Specialista in Ortopedia Pediatrica
Hip dysplasia (daily management and mobilizations)
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Hip-healthy swaddling
The chest may be wrapped, but the legs must stay free to move
If swaddling is used, wrap only the trunk and arms. The lower part must stay loose so the hips can remain flexed and open (frog position, knees higher than the bottom) and the baby can kick. Never swaddle with the legs straight and tight: it is the worst position for the hip. Baby always sleeps supine.
Every time the baby is swaddled, day and night
2.Babywearing and seats: the M position
Sling, carrier and car seat must support the thighs knee-to-knee
In a carrier or sling the baby should straddle the parent with knees flexed and higher than the bottom (M position), the fabric supporting the thigh out to the knee. Avoid narrow carriers that leave the legs dangling. In the car seat and pram check that the legs can stay apart, with no straps squeezing them together.
Check at every use of sling, carrier, car seat and pram
3.Gentle bicycle movements and free mobilization
Keeps hip and knee mobility free during diaper changes
Baby supine and relaxed on the changing table. Support the legs at the calves and move them slowly like pedalling, alternating hip and knee flexion and extension. Wide but always gentle movement, never forcing end range and never pulling the legs downward. If the baby wears a brace, do this ONLY if the specialist has authorised temporary removal.
1-2 minutes, at every diaper change
4.Symmetric hip opening (gentle abduction)
Checks and maintains free, equal opening on both sides
With the baby supine, flex hips and knees to about 90°, holding the thighs (not the ankles). Guide the knees outward symmetrically, only as far as the movement is free: no pushing, no leverage. Note if one side opens less than the other or if a click appears: report this at the visit. Never attempt reduction manoeuvres or forced rotation.
5-8 slow openings per session, 2-3 times daily
5.Tummy time and prone play
Supports overall motor development and hip extension mobility
With the baby awake and supervised, place them prone on a mat, legs free and slightly apart. Attract attention with a toy to encourage head lifting. Tummy time complements abduction positioning and reduces time spent in rigid seats and bouncers.
Start with 2-3 minutes, several times a day, increasing as tolerated
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
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MioDottoreBefore You Start
Who is this guide for?
Infants undergoing treatment for hip dysplasia. Mobilizations performed by parents as directed by specialist.
What you need
Flat safe surface, warm environment, relaxed baby (ideally after bath or during/after feeding).
Suggested frequency
Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.
Common mistakes to avoid
- •Forcing movements beyond baby's resistance
- •Performing mobilizations while baby is crying
- •Not maintaining correct position during diaper changes
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
Detailed Exercises
- 1
Hip-healthy swaddling
The chest may be wrapped, but the legs must stay free to move
If swaddling is used, wrap only the trunk and arms. The lower part must stay loose so the hips can remain flexed and open (frog position, knees higher than the bottom) and the baby can kick. Never swaddle with the legs straight and tight: it is the worst position for the hip. Baby always sleeps supine.
Every time the baby is swaddled, day and night - 2
Babywearing and seats: the M position
Sling, carrier and car seat must support the thighs knee-to-knee
In a carrier or sling the baby should straddle the parent with knees flexed and higher than the bottom (M position), the fabric supporting the thigh out to the knee. Avoid narrow carriers that leave the legs dangling. In the car seat and pram check that the legs can stay apart, with no straps squeezing them together.
Check at every use of sling, carrier, car seat and pram - 3
Gentle bicycle movements and free mobilization
Keeps hip and knee mobility free during diaper changes
Baby supine and relaxed on the changing table. Support the legs at the calves and move them slowly like pedalling, alternating hip and knee flexion and extension. Wide but always gentle movement, never forcing end range and never pulling the legs downward. If the baby wears a brace, do this ONLY if the specialist has authorised temporary removal.
1-2 minutes, at every diaper change - 4
Symmetric hip opening (gentle abduction)
Checks and maintains free, equal opening on both sides
With the baby supine, flex hips and knees to about 90°, holding the thighs (not the ankles). Guide the knees outward symmetrically, only as far as the movement is free: no pushing, no leverage. Note if one side opens less than the other or if a click appears: report this at the visit. Never attempt reduction manoeuvres or forced rotation.
5-8 slow openings per session, 2-3 times daily - 5
Tummy time and prone play
Supports overall motor development and hip extension mobility
With the baby awake and supervised, place them prone on a mat, legs free and slightly apart. Attract attention with a toy to encourage head lifting. Tummy time complements abduction positioning and reduces time spent in rigid seats and bouncers.
Start with 2-3 minutes, several times a day, increasing as tolerated
Frequently Asked Questions
Do exercises treat hip dysplasia?
No. Treatment of dysplasia is based on bracing (abduction brace or Pavlik harness) and specialist follow-up. Mobilizations and correct positioning are daily support that help keep the hip in a favourable position with free mobility, but they do not replace the prescribed treatment.
Who performs the hip ultrasound?
The hip ultrasound is performed by the radiologist. Dr. Priano handles the clinical assessment, prescription and orthopaedic management of treatment, interpreting the reports within the care pathway.