PHTY206 Lecture Notes - Lecture 15: Piriformis Muscle, Femoral Head, Massage
Physiotherapy management of hip conditions
• Learning Outcomes
o Describe the various treatment approaches to address impairments of function
related to disorders of the hip region
o Provide a rationale for the selection of treatment that is directed to specific
impairments of function as related to disorders of the hip region
• Consider contributing factors of pathology: modifiable or non?
Non-modifiable
Modifiable
• Age
• Gender
• Family history
• Past history
• Hip pathology -
dysplasia, perthes
• Trauma - labrum
• FAI
• High impact sports/activities, cutting and turning
activities, training loads
• High impact or heavy lifting occupation
• High BMI
• Physical activity levels
• Muscle function
• Joint ROM
Impairments
Activity limitations
Participation restrictions
• Pain
• Swelling
• Abnormal ROM - stiffness,
hypo/hypermobility
• Muscle function
impairments:
• ↓ muscle strength
• ↓ endurance
• ↓ power
• ↓ flexibility
• ↓ co-ordination
• ↓ balance
• Gait
abnormalities
• Poor posture
• Physical activity
limitations
• Unable to participate in
sport or exercise, ADLs etc. -
check
find more resources at oneclass.com
find more resources at oneclass.com
• Patient Management Approach
• Common Physical impairments in hip conditions
o ↓ Hip joint ROM, especially flexion and internal rotation
o ↓ Hip muscle strength in all hip muscles, especially abductors and adductors (men
and women), extensors (mostly women) and external rotators (mostly women)
o ↓ Balance in single-leg dynamic tasks
o Increased femoral adduction in single-leg squats
o ↓ Trunk muscle strength
o Alterations in gait biomechanics (primarily reduced range of hip motion in gait)
o ↓ functional performance, especially in hopping and squatting tasks
o Probably adverse loading within the hip due to morphology, changes in range of
motion, hip muscle weakness and poor functional performance
o Abnormalities of the kinetic chain
• Aims of Treatment
o Will depend on findings from subjective & physical examination
o Be aware of disease pathology & process
o Take ito aout patiets goals
o Rx directed to specific impairments of function aim to
• Decrease pain & swelling
• Increase joint range of active & passive movement
• Increase muscle strength, recruitment, coordination, & endurance
• Ability to perform functional movement -Correct contributing biomechanical
factors. Increase function & facilitate return to activity
• Principles of Management
find more resources at oneclass.com
find more resources at oneclass.com
• Management Approach of the patient with a hip condition
• Concurrent Considerations in Rehabilitation
o Primary (green)
o Secondary (orange)
o Tertiary (red)
• Decrease Pain
o Joint mobilisation
• AP/PA/lateral glides in neutral or flexion
• Longitudinal caudal glides in neutral or flexion
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Family history: hip pathology - dysplasia, perthes, trauma - labrum. Fai: high impact sports/activities, cutting and turning activities, training loads, high impact or heavy lifting occupation, high bmi, physical activity levels, muscle function. Participation restrictions: pain, abnormal rom - stiffness, Increase joint range of active & passive movement. Increase muscle strength, recruitment, coordination, & endurance factors. Increase function & facilitate return to activity: principles of management, management approach of the patient with a hip condition, concurrent considerations in rehabilitation, primary (green, secondary (orange, tertiary (red, decrease pain. Joint mobilisation: ap/pa/lateral glides in neutral or flexion. Inferential/tens - pain relief (e. g. hip oa: pulsed ultrasound - reduce swelling and inflammation (e. g. acute adductor muscle strain, heat/cold, heat - pain relief, decrease muscle spasm (e. g. hip oa) Ice packs - pain relief, reduce swelling (acute hip/muscle injury) Longitudinal caudal glides: ap/pa glides, can relieve pain and stiffness, increase rom.
