Do you find yourself using the same management approaches for patients with hip pain, regardless of their presentation?

Do you have a clear understanding of how morphology, loading patterns and muscle dysfunction may be driving anterior hip and groin pain?

Would you like to increase your skills and confidence in your assessment and management of anterior hip and groin pain?

Look forward to seeing patients with hip pain on your list!

An exploration of the available anterior hip and groin pain literature reveals a minefield of inconsistent diagnostic labels and a high volume of imaging and surgical papers describing a myriad of pathologies which may or may not be associated with a patient’s presenting signs and symptoms.

In recent years there have been some positive advances in defining clinical entities and diagnostic processes. Yet there is a persistent lack of clarity and evidence around best management. This may be related to undue focus on remediating a particular structural pathology or physical impairment, without adequate consideration of mechanisms or drivers of pain and load intolerance. Within the contemporary biopsychosocial model, health professionals acknowledge that patients may present with varying combinations of psychological and physical overload.

While the psychosocial components of management are of high importance, these will not be addressed in detail within this forum, but much education is widely available on this topic. The primary focus will be on understanding and addressing mechanisms of physical overload and impairments associated with anterior hip and groin pain.

This course aims to:

• Enhance clinical reasoning and skills for assessment for nociceptive sources, clinical entities and drivers associated with anterior hip and groin pain
• Provide a framework for development of optimally effective, targeted interventions for each individual that considers
  • Morphological variants and implications for load management advice, exercise and manual therapy
  • Adverse joint or soft tissue loading associated with kinematics and neuromotor function
  • Individual goals and functional demands
• Provide opportunity to practice to practice some useful manual therapy and nerve mobilisation techniques

Learning Objectives:

Upon completion fo this course, participants should be able to:

• Perform diagnostic tests for anterior hip and groin pain and use that information for differential diagnosis of the most likely source of nociception or a primary clinical entity
• Perform tests that aim to elicit important information regarding potential contributors or drivers of the presenting condition, such as:
  • bony morphology
  • joint range-of-motion and stability
  • neurodynamics
  • posture and key movements patterns
• Determine the most appropriate management approach for an individual's presenting condition using:
  • Key information for the patient interview and physical examination
  • Treatment direction tests
  • Clinical reasoning
  • Load management strategies
  • Exercise therapy
  • Manual therapy and nerve mobilisations as appropriate

Online Learning Component:

The substantial theoretical component of this course is presented in an online learning format for your flexibility and optimal learning experience.

• 5 hours of Powerpoint lectures with printable notes
• Learn anywhere, at your own pace, in your own time.
• Rewind and revise as many times as you like.
• Online forum for discussion.
• Self-assessment quiz.
• Three months of unlimited access for video content.

The online component will:

• Clarify definitions of anterior hip and groin pain
• Explore factors which may influence intra-articular hip joint loads
  • morphological variants (e.g. FAI, acetabular dysplasia, femoral capsulo-labrral deficits)
  • adverse joint loading associated with kinematics and neuromotor function
  • the adequacy of joint protection mechanisms

• Explore factors which may influence extra-articular loads in the4 anterior hip region

  • morphological variants (e.g. AII impingement)
  • adverse soft tissue loading associated with kinematics and neuromotor function (focus on hip flexors)

• Provide an overview of key load management and therapeutic exercise strategies for anterior hip pain, particular to the patient presentation and associated difficulties with mechanical load transfer

• Provide an update on groin pain clinical entities and where the literature sits with regard to prevention and management.

PRACTICAL WORKSHOP(1 Day)

The one-day practical workshop will include:

• Diagnostic, pain provocation tests for intra and extra-articular sources of nociception
• Assessment of bony morphology, joint stability and neurodynamics
• Assessment of posture & key movement patterns for specific pain & load intolerance presentations
• Examples of treatment direction tests (passive & active) & clinical reasoning strategies to determine best approach for reducing pain & improving load tolerance for the patient’s specific presentation
• Load management advice & key exercise strategies for specific presentations (Please Note – this course will not include detailed muscle assessment and retraining strategies. That information is provided in the Mastering Movement of the Hip & Pelvis course, which can then be applied in this course to specific conditions and clinical presentations)
• Manual therapy – some useful techniques for specific range gaining and improving pain free ROM will be demonstrated.

Tutor:

Dr Alison Grimaldi PhD, MPhty(Sports), BPhty

Alison completed a Bachelor of Physiotherapy at the University of Queensland in 1990, a Masters of Sports Physiotherapy in 1997, and her Doctorate in Philosophy in the Field of Physiotherapy (PhD) in 2008. Her PhD studies were concerned with improving our understanding of hip muscle function and the relationship with hip joint pathology and weightbearing stimulus. These studies involved research collaboration with the European Space Agency.

Alison continues to be passionate about extending our understanding of why we develop problems around the hip and pelvis, and what we can do to most effectively prevent and manage these problems. She is currently involved with research studies through the University of Queensland and University of Melbourne, co-supervises a number of PhD students, and has pioneered the use of Real Time Ultrasound technology for the assessment and retraining of muscle function around the hip & pelvis. Due to her voluntary contributions to research at the University of Queensland, Alison has been awarded the title Adjunct Research Fellow in the School of Health & Rehabilitation Sciences.

It is one of Alison’s core beliefs that research should be relevant to clinical practice and helping the patients we treat every day, and that physiotherapists in the community should have access to this valuable information to allow them to transfer this knowledge into clinical practice as quickly as possible. To this end, Alison continues to publish, present and provide practical workshops for other health professionals. Alison has published a number of papers in scientific journals, has contributed detailed information freely accessible via podcasts by PhysioEdge (itunes) and the British Journal of Sports Medicine (SoundCloud), and has recently contributed to 3 leading physiotherapy and sports medicine text books.

Alison’s publications: Link to publications

Alison continues a clinical load, working with patients with complex hip and lumbopelvic conditions, and across a broad spectrum of sports, including elite level triathlon, running, dance, cricket, athletics & swimming. She also spends a considerable amount of time mentoring her excellent staff, ensuring they are up-to-date and able to provide a high level of clinical expertise for management of musculoskeletal problems.

Further information about Alison and her courses can be found at: dralisongrimaldi.com

Follow Alison on Twitter: @alisongrimaldi

The course venue

How to get there

TUBE / OVERGROUND:

The British College of Osteopathic Medicine is 3 min walking from the Finchley Road Tube Station . Finchley Road Tube station can be reached on the Jubilee line between West Hampstead and Swiss Cottage stations and on the Metropolitan line between Wembley Park and Baker Street stations. It is in Travelcard zone 2.

The college is also a five-minute walk from the Finchley Road & Frognal station on the London Overground's North London line.

BUS:

The college is on London Buses routes 13, 113, 187, 268, C11 (going to Finchley Road Tube station).

PARKING SPACES:

The College does not have any parking spaces, but there is public road parking which is managed by Camden Council in front of the building.

Please look at Parkopedia for other parking options.