Examination and Treatment of the Hip Joint

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Why take this Course?

This course provides detailed description of hip physical examination testing, including how to rule out other the lumbar spine and SI joint/pelvic girdle as potential pain generators. The online and supplemental written material provide the clinician with great detail on how to perform examination of the hip joint, the tests to implement, what patients they should be performed on, what entails a positive (or negative test), and the diagnostic accuracy of such tests. The clinician will clearly see how to perform manual therapy, stretching, and strengthening techniques as they apply to the hip pain patient. Detailed information regarding proper set-up, hand placement, technique, re-assessment, and EMG values (exercises) are given in order for the clinician to make informed decisions on which interventions are most clinically applicable in their various types of patients.

Details about this Online Continuing Education Course

The hip joint is becoming increasingly popular, and what we’re noticing is that a lot of people actually have labral tears, hip impingement, and they have a lot of pathology that has not been known for some time. Part of this is due to the fact that diagnostic imaging, surgery and our examination are actually improving a little bit. We do still have some limitations in all these areas. The prevalence of hip joint issues, compared to those in the lumbar spine, is still not as great, but there are some reasons for this. Some of it is due to our diagnostic imaging, which at this point is not at the level it is for the lumbar spine.

Additionally, hip surgery is more complicated and more difficult than surgery for the lumbar spine in some cases. Our clinical examination is still improving to try to diagnose these issues.

So how would you differentially diagnose the hip versus the spine? What you would probably want to do is to try to rule out the lumbar spine first. As far as some subjective things and some objective measures you can look at, hip limited internal rotation range of motion is highly predictive of hip joint pathology and/or hip and spine together. A limited hip internal rotation is not likely very predictive of lumbar spine pathology by itself.

In addition groin pain is highly predictive of hip joint pathology. Groin pain, limited hip internal rotation and, actually, a patient limping, is most likely seven to 14 times more predictive of hip joint pathology by itself. Dr. Brown has discovered that a patient who has either hip or groin pain, limited hip internal rotation range of motion and/or limping is more likely to have hip pain by itself and/or hip and spine pain in combination than spine pain by itself.

The hip joint is a unique joint. It’s very similar to the shoulder in that it’s a ball and socket joint, but unlike the shoulder, it’s a weight–bearing joint. It still has motion in all three planes, but what’s more important here in the hip joint than the shoulder is its load–bearing capacity. Therefore, it has limited motion compared to the shoulder, but it also has increased load–bearing sensitivity and is more likely to have pain with weight bearing when there’s osteoarthritic or cartilage damage.

Take this online course and begin your journey into mastering examination and treatment of the hip joint

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$ 175.00 USD

CE Hours: 10.0 hrs Delivered: Online

Instant Online Access to Course Material for 365 days, Downloadable Course Manual PDF, Videos, Online Test and Printable Course Certificate

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Learn from the Expert Michael P. Reiman, PT, DPT, OCS, SCS, ATC, FAAOMPT, CSCS

Learn from the Expert <strong>Michael P. Reiman, PT, DPT, OCS, SCS, ATC, FAAOMPT, CSCS</strong>

Michael P. Reiman, PT, DPT, OCS, SCS, ATC, FAAOMPT, CSCS is an assistant professor of physical therapy at Duke University Medical Center. As a clinician Dr. Reiman has over 20 years of experience in assessing, rehabilitating, and training athletes, clients, and patients at various levels of ability. He received his doctoral degree in physical therapy from MGH Institute of Health Professions in 2007. In addition to his certifications as an athletic trainer and strength and conditioning specialist, Dr. Reiman is a manual therapy fellow through the American Academy of Orthopaedic and Manual Physical Therapists (having completed a 2 and one year fellowship program), is a USA Weightlifting level 1 coach and a USA Track and Field level 1 coach. Dr. Reiman has co-written the only textbook on functional testing, Functional Testing in Human Performance, written eight book chapters on orthopedic examination/intervention and training for strength, power, and endurance. He has also written multiple articles in such journals as the American Journal of Sports Medicine, Journal of Orthopedic and Sports Physical Therapy, and Journal of Sport Rehabilitation, as well as having served as special guest editor for a special issue on the hip joint in the Journal of Sport Rehabilitation. Dr. Reiman currently serves on the editorial board for the Journal of Sport Rehabilitation and is a reviewer for multiple orthopedic and sports related journals. Dr. Reiman presents on various levels of assessment and treatment methods at national, regional, and local conferences and actively participates in research regarding various testing methods for orthopedic examination-intervention and human performance. His current research and presentation interests focus on performance enhancement, low back/hip pain, and evidence based examination-intervention of the hip joint. He continues to practice clinically on various sports and orthopedic-related injuries. He is a member of the American Physical Therapy Association, National Athletic Trainers Association, National Strength and Conditioning Association, USA Weightlifting Association, and USA Track and Field Association

Course Objectives

Course Objectives
  • Identify how to perform a Differential Diagnosis examination to rule out the Lumbar Spine, SI Joint and stress fractures when assessing for specific hip diagnosis.
  • Discuss the definitions of diagnostic accuracy when reviewing the efficacy of specific examination and treatment approaches in relation to the hip joint.
  • Identify how to enhance examination skills by performing differential diagnostic tests to determine the underlying mechanisms of hip dysfunction and pain. Ruling out: poor alignment, hip intra-articular pathology, hip intra-articular/instability pathology, impingement labral tears, muscle dysfunction and gluteal tendinopathy.
  • Describe the steps to perform appropriate joint mobilization techniques for the hip joint dysfunction.
  • Develop evidence based rehabilitation programs for specific dysfunctions that are based on current scientific literature.
  • Identify how to utilize the information in research articles to perform the most effective tests and develop evidence based rehab programs.

