[Physio Explained] Navigating hip dysplasia rehabilitation with Andrew Wallis
Oct 2, 2024
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In this engaging discussion, Andrew Wallis, an experienced APA Sports and Manipulative Physiotherapist from St. Kilda Football Club, shares his insights on hip dysplasia rehabilitation. He emphasizes the critical role of posture and strength training in recovery. Andrew dives into innovative rehabilitation techniques that prioritize functional movements and correct habitual patterns. He also explains the importance of collaboration with orthopedic surgeons and the role of radiology in patient assessments, ensuring comprehensive care for those affected by hip dysplasia.
Postural alignment is essential in hip dysplasia rehabilitation, as improper positioning can exacerbate strain on surrounding structures.
A focused strength program incorporating functional movements and assessing abductor strength is crucial for effective hip dysplasia management.
Deep dives
Understanding Hip Dysplasia and Force Dissipation
Hip dysplasia is fundamentally linked to poor coverage of the femoral head, which results in compromised force dissipation due to a small contact area within the dysplastic acetabulum. This biomechanical fault can lead to increased strain on surrounding structures such as the labrum and synovium, especially when the body remains in sustained end-of-range positions. Postural alignment is crucial, as improper positioning, particularly sway back or lateral sway, can exacerbate these issues. Strengthening the abductors and addressing postural faults are vital to offloading stressed structures and improving overall hip function.
Crafting an Effective Strength Program for Dysplasia
An effective strength program for hip dysplasia should start with assessing the strength of the abductors and both internal and external rotators, which are often weak in affected individuals. Exercises should prioritize movements in functional positions rather than isolated muscle strengthening; this allows for better integration into everyday activities. The routine might include side-lying abduction along with prone internal and external rotation, progressing towards dynamic movements that mimic real-life challenges. Incorporating isometric contractions and perturbations into training can further enhance stability and control during functional activities.
Referral Guidelines and Collaborative Care
Deciding when to refer a patient with hip dysplasia for orthopedic evaluation hinges on specific radiological findings and clinical assessments of hip stability. Poor coverage indicated by angular measurements or significant migration of the femoral head often warrants a referral to an experienced orthopedic surgeon specializing in hip conditions. Engaging a consultant early on can provide valuable insights and a conservative approach to management while strengthening gains are established. This collaborative effort ensures patients receive comprehensive care tailored to their specific needs and conditions.
Andrew is an APA Sports and Manipulative Physiotherapist who is currently employed at St. Kilda Football Club (since 2007) and works privately at Melbourne Orthopaedic Group Sports Medicine. Over the last 20 years, Andrew has worked in both a clinical setting and within the elite sporting environment at Melbourne Victory, Adelaide Thunderbirds, SACA Redbacks, V8 Supercars, triathlon and athletics.
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Our host is @sarah.yule from Physio Network
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