Anterior Hip and Groin Pain

Wednesday, 28 October 2020 09:00 - 17:00 (GMT)


Australian Physiotherapy & Pilates Institute (APPI)
The Chapel
Wellington Road
Kensal Rise
London
NW10 5LJ

Available

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 learn how to address these issues to optimise and FAST-TRACK YOUR OUTCOMES?

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.

Learning Objectives: This practical workshop will provide skills related to:

  • Diagnostic, pain provocation tests for intra & extra-articular sources of nociception
  • Assessment of bony morphology, joint stability, neurodynamics and relevant impairments
  • Assessment of posture & key movement patterns for specific pain & load intolerance presentations
  • Treatment direction tests (passive & active) & clinical reasoning strategies to determine best approach for reducing pain & improving load tolerance for the patient’s specific presentation
  • Manual therapy - specific techniques for range gaining and improving painfree ROM
  • Load management advice & key exercise strategies for specific presentations

OnlineLearningComponent (4-6 hours)

Understanding definitions, pathology & mechanisms

Learning Objectives: The online component aims to

  • Clarify definitions of anterior hip and groin pain
  • Explore factors which may influence intra-articular hip joint loads – a. morphological variants (eg FAI, acetabular dysplasia, femoral version, capsulo-labral deficits), b. adverse joint loading associated with kinematics and neuromotor function, c. the adequacy of joint protection mechanisms.
  • Explore factors which may influence extra-articular loads in the anterior hip region – a. morphological variants (eg. AIIS/Subspine Impingement), b. 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 practical workshop first provides participants with ‘the tools’ for assessment of anterior hip & groin pain – diagnostic test procedures for intra and extra-articular sources of nociception and assessment of drivers such as FAI, femoral version, hypermobility, focal instability and key postures and movement patterns. Standardised measurement of key impairments will also be covered, important for reliable measurement of outcomes.

Armed with a full toolkit and a clear understanding of how morphology, loading patterns and muscle dysfunction may be driving anterior hip and groin pain, participants will then be guided through a clinical reasoning model to help determine the key drivers and optimal management approach for each individual.

The approach can be simply described as the What, Why & How of Managing Anterior Hip & Groin Pain.

WHAT HURTS?

  • What is the position or direction specific load intolerance with which the patient presents ie what postures or movements/functions are most provocative?

  • What structures may be involved in local nociception? (Keeping in mind that there may be multiple sources of nociception and often all related to the same mechanism of overload or driver)

WHY DOES IT HURT?

  • Explores the drivers of position or direction specific load intolerance - morphology, loading patterns, impairments - muscle dysfunction, ROM restriction, neurodynamic impairments.

HOW CAN WE CHANGE IT?

  • Uses a combination of specific treatment-direction tests and clinical reasoning strategies based on the findings from the WHAT & WHY, to develop an optimal intervention approach. Includes specific manual therapy, MWM’s, neurodynamic techniques and key load management and exercise therapy strategies.
Alison grimaldi xs small

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

Australian Physiotherapy & Pilates Institute (APPI)

The Chapel

Wellington Road
Kensal Rise
London
NW10 5LJ

How to get there

Tube

Kensal Green Tube station (Bakerloo Line) is a seven minute walk from the venue

To check for work on the tube use the Transport for London journey planner please go to www.tfl.gov.uk

Train

Kensal Rise station is on the London Overground network on the Statford-Richmond/Stratford-Clapham Junction line. It is also a seven minute walk away.

Kensal Green Station (same as the tube station mentioned above) is also on the London Overground network on the London Euston-Watford Junction Line.

Buses

Bus Route 18: Sudbury and Harrow Road to Euston - Alight at Kilburn Lane and walk 2 minutes to Wellington Road.

Bus Route 52: Victoria station to Pound Lane - Alight at Harrow Road and walk 2 minutes to Wellington Road.

Bus Route 316: Mora road to White City bus station - Alight at Harrow Road/Kilburn Lane stop and walk 1 minute to Wellington Road.

Location Map

APPI Kensal Rise