Course Overview

There are over 30 million individuals in the USA suffering personal limitations due to hip osteoarthritis (OA), femoral acetabular impingement syndrome (FAIS) and acetabular labral tears.  OA is the leading cause of chronic pain and loss of mobility in North America and is directly associated with decreased functionality, productivity and quality of life as well as increased medical utilization. Individuals with OA have almost twice the risk of losing work time due to illness.

Hip injuries make up 10% of sports medicine outpatient visits. Hip injuries can be difficult to diagnose and treat because of the multiple possible sources of pain and dysfunction including lumbar and SI. Patients with intra-articular hip pathology see an average of three clinicians before achieving a proper diagnosis., One of the most rapidly evolving pathologies of hip pain is femoroacetabular impingement syndrome (FAIS).

With Hip OA, there is an average of 3-6 year delay between diagnosis of hip OA and total hip arthroplasty (THA). During this time period, the individual can become very inactive due to the secondary capsular restrictions, pain, weakness and loss of mobility. When individuals become inactive, there is a significant increase in risk for co-morbidities including heart disease, stroke, cancer, obesity, diabetes, depression and addiction. There will continue to be a significant rise in prevalence in the future due to the aging of our populations, increase rates of obesity and lifestyle expectations.

Historically, the older and outdated model of treatment for hip OA has been exercise, losing weight, using a cane, taking NSAIDS and opioids and waiting for it to get severe enough to warrant THA.  It is in the best interest of the patient, and the healthcare system overall, to postpone THA as long as possible while not losing functionality and quality of life.  THAs will last approximately 25-30 years with today’s technology and surgical techniques.  In addition, many younger individuals just over 40 years old with FAIS and labral tears are unable to obtain hip arthroscopy due to their age and mild to moderate normal level of age-related OA.  In effect, they are “too old” for arthroscopic surgery, but “too young” for arthroplasty.  Physical therapists are poised to be the leader in the conservative management of hip OA and to assist individuals in staying active until surgery is warranted and desired.

Individuals between the ages of 40-60 year’s old are typically at their most productive earning years professionally and in many cases have greater physical responsibilities such as raising children or caring for their parents.  It is optimal to delay surgery until the individual is at least 60-65 year’s old in order to have only one THA in their lifetime, while also working hard to stay as functional and active as possible during these important years.

Newer studies confirm the significant potential in improved treatment outcomes through the combination of education, manual therapy and progressive exercise.  As there is no cure for hip OA, and it will progress during one’s lifetime, it is imperative that the patients are highly educated about expectations and are instructed in home manual therapy and exercises in addition to the treatment received in the clinic.

This course will have a specific focus on: 1) The vast and important differences in how education and expectations for these patients must be delivered to improve outcomes as compared to other pathologies, 2) Specific evaluation of hip intra-articular pathologies 3) Clinic joint and soft tissue mobilization techniques, 4) Home joint and soft tissue mobilization techniques and 5) Progressive exercises for mobility, strength and function in the young and active individual with hip intra-articular pathology. 

This class is 80% lab and 20% lecture. You will leave class ready to apply many important principles and techniques the following day in clinic.

This is a 2-day course offering 16 credit hours.

Dr. Tony Rocklin is a licensed physical therapist with 26 years of clinical experience and is a former partner, and current clinician, with Therapeutic Associates (TAI), the largest private, physical therapist-owned rehabilitation company in the USA.  Dr. Rocklin attended Oregon State University, where he was a member of the university basketball team, graduating with a BS degree in Exercise and Sport Science in 1994. He earned his Physical Therapy degree with distinction from Pacific University in Forest Grove, Oregon, and completed his clinical doctorate in 2008. He continued his advanced education with the North American Institute of Orthopaedic Manual Therapy, achieving Level IV Certification in Manual and Manipulative Therapy. Tony’s specialty, and the focus of the last 20 years of his career, has been hip intra-articular pathology, including osteoarthritis (OA), femoral acetabular impingement syndrome (FAIS) and acetabular labral tears. He is an active advocate for improvements and modernization in the conservative management of these conditions prior to surgery.

Dr. Rocklin is a regular speaker on conservative treatment of hip intra-articular pathologies. He has authored Modern Conservative Management White Paper V2.1 and is co-author of the study, “Manual Therapy, Therapeutic Exercise and HipTrac for Patients with Hip Osteoarthritis: A Case Series" published in the January 2017 issue of Orthopedic Physical Therapy Practice.  Dr. Rocklin has been a member of the American Physical Therapy Association as well as the Oregon Physical Therapy Association since 1995.  You can contact him trocklin@medrock.com.