Resources for Best Practices & Getting the Most Out of Your HipTrac.
Health Care providers and patients who have not used HipTrac before generally have the same 3 important questions: 1) How hard or intense do we start? 2) For how long do we use it? 3) How many times per week can we use it? To answer these questions, best practice is to start with the Orientation Test. Not only does this help you answer these questions, but also provides some framework for progressing the different parameters. Like any tool, device or technique, the health care providers will use the 3 pillars of evidence-based medicine in order to apply or use the treatment. These 3 pillars are patient experience, provider experience and the research. The Orientation Test combines all 3 of these pillars to help you get started!
The Two Different Orientation Tests and Protocols
You will see two different Orientation Test and Protocols depending on if the patient is using HipTrac before or after surgery (Pre-Operative or Post-Arthroscopic). If the patient has not had any surgery then begin with the Pre-Operative version. If the individual has had arthroscopic surgery in the last 4 months or less , they would begin with the Post-Arthroscopic Orientation Test and Protocols.
Being Conservative in the Beginning
There are many patients having pain related to an acetabular labral tear, but they only have a minimal to moderate loss of mobility due to some capsular restriction. In these cases the patient does not need intensive HipTrac to improve mobility, but they do obtain quite a bit of relief with gentle long axis traction. In these cases, we would recommend beginning with the Post-Op Orientation Test and Protocol to more gently assess their sensitivity and irritability even though they have not had surgery. Essentially, the main difference between the two Orientation Test and Protocol versions is that the Post-Op version begins more gently at 25-35 PSI. If you think about it, it just makes good sense because individuals who have a minimal loss of mobility do not need intensive traction to mobilize the joint in the first place. They already have fair mobility and the joint will move more in response to the traction. They may be more vulnerable to irritability or sensitivity so it makes good sense to start off easier and progress up from there. There is no concern or worry that the Pre-Op version would injure them or flare them up, only that they will have more movement and the point of the test is to assess their sensitivity.
Significant Capsular Restrictions vs Painful Hypermobility
Evidence and experience tells us that the more restricted the joint is, such as in moderate to severe osteoarthritis, the more intense traction the joint can tolerate and appreciate. So if the person does not have significant restrictions, but are having pain, just start off easier with the Post-Op Orientation Test and Protocols. For individuals such as the 19 y.o. hypermobile dancer with a labral tear, we would recommend not using HipTrac at all and just going with a Cross Fit or Superband for gentle unloading if indicated. They absolutely do not need more mobility as they are already hypermobile, yet the joint still enjoys some unloading for pain relief. You could use HipTrac at 10-15 PSI, but why bother when you can just strap a simple band on them and unload. It would be like buying a Ferrari and only driving it 5-10 MPH, what’s the point?!
Check out our FAQs
If you have significant capsular restrictions and you pass the Orientation Test, you can start out at a higher intensity and feel the benefits of HipTrac in less time. Follow the instructions at the top of the Orientation Test to know where best to start for your specific case. You should also review our Healthcare Provider FAQ. If you have any questions or issues in getting started, please give us a call or email us at firstname.lastname@example.org
White Paper: Modern Conservative Management of Hip Osteoarthritis and Other Intra-Articular Pathologies of the Hip: Alternatives to Opioids and Just Waiting for it to Get Bad Enough
The Quick Start guide below shows how to put on the bindings and use HipTrac for the first time. The Orientation and Protocols will guide both the patient and the providers on the positions of use, intensity, frequency and duration.
The Quick Start shows how to put on the bindings and connect to HipTrac. View PDF
Orientation Test and Protocol – Pre-Surgery
This will guide both the patient and the healthcare provider on the positions of use, intensity, frequency and duration for using HipTrac prior to any surgery. View PDF
Orientation Test and Protocol – Post-Arthroscopy
This will guide both the patient and the healthcare provider on the positions, intensity, frequency and duration of use following arthroscopic surgery. Use typically begins at week 4 post-op, but we recommend you communicate with your surgeon and physical therapist for instructions specific to you. View PDF
Instruction and Owner’s Manual
Detailed instructions and diagram of HipTrac showing its parts. Owner’s Manual
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I get a lot of pain relief when I use HipTrac. How does it do this?
Your pain is caused by the tightening of structures around your hip joint, which places more pressure on the arthritic parts in the joint. HipTrac works to decrease the tightness of these structures and decrease the pressure within the joint. Decreased pressure means decreased pain and increased movement.
I have been diagnosed with only mild hip osteoarthritis and don’t really feel that much pain or disability. Should I still use HipTrac?
You can absolutely still benefit from the use of HipTrac. Studies show that the earlier you work on your mobility, strength and coordination around your hip, even with mild OA, the better you will do. Like anything in life, the sooner and earlier you attend to a beginning problem, the easier it is to improve and maintain it.
When should I use HipTrac? Morning or evening? Before or after exercise?
