Hip

Diagnosis, Subgroup Classification and Motor Control Retraining of the Hip

Most hip pain can be subgrouped into a series of mechanical dysfunctions related to uncontrolled movement. Identify and retrain motor control issues relating to insidious, chronic and recurrent hip problems.

Course Outline

Mechanical dysfunctions of the hip commonly present as combinations of impingement, instability and rotational strain dysfunctions…all of which can develop into degenerative conditions. Motor control dysfunction within the hip local and global musculature contributes significantly to insidious onset, chronicity and recurrence of these hip problems. When symptoms are produced from mechanical dysfunctional in the regional tissues, consistent patterns of motor recruitment dysfunction are evident. These recruitment patterns present as motor control inhibition of muscle function and imbalance between stability and mobility roles within the global musculature.

The course outlines impingement and instability mechanisms and details the assessment of local and global motor control dysfunction around the hip joint. The diagnosis of mechanical hip dysfunctions is based on assessment and causing uncontrolled movement. The relationship of these imbalances to buttock pain, lateral pain and thigh pain, ilio-tibial band syndromes, recurrent groin pain and recurrent hamstring insertion pain is discussed. The development of dysfunction specific retraining programmes to regain functional stability of the hip is based on a clinical reasoning framework. This course is orientated to a ‘hands on’ practical application of dysfunction assessment and stability retraining using patient examples where possible.

Key Features

This course addresses:

• what goes wrong with the control of hip movement when people have pain
• how to test for uncontrolled flexion, extension, rotation and translation of the hip
• how prioritize the where to start therapeutic exercise and how to develop progressions

This course will help you to:

• re-evaluate muscle function around the hip
• identify direction - related uncontrolled movement related to symptoms
• identify and retrain abnormal strategies and patterns within the global muscle system
• diagnose instability mechanisms of the hip and assess for motor control dysfunction in the local muscle system
• determine the optimal retraining strategy to restabilize the ‘clicky’ or unstable hip using an evidence based clinical reasoning framework
• design specific individual retraining programmes

Learning Outcomes

At the end of this course the student should be able to:

• Classify muscles roles based on function & dysfunction
• Understand the development of movement and stability dysfunction
• Analyse the inter-relationship between restriction and compensation in articular and myofascial tissues
• Clinically assess hip motor control strategies to identify and diagnose the site and direction of stability dysfunction and retrain direction specific dysfunction
• Assess and rehab local stabiliser function at the hip
• Identify and correct global imbalance in stabiliser - mobiliser function
• Rate the degree of severity of stability dysfunction and discuss prognosis

The participant should demonstrate the ability to apply principles of assessment and motor control retraining to:

• Develop an evidence based management plan to improve functional control
• Use clinical reasoning to prioritise initial management and plan a progression of rehab
• Apply rehabilitation strategies to manage stability dysfunction
• Use re-assessment tools to guide the rate of progression of an individual patient through their rehab programme

Programme Outline

• Brief review of controlled movement theories

• Diagnosis of uncontrolled movement relating to direction specific stress and strainat the hip

• Assessment and retraining of global muscle imbalance at the hip

• Restrictions due to over-dominant mobilisers

• Uncontrolled movement due to inefficient stabilisers

• Mechanisms & Tests for impingement and instability

• Assessment and rehab of local muscle control of the hip translation

• Diagnosis and rehab of specific movement dysfunctions