Table 1 Manual therapy techniques: a semi-standardised approach

Soft tissue massage and trigger point release of iliopsoas, adductor group, gluteus minimus, gluteus medius, piriformis and tensor fascia latae

Address soft tissue restrictions with the aim of reducing pain and increasing hip joint range of movement

Sustained digital pressure to each trigger point, with the muscle positioned on stretch

30 - 60 seconds digital pressure per trigger point

Session 1 - 8

Massage longitudinally along the muscle belly

2 - 5 minutes of massage per muscle

Mobilisation of lumbar spine

To improve lumbar spine mobility and restore normal lumbo-pelvic movement

Unilateral postero-anterior accessory glides, Grade III or IV

3 - 5 sets of 30 - 60 seconds

Session 1 - 8

Correction of sacro-iliac joint asymmetries

To optimise the position of the ilium and therefore the orientation of the acetabulum

Massage to iliopsoas

2 - 5 minutes of massage

Session 1 - 8

Mobilisation of sacrum

Manual traction if ligamentum teres is intact or ligated and patient is >3 months post-labral repair

Increase hip flexion and/or IR/ER range of motion

Seatbelt around patient's proximal femur and therapist's hips. Gentle inferior and/or lateral traction force applied. May include patient actively moving hip into flexion as traction is applied

3 sets of 10 seconds. If tolerated, increase by 1 set per treatment session to a maximum of 6 sets in total

Session 1 - 8