Patients with hip pathology
In this excerpt from his workshop at OPTA 2016, Dr. Tony Rocklin reviews soft tissue releases, strengthening and biomechanics as part of conservative treatment of intra-articular hip pathology. He also discusses his approach to starting new patients on therapeutic exercises and giving them the “tools” to participate in improving their own condition – and explains how positive reinforcement of small improvements can keep them engaged. Tony also covers the importance of educating new patients on pain and setting expectations on the results they can expect from their course of treatment. Watch this final segment below and see previous installments here.
Conservative treatment that isn’t “drug-centric”
Dr. Rocklin is a leading advocate for conservative treatment that isn’t “drug-centric” for patients with hip osteoarthritis. While the disease is degenerative and can’t be cured, the symptoms associated with it can be treated with manual therapy and therapeutic exercises. This minimizes the use of dangerous medications and opioids, which are currently over-used in the US to the extent that usage is described as an “opioid epidemic”.
Unlike the use of drugs, which focus just on relieving pain, manual therapy and therapeutic exercises can target the source of the pain and decreasing mobility in the degenerative hip. That is the joint capsule, the deep connective tissue that surrounds the hip joint. The joint capsule helps to stabilize and control the range of motion of the hip joint. As hip OA progresses, the joint capsule becomes inflamed and very tight. This causes the femoral head to migrate superiorly and severely restrict normal movement of the hip. The capsular tightening, inflammatory reaction and loss of range of motion increases pressure within the joint which causes immediate increased pain.
Maximizing quality of life
Manual therapy – including long axis traction – can distract the hip, relaxing the joint capsule and surrounding tissues. This provides natural pain relief and improved mobility. It is best combined with therapeutic exercises for hip OA that patients can learn in clinic and continue at home. This approach maximizes the patient’s quality of life during that period of time – most often multiple years – between diagnosis and THR surgery.
Watch the video below. You can see other excerpts from Dr Rocklin’s OPTA 2016 presentation here.