Best Practice Case Studies-Sports Medicine Cases RC (WHEN THE BALL AND SOCKET BECOME ONE)

Video Transcription

Hi, my name is Felix Takachi-Nagy, and I'm a physical therapist at Los Gatos Orthopaedic Sports Therapy in Los Gatos, California.  In this case, we have a patient with some hip osteoarthritis. Evidence shows that the most limited motions, or the capsular pattern for the hip when it  comes to osteoarthritis, are that flexion, internal rotation, and abduction are most commonly limited.  In this case, we want to offload the joint by performing some distraction to increase the space for the joint to articulate and move around during specific motions.  So for that, we can use a general technique to start, mainly for comfort, as well as overall hip motion. So that's called a general traction or distraction technique.  In this technique, we're going to place the hip joint in an open pack position, which is the position with the least joint contact surface occurring.  So this would be an approximate position of 30 degrees of flexion, 30 degrees of abduction, and slight external rotation of the hip.  In this, we're performing an end range mobilization, where I'm holding with an end feel of the joint and pulling on her leg, which should create some comfort and relief in the hip.  This can be held for any period of time, up to about 2 to 5 minutes, or performed at several bouts of shorter periods of time.  After performing this, I can perform more directional mobilizations specific to the motions that are limited. One of those being a posterior glide for internal rotation of the hip.  In this case, this can be an aggravating position based on the fact of the osteoarthritis creating some discomfort in the hip. If it is not, then I can perform it this way.  So at this point, I'm just providing a force through her knee, which goes to the back of her hip and glides the hip posteriorly.  This can be held just as long as the other one, and I will show a one for abduction now. So this one is an inferior glide, which is what is occurring at the hip when abduction  is occurring. So I'll just grab here. The towel is here for modesty, as well as just comfort.  In this case, I'm now pulling the hip inferiorly as I provide a counterforce with my shoulder through the femur.

Video Summary

Felix Takachi-Nagy, a physical therapist, discusses treating a patient with hip osteoarthritis at Los Gatos Orthopaedic Sports Therapy. Common limitations with osteoarthritis involve flexion, internal rotation, and abduction. To alleviate these, a general traction or distraction technique is employed, placing the hip in an open pack position with 30 degrees of flexion, 30 degrees of abduction, and slight external rotation to reduce joint contact and increase comfort. Further techniques include a posterior glide for internal rotation and an inferior glide for abduction, aimed at improving mobility while considering the patient's comfort.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 25

Topic Hip

Keywords

3rd Edition, CASE 25

3rd Edition

Hip

hip osteoarthritis

physical therapy

traction technique

joint mobility

Los Gatos Orthopaedic