The Athlete’s Hip: Simplifying Evaluation, Treatment, and Return to Sport

The Athlete’s Hip can be a complicated issue for sports medicine professionals and athletes alike… Do you want to learn how to accurately and efficiently evaluate and treat this population?

Currently scheduling for 2018/19, see below for information regarding the course and learn if you want to host a course!

Description:

Hip pathology is an often under-appreciated and misunderstood problem for clinicians and athletes alike. As intra-articular and extra-articular hip pain has become more prominent, surgical procedures have increased exponentially, but examination and conservative management have unfortunately lagged behind.

This two-day course will delve into evidence-based evaluation, conservative management, and return to sport of athletes presenting with hip pain. Through lecture and lab sessions, you will learn how to evaluate and treat athletes presenting with intra-articular (femoroacetabular impingement syndrome, acetabular labral pathology, and ligamentum teres pathology) and extra-articular pathology (sacroiliac joint, extra-articular impingement, athletic pubalgia, piriformis syndrome, proximal hamstring pathology, and greater trochanteric pain syndrome).

By simplifying the evaluation and management of these conditions, at the conclusion of this course, clinician will be more confident in determining underlying pathology, appropriate management, need for surgical consult, and safe return to sport.

Presenter:

John Snyder, PT, DPT, OCS, CSCS

Objectives:

Upon completion of this course, participants will be able to:

  • Understand the complexity of pain and its impact on hip pathology
  • Understand the impact of femoroacetabular biomechanics on hip and concomitant LE pathology and injury risk
  • Be able to accurately assess for red flags (avascular necrosis, femoral stress fracture, and inguinal hernia) and referral from proximal regions
  • Be able to accurately and efficiently evaluate extra-articular and intra-articular hip pathology
  • Be able to screen for and determine the need for surgical intervention
  • Understand pathology dependent and region dependent manual therapy and exercise progression for hip pathology
  • Progression of LE exercise and end-stage rehabilitation principles
  • Be able to determine psychosocial, functional testing, and pathology specific factors to determine safe and efficient return to sport

Schedule

Day 1

09:00 – 09:30 Introduction & Pain Science
09:30 – 10:15 Impact of hip pathology and biomechanics on movement
10:15 – 11:00 Screening of Pelvic/Hip Region (Lab/Lecture)
11:00 – 11:15 Break
11:15 – 12:15 Examination of Intra-articular Pathology (Lecture)
12:30 – 13:30 Lunch
13:30 – 14:30 Examination of Intra-articular Pathology (Lab)
14:30 – 15:15 Examination of Extra-articular Pathology (Lecture)
15:15 – 15:30 Break
15:30 – 16:00 Examination of Extra-articular Pathology (Lab)
16:00 – 17:00 Where does surgery fit in?

Day 2

09:00 – 10:00 Epidemiology of Conservative and Surgical Interventions
10:00 – 10:45 Treatment of Intra-articular hip pathology (Lab/Lecture)
10:45 – 11:00 Break
11:00 – 12:00 Treatment of Extra-articular hip pathology (Lab/Lecture)
12:00 – 13:00 Lunch
13:00 – 14:00 End-stage Rehabilitation Considerations
14:00 – 15:30 Return to Sport Determination (Lecture/Lab)
15:30 – 15:45 Final Comments/Conclusion

Scheduled Dates

I am currently scheduling for 2018-2019. Please contact me if you are interested in hosting The Athlete’s Hip or Management of the Ice Hockey Athlete at your facility.

2014 Therapydia Blog Awards: Best Student Blog!

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Orthopedic Manual Physical Therapy was officially named ‘Best Student Blog’ in Therapydia’s PT Blog Awards for the second consecutive year! Thank you so much for the continued support and taking time out of your day to to vote for OMPT! I was honored just to be nominated along with The AAOMPT sSIG, Pitt Physical Therapy, The Student Physical Therapist, and A Cup A Day.

OMPT also came in 3rd place for ‘Best Research Blog’ and it was honestly great just to be named in the same breath as Body in Mind and Forward Thinking PT. Congratulations to Joseph Brence, DPT, FAAOMPT and all those that contribute to Forward Thinking PT!

Thanks again for all of your continued support,

John Snyder, DPT, CSCS

Help Run the AAOMPT Booth at CSM!

 

The AAOMPT Student Special Interest Group is recruiting students to help run the booth at the upcoming Combined Sections Meeting in Las Vegas, Nevada from February 4-6th. While at the booth you will have the opportunity to help advocate for the American Academy of Orthopaedic Manual Physical Therapists and the value that we bring to the physical therapy profession. You will also have to chance to help run our raffle where we are giving away 3 yearly subscriptions to MedBridge Education‘s online continuing education resource.

Click here to sign up for a date and time in the Google Doc

Thanks in advance for your help in promoting this great organization!