You can use the HipTrac any time of day for relief of hip pain and to stretch the tight structures around your hip. Some individuals have found it helpful to use prior to sporting events like golf or even before to going to a dinner party when they might have to do prolonged standing. HipTrac can be used before and/or after any type of activity or event in which you want pain relief and/or increased mobility. Many individuals have discovered that using it before bedtime allows for much more comfortable sleep. You can use it 1-3 times per day and over time, you will discover the best times of day for you.
Should I use HipTrac if I am currently receiving treatment from a physical therapist or chiropractor?
Yes! Discuss this with your health care provider as starting to use HipTrac sooner rather than later will help maintain and promote the positive treatment effects from your provider. You can direct your provider to this website or print off this summary page and give it to them during your next visit. HipTrac does not replace treatment by a provider; it serves as a supplement and an extension of treatment before and after discharge. It is important to receive proper evaluation and treatment from your provider in addition to using HipTrac regularly.
Can I use HipTrac if I’ve had surgery on my knee such as ACL reconstruction or a knee replacement?
Always discuss your specific situation with your health care provider prior to using HipTrac, however HipTrac was designed to perform hip traction with the person’s knee in full extension (straight). This allows the pulling force to move through the knee with the least amount of stress to the knee as would be performed by the provider’s hands in the clinic. It is safe to perform this in most situations, but consult your provider and do not use if there are any pain/sensitivities at the knee. Some individuals find comfort in placing a small towel roll under their knee during HipTrac use. This is acceptable as well if approved by your health care provider. The short answer is yes, in most cases, it is completely safe.
Is HipTrac covered by any repair guarantee or warranty?
Yes. There is a one year parts and service warranty from date of issuance. When you receive your HipTrac, make sure you fill out the registration card and send to address listed to receive our extended warranty of three additional months.
Does my insurance cover the HipTrac?
Because this is a new medical device, it does not have its own specific insurance code for home purchase or rental at this stage. That being said, Veteran’s Administration (VA) pays 100% for HipTrac as well as 3rd party such as Motor Vehicle and Workers’ Comp Insurance. You also have a very good chance for coverage from your private insurance company if you have a Flex Spending Account or HSA card. We have had some individuals receive reimbursement from their private insurance such as MODA and Cigna, but it is up to the individual to send in their paid invoice with a claim form for reimbursement. Private payers do cover Hiptrac when used in a health care provider’s clinic. We offer cash pay discounts and a few payment options if your insurance company does not cover it. In addition, you may contact various companies that will finance health related equipment.
Have there been any clinical studies performed on HipTrac?
Yes. The first study was published in January 2017 in the American Physical Therapy Association’s journal Orthopedic Practice. There are two other studies that are in the planning phases right now that will be researching the improved cellular response of articular cartilage with prolonged traction as well as improvements in pain scores, range of motion and functional index scores. We are receiving a lot of attention from healthcare providers from around the world on the positive responses to date and are looking forward to further research.
I don’t like taking pain pills and other medications. Can I stop taking them if I use HipTrac?
Always follow the medical advice of your physician when it comes to taking medications. Many people will notice that they can reduce or stop their pain medications because of the pain relief they feel after using HipTrac. In most cases, the more consistently you use HipTrac as instructed, the longer the pain relief lasts. Discuss your pain and medication needs with your health care providers as you continue to use the HipTrac and perform your independent exercise program in the long term.
Will HipTrac cure my hip osteoarthritis?
HipTrac won’t cure osteoarthritis. In fact, there is no cure for osteoarthritis. HipTrac treats the secondary effects of osteoarthritis including pain, tightness and immobility. HipTrac works to minimize these secondary effects so that you can be more active with less pain. This allows for greater quality of life, more comfortably delaying hip surgery and preventing other problems that can occur with inactivity.
Does HipTrac provide the same kind of hip traction effects as when the healthcare provider does it in the clinic?
HipTrac was designed to replicate the specific technique of Long Axis Traction as performed by the clinician. HipTrac is able to perform this technique at 0, 10, 20, and 30 degrees of flexion just like your provider does as well as any degree of abduction, rotation and extension. With HipTrac at home, you can use it as many times a day as you want and for up to 15-30 minutes. In a clinic, your provider will usually perform the hip traction for 15 minutes or less, a few times each week so the advantage of having one at home is immense.
If I use HipTrac, do I still have to go to the physical therapist or chiropractor?
We recommend that you seek professional treatment from the appropriate health care provider following your evaluation. Some individuals need specific manual therapy for a certain period of time from a provider in order to optimize your hip range of motion. Also, it is optimal to learn and combine a specific home exercise program with use of HipTrac at home for the long term. The HipTrac offers positive effects when used by itself but we always encourage total comprehensive treatment as the combination offers the greatest possible benefits.
I have arthritis in my hands and don’t have anyone to help me at home. Can I still use HipTrac?
