Each individual’s HipTrac protocol should be based on goals for use, subjective reports, clinical reasoning and clinical presentation. The HipTrac can perform traction in supine or sidelying. In Supine, the person’s hip can be placed in flexion from 0-30 degrees, any degree of abduction available and any degree of rotation available.
If the initial goal is pain relief then you will want to perform traction in as close to what we call the “loose-packed position” as possible: 30 degrees of flexion (up from floor), 30 degrees of abduction (leg moved out to side) and leg relaxed in as much natural available external rotation as possible (toes turned out).
If your goal is to increase stretch to the restricted joint capsule and gain range of motion, you will want to move towards what we call the “closed-pack position” of the hip: less flexion (closer to floor) while maintaining abduction and natural available external rotation as above. Some people can improve this stretch even further by using the HipTrac in side-lying so that they can perform traction with their hip extended behind them and rotating internally slightly (see How The HipTrac Works for videos and more information).
Overall, we encourage each person to “discover” what angles/positions in which they obtained the greatest relief and capsular stretch as desired. Oftentimes, individuals will feel greater mobility changes and pain-relief in a lower position. In many cases, individuals with hip osteoarthritis do not follow one strict protocol for their specific needs so we encourage you to discover your most pain-relieving and capsular stretching positions.
Day 1-7: 1 minute holds under traction at 20-30 PSI, 5-10 second release half way. Repeat 6-8 times.
Day 8-14: Begin to increase to 1-3 minute holds at 30-50 PSI, 5-10 second release half way, Repeat for a total of 12-15 of traction time; chooses the cycle based on comfort.
Day 14+: 1-5 minute holds. Progress gradually over time to as high of PSI (40-100+) as you deem comfortable for total of 15-20 minutes of traction time, with 5-10 second release half way. Choose the duty cycle based on comfort.
We encourage you to use it regularly in the presence or absence of pain to maintain consistent capsular mobilization/stretching and also when any flare-ups occur from harder physical days at work or home as needed. Most individuals feel that they do not need to use it as often as time goes on as there is an accumulation effect that occurs overall. When you first use it, pain relief only lasts minutes or while on it. As you progress, relief will began to last longer and up to days after use so you may be able to reduce their use to 2-4 times per week, rather than 10-20 times per week. Again, we encouraged you to find your optimum position, amount of time and traction force when using the HipTrac. If you are working with a healthcare provider, always consult with them on the protocol that would work best for your individual needs.