-style): A global technique to improve all ROM, including proper belt placement and stabilization.

✅ Caudal Glide in Flexion: Master the force direction for a straight inferior pull, and how to safely grade this for FAI/OA patients.

✅ Advanced Techniques: Including distraction with internal rotation, medial glide (with handy modifications for smaller clinicians!), and the long-axis manipulation setup.

✅ Critical Context: Understand the evidence comparing manual therapy + exercise vs. exercise alone, so you know when and why to use these skills.

TIMELINE

  • 0:00 - Intro
  • 0:12 - Why Manual Therapy?
  • 0:28 - Patient Education & Exercise
  • 1:14 - Hip Anatomy
  • 1:53 - Hip Posterior Glide
  • 2:48 - Lateral Hip Distraction
  • 4:40 - Hip Caudal Glide
  • 5:38 - Hip Internal Rotation with Distraction
  • 6:23 - Hip Long Axis Distraction
  • 7:40 - Hip Medial Glide
  • 8:47 - Hip Lateral Glide
  • 9:26 - Dosage of Manual Therapy

Pull on those hips!

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Runge N, Aina A, May S. The Benefits of Adding Manual Therapy to Exercise Therapy for Improving Pain and Function in Patients With Knee or Hip Osteoarthritis: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2022 Oct;52(10):675-A13. doi: 10.2519/jospt.2022.11062. Epub 2022 Jul 26. PMID: 35881705.
  2. Ishøi L, Nielsen MF, Krommes K, Husted RS, Hölmich P, Pedersen LL, Thorborg K. Femoroacetabular impingement syndrome and labral injuries: grading the evidence on diagnosis and non-operative treatment-a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). Br J Sports Med. 2021 Nov;55(22):1301-1310. doi: 10.1136/bjsports-2021-104060. Epub 2021 Sep 16. PMID: 34531185.
  3. Cibulka MT, Bloom NJ, Enseki KR, Macdonald CW, Woehrle J, McDonough CM. Hip Pain and Mobility Deficits-Hip Osteoarthritis: Revision 2017. J Orthop Sports Phys Ther. 2017 Jun;47(6):A1-A37. doi: 10.2519/jospt.2017.0301. PMID: 28566053.
  4. Monselli C, Bianco Prevot L, Accetta R, Tronconi LP, Bolcato V, Basile G. State of the Art in Rehabilitation Strategies After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Systematic Review. J Clin Med. 2024 Nov 30;13(23):7302. doi: 10.3390/jcm13237302. PMID: 39685760; PMCID: PMC11642080.
  5. Hando BR, Gill NW, Walker MJ, Garber M. Short- and long-term clinical outcomes following a standardized protocol of orthopedic manual physical therapy and exercise in individuals with osteoarthritis of the hip: a case series. J Man Manip Ther. 2012 Nov;20(4):192-200. doi: 10.1179/2042618612Y.0000000013. PMID: 24179327; PMCID: PMC3500131.

  6. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: a randomized controlled trial. 1: clinical effectiveness Abbott, J.H. et al. Osteoarthritis and Cartilage, Volume 21, Issue 4, 525 - 534