Rule out the Lumbar Spine, SI Joint and Stress Fractures

Rule out the Lumbar Spine, SI Joint and Stress Fractures
  • Repeated Motions (Flexion and Extension) of Lumbar Spine
  • Posterior-Anterior Glide Assessment for Facet Joint Dysfunction
  • Extension Rotation Test for Facet Joint Dysfunction
  • Thigh Thrust Test

Ruling out poor alignment, hip intra-articular pathology, hip intra-articular/instability pathology, impingement labral tears, muscle dysfunction and gluteal tendinopathy

Ruling out poor alignment, hip intra-articular pathology, hip intra-articular/instability pathology, impingement labral tears, muscle dysfunction and gluteal tendinopathy
  • Fracture/Stress Fracture Tests
  • Fulcrum Test
  • Patellar-Pubic Percussion Test
  • Fracture/Stress Fracture Tests
  • Fulcrum Test of Femur
  • Hip Range-of-Motion (ROM)
  • All ranges of hip motion are assessed
  • Hip IR < 15 degrees and flexion < 115 degrees is suggestive of hip osteoarthritis
  • Assess Hip Alignment - Craig’s Test
  • Hip Intra-Articular Pathology - Heel Strike Test, Resisted Straight Leg Raises (SLR) Test, Hip Scour Test, FABER (Flexion-Abduction-External Rotation) Test

Ruling out poor alignment, hip intra-articular pathology, hip intra-articular/instability pathology, impingement labral tears, muscle dysfunction and gluteal tendinopathy

Ruling out poor alignment, hip intra-articular pathology, hip intra-articular/instability pathology, impingement labral tears, muscle dysfunction and gluteal tendinopathy
  • Assess for Capsular Laxity - Dial Test, Log Roll Test, Abduction–Extension–External Rotation Test
  • Test for potential labral pathology - Flexion–Adduction–Axial Compression Test, Flexion–Internal Rotation Test, Internal Rotation–Flexion–Axial Compression Test
  • Hip impingement - FADDIR (Flexion–Adduction–Internal Rotation) Test
  • Assess for tight hip flexors and/or tight quads - Thomas Test
  • Assess for IT band flexibility - Ober’s Test
  • Piriformis syndrome - FAIR (Flexion–Adduction–Internal Rotation) Test
  • Gluteal tendinopathy - Resisted Hip Abduction Test
  • Trendelenburg Sign
  • Resisted External Derotation Test

Treatment of the Hip

Treatment of the Hip
  • Hip Lateral Distraction Mobilization
  • Hip Longitudinal Distraction Mobilization from Knee Purchase
  • Hip Longitudinal Distraction Mobilization from Ankle Purchase
  • Hip Mobilization Direct Distraction
  • Hip Posterior Glide Mobilization from Knee Purchase

Treatment of the Hip

Treatment of the Hip
  • Hip Posterior Glide Mobilization from Anterior Hip Purchase
  • Hip Anterior Glide Mobilization from Posterior Hip Purchase I
  • Hip Anterior Glide Mobilization from Posterior Hip Purchase II
  • Hip Anterior Glide Mobilization in Prone Crawl Position
  • Hip Mobilization with Belt for Flexion
  • Hip Mobilization with Belt for Internal Rotation
  • Indirect Mobilization Technique for Hip Internal Rotation

Master Exercises and Stretches to Improve Hip Function

Master Exercises and Stretches to Improve Hip Function
  • Posterior Hip Self Stretch–Mobilization
  • Self Hip Flexor/Anterior Capsule Stretch (Standing
  • Self Hip Flexor/Anterior Capsule Stretch (Tall Kneeling
  • Clam Exercise
  • Hip Abduction Exercise
  • Bilateral and Unilateral Bridge Exercise
  • Bilateral and Unilateral Bridge Exercise–Lying on Physioball
  • Bilateral Bridging on Physioball–Knees Straight
  • Bilateral Bridging on Physioball–Knees Bent

Master Exercises and Stretches to Improve Hip Function

Master Exercises and Stretches to Improve Hip Function
  • Bird Dog Exercise
  • Lunge Exercise Variations
  • Unilateral Mini–Squat Exercise
  • Single Limb Squat Exercise
  • Single Limb Deadlift Exercise
  • Forward Step–Up Exercise
  • Side–Bridge Exercise
  • Hip Hike