John Snyder, SPT, CSCS
Vice President AAOMPT Student SIG
JSnyderPT@gmail.com

OMPT Joins MedBridge Education as an Affiliate

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Over the past year, I have been writing articles for MedBridge Education’s Blog and recently, I have agreed to an Affiliate Partnership with this great continuing education company. In doing so, my readers and followers have the opportunity to purchase a discounted yearly subscription (saving $225) to MedBridge’s extensive online course library, which features instructors such as Chad Cook, Louie Puentedura, Terry Malone, Lenny Macrina, Kyle Kiesel, Phil Plisky and much more. I have already taken several courses and I 100% believe the money spent will be well worth it for any physical therapist or DPT student.

For the Discounted rate, CLICK HERE or feel free to check out the MedBridge website and use promo code orthomanualPT when you’re ready to buy!

Thanks and enjoy!

John Snyder, SPT, CSCS

2013 AAOMPT Student SIG Elections!

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We want you to join the Student Special Interest Group of AAOMPT!

2013 AAOMPT student special interest leadership elections are under way! If interested in applying for a leadership position please send an e-mail to Cody Mansfield, SPT (cody.mansfield@duke.edu) or myself (jsnyderpt@gmail.com) with the information below by October 4th, 2013*:

Name:
Physical Therapy Program:
Year in program:
Position Applying for:
200 word platform describing your qualifications and interest in manual therapy:

*Once platforms are collected, members of the AAOMPT student sig will vote.  Election date is TBD (likely mid to late October).  Newly elected members will start in November. All leadership positions are available: President, Vice President, Secretary, Treasurer, Web Administrator, Social Committee Chair, Member at Large, Employment Chair, and Fundraising Chair. Refer to link for specific leadership role responsibilities.

The CSCS: What is it, Why to Pursue it, and How to Study for it

NSCA - CSCS

During the months prior to beginning physical therapy school, I began studying for and eventually took the examination to become a Certified Strength & Conditioning Specialist (CSCS) through the National Strength & Conditioning Association (NSCA), but why? Did I envision becoming the head strength coach at a prestigious university? No. Did I want to open a strength and conditioning facility for young athletes? Nope. Did I need a few more letters behind my name to feed my ego? Maybe… but still no.

Before I get into why I chose to pursue this certification, let me explain a little bit about what the CSCS actually is…

To start, here is the scope of practice of a CSCS, as determined by the NSCA:

Certified Strength and Conditioning Specialists (CSCSs) are professionals who apply scientific knowledge to train athletes for the primary goal of improving athletic performance. They conduct sport-specific testing sessions, design and implement safe and effective strength training and conditioning programs and provide guidance regarding nutrition and injury prevention. Recognizing that their area of expertise is separate and distinct, CSCSs consult with and refer athletes to other professionals when appropriate.

As a future physical therapist, within the scope of practice, there are several areas that jump out as paramount in the rehabilitation of athletes. First of all, “Professionals who apply scientific knowledge to train athletes for the primary goal of improving athletic performance” is a strong statement demonstrating the need for evidence-based training principals. This is one area where the PT community has some short-comings. I have seen far too many therapists utilize the “3 sets of 10” philosophy… AND IT DRIVES ME CRAZY! We must use our knowledge of biomechanics, bioenergetics, and general exercise physiology to guide our exercise prescription. A 300 pound offensive lineman should not be performing the same program as a 160 pound soccer player (let alone your geriatric patient). Preparation for the CSCS reinforces these basic principles that should be in the back of the therapist’s head every time an exercise is prescribed.

In addition, “conduct sport-specific testing sessions, design and implement safe and effective strength training and conditioning programs and provide guidance regarding nutrition and injury prevention” are all areas that therapists should strive to excel at. Sport specific testing, especially when determining an athlete’s readiness to return to sport, must be utilized by ALL therapists. These testing procedures have come a long way even during my short career and if you want to provide the best possible care to your athletes, you must have an intimate knowledge of these protocols. Also, injury prevention is such an integral aspect of a PT’s job that it’s hard to argue with furthering your education through studying for the CSCS. In regards to nutrition, I do not see this as an area that PTs should necessarily ‘own’, but we should have enough working knowledge to understand why and when to refer a patient to receive nutritional counseling.

So, now that we understand what the CSCS is, why did I pursue it?

Inherently and somewhat secretly, I am a nerd at heart. To that end, I absolutely love broadening my understanding of just about anything that will aide me in becoming a better therapist. Studying for the CSCS gave me a great opportunity to learn a large amount of material that is most definitely applicable to the physical therapy profession. Whether it be basic exercise physiology, nutrition, exercise testing, or exercise technique, all aspects of the material for this examination have a place and should be engrained in the well-informed therapist’s mind. Upon completion of this process, you will by no means be at the level of a head strength coach, but it will give you a basic understanding of all aspects of exercise prescription and programming. This information will aide me in treating and implementing rehabilitation programs geared towards an athletic population. In addition, I believe it gives you further credibility in the eyes of patients, employers, and colleagues because of the importanace and relevance of the knowledge necessary to gain certification. If you are seeking employment within a sports medicine clinic, I believe this is a good measure of your drive and understanding of rehabilitation concepts related to an athletic population.

