Lucie Gosling is an Extended Scope Practitioner (Specialist Physiotherapist, Young Adult Hip Service) at The Royal Orthopaedic Hospital. She now also works at Physiokinetic. For this month’s Blog, she provides an insight to her expertise in this relatively new, exciting area of orthopaedic medicine. Arguably the foremost authority in this specialist area of physiotherapy in the Midlands, Lucie now leads Physiokinetic's service for patients requiring expert hip assessment and treatment.
"I have been working with patients who have hip pain for over ten years, predominantly at The Royal Orthopaedic Hospital in Birmingham and more recently at Physiokinetic. My experience is made up of treating patients with a wide variety of hip problems, from underlying bony abnormalities through to biomechanical issues and sports injuries. For the last year, I have been working closely with the Consultant Orthopaedic Surgeons who specialise in treating Young Adults with hip pain at The Royal Orthopaedic Hospital. Through this, I have contributed to the development of The Young Adult Hip Service which provides clinical and diagnostic assessment together with conservative through to surgical care for patients with hip pain.
The hip is a key weight bearing joint which interacts with the lumbar spine and sacroiliac joint above and knee and ankle joint below. It can be subject to altered loading for reasons such as mal-alignment, weakness, soft tissue tightness and repetitive activities, in particular sports, which can cause pain. We know that Physiotherapy can play an important role in effective treatment of many of these conditions. Treatment may encompass stretching, strengthening, stability work, addressing muscle imbalance, movement and loading modification, acupuncture and addressing biomechanical issues (such as control and stiffness of other joints). A common presentation are patients who have become tight in certain structures and weak in other muscle groups as a result of posture or repetitive activities and these can be treated relatively easily.
There have been significant advancements in the management of patients with hip pain over the last 5-10 years, through the increased use of hip arthroscopy surgery alongside improvements in imaging. (Hip arthroscopy involves putting a camera into the hip joint and addressing bone, cartilage or soft tissue issues where possible). Through this, we have a much greater understanding of intra-articular (within the joint) hip conditions such as cartilage tears and impingement than we have ever had. As a result, our ability to diagnose these in the clinical setting has increased and alongside this, our knowledge and understanding of how best to treat these conditions with either Surgery or Physiotherapy has improved too.
One of the key things that has become more apparent through working in the Young Adult Hip Service is that hip pain in some patients can be due to underlying hip conditions such as Perthes, Slipped Upper Femoral Epiphysis or Developmental Dysplasia of the hip. Whilst the incidence of these conditions is low, they should still be considered when assessing any young patient with hip pain and Physiotherapists can play a key role in diagnosis and providing advice regarding further management."
If you have or think you may have a hip joint problem, and would like to make an appointment for assessment, diagnosis and treatment, please contact us on 0121 440 7736. If you have any questions about your hip injury/complaint before making an appointment, please email firstname.lastname@example.org and Lucie or one of the team will get back to you within the same week.