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Moving Towards Physical Therapy and Pre-habilitation as Standard Management for Hip OA

Changes in our healthcare system come slowly Nothing changes quickly in our healthcare system; change is a marathon, not a sprint. Now that we've finally recognized the opioid epidemic, individual states are taking steps to stem their overuse. Patients with chronic pain – and their doctors – are looking for other ways to deal with their pain, and one of those ways is physical therapy. In fact, one of the most common sources of chronic pain is hip osteoarthritis, a degenerative disease that strikes more than 1 out of every 5 Americans. But not many primary care doctors are aware that physical therapy can relieve the pain and other symptoms of hip OA – before surgery becomes an option. And...

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Predicting Patient Response to Physical Therapy for Hip Osteoarthritis

Physical Therapy Helps Many Physical therapists who work with patients diagnosed with hip osteoarthritis know that education, manual therapy and therapeutic exercise can provide significant pain relief and improvements in ROM for many of them. However, there hasn't been sufficient research into the factors that can predict which patients will respond and by how much, when attending physical therapy. This is important because hip osteoarthritis is one of the most common causes of chronic pain, and chronic pain has often (too often!) been treated with opioids and NSAIDs, rather than physical therapy. As the healthcare system evaluates "pre-habilitation" "“ physical therapy before surgery in place of opioids "“ knowing who will benefit most would speed the process. Predicting Patient Response...

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Mobilization with Movement, Part 3

More Self-Mobilization Options for Patients This is the third part of Dr. Tony Rocklin's focus on mobilization with movement that patients can independently do at home. This discussion is excerpted from Tony's presentation at OPTA 2016. You can watch the first part of this discussion here, the second part here, and other excerpts here. Or listen to the full one-hour presentation here. Dr. Rocklin is one of the leading advocates for the efficacy of conservative treatment for patients with hip osteoarthritis, regardless of whether they are preparing for, waiting for, or not candidates for hip replacement surgery. Physical therapy that combines education, manual therapy, and therapeutic exercise can both relieve the pain and improve joint mobility, enabling the patient to...

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Mobilization with Movement Part 2

Home Mobilization Options for Patients This is the second part of Dr. Tony Rocklin's focus on mobilization with movement that patients can do independently at home, excerpted from his presentation at OPTA 2016. You can watch the first part of this discussion here, see other excerpts here, or listen to the full one-hour presentation here. One of the challenges in treating patients with hip osteoarthritis is that most insurance companies limit the number of visits for physical therapy they will cover, although it is less expensive than reliance on prescription painkillers and NSAIDs throughout the disease. And because it is incurable and degenerative, patients will need continuing treatment. As a result, best practices for physical therapists working with these patients include...

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Mobilization with Movement, Part 1

Mobilization with Movement for Home As May is Arthritis Awareness month, it's worth remembering that 1 out of 5 people in the United States will suffer from hip osteoarthritis during their lifetimes. Hip osteoarthritis is one of the most common chronic illnesses in the US today. Unfortunately, our healthcare system has historically only prescribed pain medications and NSAIDs, use of a cane, weight loss, and independent exercise alone while waiting for it to get bad enough for surgery. The period between diagnosis and hip surgery can be, on average, three to six years. As the OA progresses, pain increases, activity decreases, and patients are increasingly at risk for other co-morbidities related to inactivity such as heart disease, obesity, diabetes, depression, addiction,...

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