An Evidence-Based Approach to the Athlete with Hip Pain: Introduction (03:04)
Dr. Pete Seidenberg and Dr. Jim Bowen experienced difficulty in understanding the interaction between the spine, hips, and pelvis. Seidenberg outlines the discussion on athletes with hip pain. Patients often present with vague complaints.
Patient history should include: age, mechanism of injury, acute vs. chronic, pain causes, timing of pain, what makes pain better, the sport, player position, and more. Identify systemic symptoms,
Physical Examination (03:58)
The examination of an athlete presenting with hip pain should include: vitals, standing posture, muscle wasting, gait, low back active ROM, lumbosacral palpation, Trendelenburg sign, and sit and stand tests.
Physical Examination: Part Two (07:09)
The examination of an athlete presenting with hip pain should also include: abdominal exam, male genital exam, hernia exam, pelvic exam, hip ROM, STD, hip pelvic palpation, neurovascular exam, strength, sensation, reflexes, and pulses.
Physical Examination: Special Tests (07:12)
Special tests for evaluating an athlete presenting with hip pain include: log roll, Stinchfield, SLR, Thomas test, FABER/Patrick's test, Ober's Test, lateral pelvic compression, and Ely's test. See a demonstration of each test.
Physical Examination: Special Tests: Part Two (05:37)
Special tests for evaluating an athlete presenting with hip pain include: scour, piriformis test, Weber-Barstow test, long sit test, and standing flexion. See a demonstration of each test.
Special Tests, What Research Shows (03:38)
See sensitivity and specificity results for positive SI dysfunction tests. Tests include: FABER, positive piriformis, SLR, contralateral SLR, long sit, and standing flexion.
Questions: Pelvic Tilt and Leg Length Discrepancy (02:01)
Seidenberg discusses the need for leg length films for patients with a pelvic tilt.
Questions: Sacrum and Length Discrepancy (02:27)
An audience member uses a "plumb bob" during an x-ray to measure a patient's sacrum. Seidenberg and Bowen order films to confirm what they believe is the correct diagnosis.
Questions: Manipulation and Therapy (02:35)
Seidenberg uses leg pull and muscle energy when testing for length discrepancy. Bowen discusses the importance of a thorough exam before doing a leg pull.
Questions: Suspected Stress Fracture (04:54)
An audience member explains his method of examining patients who present with hip pain including dorsiflexing the ankle and the slump test. Ultra-endurance athletes do not have normal pain perception.
Questions: Disability Exams (02:18)
A positive labral test indicates relative instability. Complete range of motion testing for the uninvolved side and the symptomatic side. Perform an impairment evaluation.
Questions: Thomas Test (04:39)
Experts discuss the value of the Thomas test, other tests that can be performed while the patient is in the Thomas test position, and the specificity/sensitivity of the test. Think about what you are stressing when performing the tests.
Questions: Isolating Muscle Groups (01:15)
A runner presents with hip pain. Isolate the muscle groups with running tests. Strengthening muscle groups can help some patients who present with hip pain.
Questions: Acute Disk Herniation (01:02)
An audience member reflects on the use of a slump test in the classic position when you suspect a herniated disk; he does not like tests where he cannot see the patient's face.
Patient Specific Care (01:26)
Bowen introduces a primer on hip and sports medicine and thanks audience members for attending the presentation.
Credits: An Evidence-Based Approach to the Athlete with Hip Pain (00:25)
Credits: An Evidence-Based Approach to the Athlete with Hip Pain
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