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Adductor Lengthening

These protocols are for physiotherapy following adductor lengthening.

Therapy interventions should be tailored to the individual child.

Phase 1: Post-op Day 1 to 4-6 weeks – Period in cast/full time splint

Goals: pain management, equipment, mobilize, educate and involve the family

  • Provide positioning options in cast/splint
  • Avoid windswept posturing during the healing period
  • Frequent position changes to prevent pressure areas
  • Utilize long leg casts/brace to stretch hamstrings in long sitting, if indicated
  • Ankle plantarflexor stretches, if required
  • Isometric contraction of the gluteus maximus, quadriceps, hamstrings, if able
  • If in hip abduction splint, may remove and perform knee ROM after 10 days (earlier may lead to spasms) – Caution: splint may be difficult to re-apply if spasms present

Phase 2: Post-op 4-6 weeks to 3 months – Post cast removal

Goals: Maintain new ROM, return to previous level of function 

  • Use resting splint or pillow throughout the night for 3 months and use during the day when napping, floor/sitting activities (e.g. watching television)
  • Out of brace for functional mobility during the day
  • Return to regular wheelchair seating with wide pommel

Consider stretching the following:

  • Adductors
    • Hip in extension (ie supine) - with knee extension and knee flexion (frog leg position)
    • Hip in flexion - with knee extension and knee flexion
  • Ring or cross leg sitting for play
  • Hip flexors
    • Lying on stomach
  • Hamstrings

Consider strengthening reciprocal muscle groups (hip abductors and extensors, knee flexors and extensors).

Continue with current individualized therapy goals.

SOURCE: Adductor Lengthening ( )
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