Earlier this year I was able to travel to the VA Sierra Nevada Health Care System at the Main Hospital Campus in Reno, Nevada. I provided an educational in-service to the rehabilitation team regarding how HipTrac can help with the care of their veterans in clinic and at home.
During this visit, we also discussed how HipTrac can be used to provide unilateral lumbar traction to the patient. HipTrac was created to be able to provide isolated traction to the hip joint in cases where the patient had a sensitive lumbar spine that did not tolerate traction well. For example, a case in which the veteran has hip osteoarthritis which likes traction, but a grade III spondylolisthesis at L4/5 that definitely does not like the traction.
Although we do see these more complicated cases and it is great that we have a tool that isolates true femoroacetabular traction, in many more cases, there are patients who have bony stenosis or other lumbar pathologies that really do like the traction. I wanted to discuss how to perform a simple modification using HipTrac if you wanted to provide more lumbar unilateral traction to your patient. The instructional videos at www.hiptrac.com all show how to use your body weight and more specifically where to place your ischial tuberosity right up against the HipTrac. As the HipTrac starts to move, your body weight will stop it and it will traction your femur away from your pelvis.
The simple modification to add more lumbar traction is to not use your ischial tuberosity/pelvis to block the unit. When the veteran is using HipTrac for more lumbar traction, simply place the unit against the edge of a wall, couch, chair, or really any heavy object on the floor or bed. Move your body close to it just like the usual set-up, but instead of your body stopping HipTrac from moving, just make sure the inanimate object is stopping it from moving. In this way, the traction will flow through your hip joint and into your lumbar spine.
You can use this simple modification in supine or side-lying as you wish. As physical therapists, we are creative and use our artistic imagination to perform mobilizations in a variety of positions and combinations of joints. Play with this modification and discover all the possibilities of tractioning a patient's lumbar spine in hip flexion or hip extension. Mobilize the patient's hip with or without lumbar traction. You are truly only limited by your own imagination with HipTrac!
During this meeting, we also discussed the typical uses of HipTrac and how it helps to mobilize the veteran's hip with osteoarthritis in the clinic and more importantly at home. We have seen all across the country how the PT's are facing the challenge of getting their patients into the clinic on a consistent basis due to their insanely busy schedules. HipTrac is a super helpful tool in that it serves as a supplement to and an extension of that physical therapy every single day in the veteran's home.