We conducted physical therapy for a patient who experienced pain in the right gluteal and lateral femoral regions during walking following right hip replacement. Pain appeared due to flexion, adduction, and internal rotation of the right hip joint accompanied by exaggerated anterior inclination and right rotation of the pelvis on right heel contact through to right mid-stance. Physical therapy was conducted for the limited range of right hip joint motion and muscle weakness around this joint, which was assumed to be the cause of the abnormal gait and pain. Following this, standing step practice (Physical Therapy A) was conduced. After 6 weeks of Physical Therapy A, the limited range of right hip joint motion and muscle weakness around the joint had improved; however, the gait and pain had not improved. Thus, the therapy was re-evaluated, and bridge exercise was added to Physical Therapy A (Physical Therapy B). Physical Therapy B enabled induction of muscle activity and contractile patterns similar to those occurring during walking with respect to the muscle activity around the right hip joint that is necessary for right heel contact through to right mid-stance. A single session of Physical Therapy B improved the gait and reduced pain. Therefore, we concluded that the promotion of complex muscle activity, not in a single direction, and improvement of the muscle strength and contractile pattern are necessary in physical therapy for problematic muscle weakness.
