Clinical Edge - Functional hip assessment Clinical Edge - Functional hip assessment

Functional hip assessment

Functional hip assessment

Lateral knee pain when running or walking may have contributing hip strength or control issues, and identifying this can help focus your treatment time and patients efforts where it is needed. How can you assess the hip in standing and functional activities?

In this video, Hailey Welch guides you through where to start your functional assessment of anterior and lateral hip control and observation of a common motor control issue around the hip.

This video is part of the video series by Hailey Welch on Hip - Retraining neuromuscular function available for members of www.clinicaledge.co

Poor hip control can contribute to local musculoskeletal conditions such as gluteal tendinopathies and groin pain, and can also contribute to pain and dysfunction in other areas such as the low back, knee, foot and low back. A common patient presentation is poor hip control leading to pain around the lateral knee and ITB insertion.

How can you identify when your treatment should focus on the hip to treat these conditions? Beside strengthening the hip and waiting six to eight weeks for a strengthening effect and pain reduction, how can you test to see if you should focus on the hip? If you have got stuck into some manual therapy or needling around the hip, what exercises can you use to retrain motor control of the deep hip musculature? How can you use RTUS or palpation in your retraining to target your strengthening to the muscles that need it?

In this video on "Retraining neuromuscular control of the hip", Hailey Welch explores the case study of a runner with lateral knee pain that comes on 10 minutes after commencing running. In this video you will learn:

  • Special tests to diagnose the source of the pain in the lateral knee
  • Differential diagnosis for lateral knee pain
  • Functional tests to confirm the role of the hip in lateral knee pain
  • Screening tests for the hip
  • Muscle length testing
  • The use of video in running analysis
  • Postural screening of the hip and pelvis
  • Manual positioning of the femoral head in the acetabulum
  • Recognising and changing "Gripping" patterns of muscular activity around the hip
  • Incorporating manual therapy into your retraining program

Using RTUS to

  • Assess muscle activation patterns around the hip
  • Assess timing of stabilising system in relation to the global system
  • Motor control and deep system training compared to strength training initially
  • Muscle strength testing
  • Identifying factors that may be contributing to neuromuscular dysfunction around the hip
  • Rehabilitation
  • Timing and endurance of stabilisers using RTUS
  • Timing and endurance of stabilisers using palpation instead of RTUS
  • Exercises for the deep system around the hip
  • Positions and exercises to avoid in the early stages of rehab
  • Day 1 exercises to incorporate
  • Early stage exercise progressions
  • Later stage exercise progressions
  • Return to running

You will learn to identify the neuromuscular deficit at the hip, whether that is:

  • Activation
  • Endurance
  • Control
  • Synergy
  • Strength

You will then learn the most effective methods to address these, to achieve the best possible outcome for your runners with lateral knee pain.

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