Soft Tissue Releases, Strengthening & Biomechanics

Patients with hip pathology

In this excerpt from his discussion 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 cannot be cured, the signs and symptoms associated with it can be treated with manual therapy, therapeutic exercises, and education. 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 work to improve mobility in the degenerative hip. The joint capsule around the hip helps to stabilize and control the range of motion of the hip joint. As hip OA progresses, the joint capsule becomes inflamed and progressively tighter. This causes the femoral head to migrate superiorly and severely restricts the normal movement of the hip. The capsular tightening, inflammatory reaction, and loss of range of motion increase pressure within the joint which causes immediate increased pain.

Maximizing quality of life

Manual therapy – including long axis traction – can distract the hip, mobilizing the joint capsule and relaxing surrounding tissues. This provides natural pain relief and improved mobility. It is best combined with therapeutic exercises that patients can learn in clinic sessions 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.