Well, enough rambling, how should you study for the exam?

First, you must take into consideration how the exam is formatted. There are two different sections on the exam. The first is referred to as ‘Scientific Domains’ and is further broken into ‘Exercise Science’ and ‘Nutrition’. There is roughly a 70/30 split between exercise science and nutrition questions (with the majority being exercise science). This section is where your knowledge of exercise physiology, bioenergetics, biomechanics, and basic nutrition come into play. From my memory, the majority of questions were straight forward, but could get a bit complex at times. This was especially true when it came to nutrition questions as this is an area that I have not had a great deal of exposure to and my understanding reflected that. My suggestion would be to spend the vast majority of time delving into the complex princicples in regards to bioenergetics/energy systems as there was a large body of questions on this topic. Also, determine what areas you lack understanding in (whether it be through practice tests or self-awareness) and devote the necessary time to these areas.

The second section of the exam is titled ‘Practical/Applied’ and was purely dedicated to your ability to use priniciples from the ‘Scientific Foundations’ section in your exercise prescription/programming. This section is once more broken down into smaller sub-sections. The ‘Exercise Technique’ questions (36% of the section) would give you a scenario or video of an exercise technique (resistance training, speed training, or plyometrics) and from the information provided, you would have to either correct the client’s form or modify the exercise due to extenuating circumstances. If you have experience training clients or working in physical therapy practice, these questions should typically be ‘gimmies’. The ‘Program Design’ section (36%) will ask you to demonstrate your ability to apply proper exercise selection, progression, and overall design to specific athletes. These questions are challenging, but by knowing the demands of each sport (energy systems, biomechanics, etc.), you will be able to eliminate those answers that do not apply fairly quickly. Going hand-in-hand with the ‘Program Design’ questions will be questions testing your knowledge of ‘Exercise Testing’ (18%). There will be questions regarding specific protocols as well as your interpretation of an athlete’s results. You must become familiar with the results charts within the NSCA’s Essentials of Strength & Conditioning text book as this is where your justifications will come from. You will be able to use common sense for many of the questions, but having a general understanding of what is good and what is bad will go a long way on this portion of the exam. The final section of this exam is ‘Organization and Administration’ (10%), which I admittedly did not study very intensely and subsequently did not do too hot on. The material is very dry and boring in my opinion, but thankfully these questions do not make up a large portion of the exam. You will be asked to answer questions dealing with policies and procedures, staffing, layout and safety guidelines for facility design.

After all was said and done, I read the text book cover to cover, reviewed applicable notes from my exercise physiology and program design courses, and spent significantly more time on areas of the exam that I did not feel confident in. This would be my overall reccomendation to anyone that is considering pursuing this certification. It is a lot of information, but if you have an exercise science or physical therapy background, the material should not be overwhelming.

With any standardized exam, there are plenty of resources, but which ones are actually beneficial? Here is a rough list of what is available and my opinion as to their importance in your preparation:

Essentials of Strength & Conditioning, 3rd edition – $91.00 (non-member), $89.00 (NSCA member)

This is a must have resource as the questions from the exam primarily come from this text. Each chapter has information that is applicable to your studies and the majority of your study time should be spent utilizing this textbook. If you only plan on using one resource, this is without a doubt your best bet.

CSCS Exam Content Descripton Booklet – $36.00 (non-member), $17.95 (NSCA member)

This booklet outlines the major content areas on the exam. Is it worthwhile? I’m sure it is, but I think I only opened it twice.

CSCS Exam Practice Set – $184.50 (non-member), $75.60 (NSCA member)

These exams should be an integral part of you preparation. I took one exam before beginning the studying process to identify areas of deficiency and this allowed me to study more efficiently. If there’s one tip I would give, it would be to identify the areas that you are not comfortable in and hit those sections hard during your studies.

Exercise Technique Manual – $80.95 (non-member), $65.00 (NSCA member)

Do you know how to squat? Do you know how to bench press? Do you know how to deadlift? If the answer is yes, there is no need to buy this book. There is absolutely no substance outside of exercise technique within this book. I bought this and, once again, opened it a grand total of two times. Even if you are not comfortable with all the exercise techniques, take advantage of the resources available on the NSCA website and save yourself the money.

So that’s the CSCS in a nutshell. If you are currently pursuing this credential and need additional help or advisement, feel free to send me an e-mail.