Yes! HipTrac was designed to be light-weight and portable. There are handles and wheels to allow you to pull it easily like rolling luggage so you do not have to carry it. Once home, it folds up so that it can be easily stored under a bed or in the closet. The hand pump was designed to be super easy to pump even with painful or sensitive hands. If you have any trouble, please consult with your healthcare provider in finding solutions. If unable, contact us for more assistance.
What do I do if something breaks on my HipTrac?
There is a 1 year warranty on your HipTrac from date of issuance. If something breaks or is not working, please contact us immediately to discuss your options and find replacement parts so that there is no delay in your home treatment.
Has the FDA cleared the use of HipTrac in the United States?
Yes, HipTrac was cleared by the FDA in 2012 as a Class 1 medical device. It has also received its CE Mark for approval in Europe as well.
FOAM ROLLING FAQs
I started foam rolling and it just feels too intense!
Foam rolling can begin with quite a bit of discomfort, but have peace of mind, it gets better quickly. When our bodies have not had a certain stress, the tissues can react with quite a bit of discomfort. The good news is that the more you do it, the sooner it gets better. Think about what happens when you floss your teeth for the first time. Your gums bleed and get irritated. If you continue with consistent flossing, the gums stop bleeding, feel less irritated and really are healthier than ever. It is similar with foam rolling in the sense that if you are consistent, the initial tenderness will go away sooner and your tissues will be healthier than ever!
Why is it better to add heat to the foam roller as in the case of HotRock?
There are many benefits to adding heat to your foam rolling experience. The positive benefits of heat include pain relief, muscle relaxation, increased circulation, oxygen and nutrients to help heal damaged tissues, relieves stress, flushes cellular waste, increases range of motion, decreases muscle spasms. It is proven that that tissue temperatures are higher and get there quicker using HotRock as compared to using a non-heated foam roller.
Sometimes my HotRock feels like it is hotter during some uses more than others, even though the display says the same temperature?
There are many factors that affect the perception of the same temperature. For example, if you are using HotRock in a super cold room or on a cold, cement floor, it will be more difficult for the HotRock to get hotter as quickly. HotRock is trying to heat up the entire room and will be affected by the ambient temperatures. If you want your HotRock to feel hotter, try placing a blanket or yoga mat underneath you or rolling on carpet. There are some floors or materials that want to absorb the heat and others that can reflect it back to you. In addition, your body will want to warm up and absorb the heat which is the whole point of HotRock. Much like first getting into a hot shower or hot tub, the water can feel almost too hot, but within a few minutes, you feel like it’s no big deal anymore and not as hot. The truth is, the water temperature is still the same, it’s just that you are now getting used to it. This is all normal and rest assured your HotRock is still pumping out the same great temperatures.
I tend to use HotRock with heavier clothing so it doesn’t feel as hot. Any tips on how to help with this?
For those who want more heat, there are a few tricks and tips to achieve this. Use the HotRock Carrying Bag as an incubator. The inner lining of the bag has reflective material so after you turn your HotRock on and select 160 deg F, place it in the bag for 3-4 minutes. Be careful as it can come out super hot which is perfect for rolling over clothes. You can also wrap HotRock inside a thick blanket for the same amount of time to achieve higher temperatures. Always feel the surface of the HotRock before applying to sensitive and bare skin. Another tip is to rotate the HotRock every minutes or two. For example, when using for headaches or neck pain, place HotRock under neck and perform the appropriate head and neck movements (see our videos in Resources). After 1-2 sets of the exercises, simply grab HotRock and rotate it so that the side that was closest to the floor is now touching your skin. It will feel warmer as it was getting hotter from being near a blanket and not a colder body. You can repeat this for the duration of the movement. You can also wear less clothing and use on your skin.
How often should I use my foam roller?
Depending on your reason for using your foam roller, it is safe to perform these movements 1-3 times per day to every other day. Some people use it for 3-10 minutes a few times per day to improve posture and mobility, while others use it 2-3 times per week before going for a run. If you are rehabilitating from an injury, talk to your healthcare provider about what is safe for you.
My wrist is hurting from holding myself up on the foam roller. Is there anything I can do to prevent this?
For a lot of people, the discomfort at the wrist should go away as per the analogy above. However, for those with really sensitive wrists or with wrist problems, try going near a step or bottom of stair case and propping yourself up on your forearm on the step instead of your hand/wrist. This gets you the angle you want without putting all your weight through your wrist. Of course, you may also want to consult your healthcare provider about your wrist pain as well!
When using HotRock, will the cord get tangled up?
Absolutely not! HotRock has an extra-long cord so that you can move away from the wall and furniture into the middle of your room. Additionally, when people use HotRock to massage their legs or improve their spinal mobility, the movements are only 8-10″ long so there is not a lot of movement. This is true even with 6’11” NBA basketball players. HotRock was designed to be easy to use and free from getting tangled up.