The Hip Complex: An Advanced Evidence Based Evaluation and Treatment Approach

Instructor:

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 Orthopedic and Manual Physical Therapists (having completed a 2 ½ 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 ex-amination/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 sociation, USA Weightlifting Association, and USA Track and Field Association and IL, IL PT Provider #216000074

Course summary: 

Two-day advanced level course is designed to provide the medical professional with the information necessary to develop a comprehensive evaluation and treatment program for the Hip Joint. Anatomy of the hip, pelvis and lumbar spine region will be covered. In depth analysis of the of biomechanics of the hip joint, and even more importantly, the evidence supporting differential diagnosis of the hip joint is presented as the basis for evaluation. The participants, through extensive lab exercises, will be led through the development of treatment plans by applying joint mobilization, and muscle re-education techniques. Course instruction will also focus on developing a working knowledge of the theory behind joint mobilization techniques combined with supporting evidence from the current literature. The practical application labs will be supplemented by lecture and group discussions. Efficacy of the various techniques will also be discussed in order to allow the participant to determine the best evidence-based treatments for their clients. Specific types of clients discussed will include those with hip osteoarthritis, femoral neck fractures, avascular necrosis, impingement, labral tear, athletic pubalgia, sports related chronic groin pain, snapping hip, and exertional related pain in endurance athletes. A comprehensive course manual with illustrations and step-by-step instructions will assist the clinician in immediately and confidently applying these skills to their clinical setting. This course is designed to enhance the clinician’s critical thinking by providing the latest evidence to sup- port their practice. The intent of the course is to critically examine the current literature as it applies to hip joint differential diagnosis, examination, intervention, and post-operative strategies. The participant will clearly understand the strengths and weaknesses of the current literature as it relates to hip joint pathology.

Objectives: 

Upon completion of this course participants will be able to:

• Describe the functional anatomy of the hip joint.

• Recognize common hip joint dysfunction and demonstrate comprehensive evaluation techniques.

• Explain the theoretical foundation of joint mobilization techniques.

• Describe the current findings in the peer-reviewed literature that impact hip joint diagnosis and treatment.

• Describe the indications and contraindications for using joint mobilization relevant to the hip joint.

• Identify key elements of a patients history to assist in the diagnostic process.

• 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

Agenda:

 DAY 1

7:30 8:00 Registration

8:00 9:00 Introduction/Anatomy and Biomechanics of the Hip

9:00 9:45 Subjective History related to Hip Joint 9:45 10:00 Break

10:00 1200 Subjective History continued. Red Flags/Screening/ Observation (Lecture/Lab)

• Muscle length testing

12:00 1:00 Lunch (on your own)

1:00 1:45 Hip Osteoarthritis Examination (Lecture/Lab)

• Examination

1:45 4:00 Other Intra-Articular Pathologies Examination (Lecture/Lab)

• Vascular causes of groin pain

4:00 4:15 Break

4:15 5:45 Case Study Presentations

• Gluteus medius dysfunction

DAY 2

8:00 8:30 Review of Day One Material

8:30 9:00 Differential Diagnosis (Lecture/Lab)

• Algorithm (Evidence Based) differential diagnosis - Lumbar spine vs SI joint vs hip dysfunction

9:00 9:45 Treatment and Exercise Prescription

• Home exercise programs

9:45 10:00 Break

10:00 11:30 Manual Therapy Intervention (Lecture/Lab)

• Home exercise programs

11:30 12:30 Lunch (on your own)

12:30 2:15 Post Operative Exercise Prescription. Particular Emphasis Placed on Hip Labral Tears, Impingement and Total Hip (Lab)

• Exercise prescription based on the findings

2:15 4:00 Case Studies

• Relevant to post operative diagnosis

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