Femoroacetabular impingement (FAI) may contribute to hip and groin pain, buttock pain, pelvic or low back pain and referred pain into the thigh. Is conservative management effective in patients with FAI, or is surgery required? If we can treat FAI conservatively, what is the best treatment, and how can you tailor your treatment to your individual patients?

In episode 74 of the Physio Edge podcast with Dr Joanne Kemp you will discover:

• What is FAI, and how can you identify it?
• Common clinical presentations
• Key subjective questions to ask
• Types of FAI morphology and how they are identified
• Is FAI just a normal finding?
• How you can perform an objective assessment in patients with FAI
• Differential diagnosis
• Components you need to include in your conservative treatment for FAI
• Which objective markers to use when treating FAI
• How to address common impairments in your rehabilitation, including strength, functional tasks, cardiovascular training and range of movement
• When to refer for a surgical opinion
• Outcomes of surgical treatment
• Future risk of developing OA in presence of FAI

Sports Injuries virtual conference presentation

As mentioned in this episode Joanne will be part of the Sports Injury virtual conference. Her pre conference presentation will discuss FAI and the diagnostic process in more detail. Her subsequent conference presentation will be available on 9-10 December 2017, with access for up to 12 months following the conference, and will discuss:

• Conservative management of FAI
• Specific exercise progressions you can use
• Return to sport for athletes

Enrol on the 2017 Sports Injuries virtual conference by CLICKING HERE

Links associated with this episode:

• Get your free access to Sports Injuries presentations with Dr Ebonie Rio, Jack Hickey, Dr Adam Weir, Dr Michael Rathleff, Jo Gibson and Prof Bill Vicenzino
• Enrol on the 2017 Sports Injuries virtual conference
• Twitter - @JoannaLKemp
• Joanna Kemp - Research gate
• David Pope on Twitter
• Clinical Edge on Facebook
• Have a free trial Clinical Edge membership
• LaTrobe Sports and Exercise Medicine Research Blog
• Twitter - @LaTrobeSEM
• GLA:D Australia
• Lake Health Group

Articles associated with this episode:

• Griffin et al. 2016. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement.

• Articola et al. 2014. A Cam Deformity Is Gradually Acquired During Skeletal Maturation in Adolescent and Young Male Soccer Players. A Prospective Study With Minimum 2-Year Follow-up.

Other episodes of interest:

• Physio Edge 054 - Hip and groin pain part 2 with Benoy Matthew
• Physio Edge 053 - Hip and groin pain part 1 with Benoy Matthew
• Physio Edge 009 - Lateral hip pain with Dr Alison Grimaldi
• Physio Edge 004 - Hip injuries and labral tears with Nicole Hamilton

Strengthening is not commonly used in neck pain treatment and rehabilitation, however athletes may place large demands on their neck during training and play that require a high level of strength or endurance.

When should you include strength training in your rehabilitation? What patients will benefit from strength training? How can you incorporate strengthening into your treatment?

In episode 73 of the Physio Edge podcast, we explore the role of neck strengthening with Kay Robinson, Physiotherapist working with Australian sailing, and previously with the British Olympic Skeleton team.

In the podcast you will discover:

• Objective assessment of patients with neck pain
• Range of movement and strength tests you can use with your neck pain patients
• How to assess neck strength in your patients
• Indications for strength training
• Is strength training suitable in the early stages of neck pain rehabilitation?
• Early-stage cervical spine rehabilitation exercises you can use
• Exercise progressions to improve neck strength
• Neck strengthening in concussion
• Is neck strength training suitable for whiplash patients?
• Aspects incorporated into a typical neck strengthening program

Kay Robinson will also be presenting at the 2017 Sports Injury virtual conference. Her conference presentation on neck strengthening will discuss:

• How to incorporate neck training into rehabilitation post injury
• Neck strengthening for injury prevention
• How to make exercise patient or sport specific
• Other consideration with neck training
• Case studies

Links associated with this episode:

• Kay Robinson on Twitter - @kaylourob
• Kay Robinson at Total Physiotherapy
• David Pope on Twitter
• Clinical Edge on Facebook
• Have a free trial Clinical Edge membership
• Book - Sports Injury Prevention and Rehabilitation: Integrating Medicine and Science for Performance Solutions
• High-Performance Training for Sports

Articles associated with this episode:

• Durall. 2012. Therapeutic Exercise for Athletes With Nonspecific Neck Pain: A Current Concepts Review.

• Falla et al. 2003. An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion.

• Falla et al. 2007. Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting.

• Jull et al. 2009. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain.

Other episodes of interest:

• PE 013 - Cervical Spine Artery and VBI Testing with Roger Kerry

• 5 Minute Physio tip - Manual therapy for the cervical spine - Is there any evidence?

• 5 Minute Physio tip - Contraindications and red flags to cervical spine manual therapy.

Injured athletes like to recover and return to play as quickly as possible, and we need to balance return to play against impaired strength, performance and risk of reinjury. Initial injury rehabilitation often commences with isometric exercises, progressing into concentric/eccentric style exercises when isometric tests are pain-free. Finally high load eccentric exercises such as the Nordic hamstring are introduced for their positive effects of increased strength, fascicle length and reduced injury risk.

High level and eccentric exercises are often avoided in the early stages of rehab, for fear of aggravating the injury. What if we could commence higher-level and eccentric exercises safely at an earlier stage? Would this impair or accelerate your patients' recovery?

In this podcast with Jack Hickey, currently completing a PhD with the QUT/ACU hamstring injury research group, we explore an accelerated hamstring injury rehabilitation program, and how this can be implemented with your patients. You will discover:

• The limitations of traditional rehabilitation
• What is the evidence for only using isometric exercises in the early stages of rehab
• Why eccentric exercises are commonly thought of as too high a load for initial rehab
• More modern rehabilitation programs for hamstring strain injuries, including the Askling (2013), Aspetar (2017) and Mendiguchia (2017) programs
• An accelerated rehab program, introducing higher-level and eccentric exercises at an early stage
• When you can start your patient's rehabilitation
• Which exercises you can use with your hamstring injury patients
• How to know when to progress your patient's exercises
• How often high-level exercises need to be performed
• When your patients can return to running
• How to progress your patients through a return to running program
• When your patients are suitable for return to sport

Links associated with this episode:

• Sliding discs to use in hamstring slider exercises in your clinic - available in Australia. Use the code "clinicaledge" to get 20% off your order (at the above link, not applicable on Amazon)
• Amazon (outside Australia)- Sliding discs to use in hamstring slider exercises

Other episodes of interest:

• PE 071 - Hamstring strengthening, lengthening and injury prevention with Dr David Opar
• PE 019 - Hamstring strength, flexibility and injury reduction with Dr Kieran O’Sullivan
• PE016 - Preventing hamstring injuries with Dr Kristian Thorborg

Articles associated with this episode:

• • Askling et al. 2013. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols
  • Aspetar Hamstring Protocol
  • Hickey et al. 2016. Criteria for Progressing Rehabilitation and Determining Return-to-Play Clearance Following Hamstring Strain Injury: A Systematic Review
  • Jacobsen et al. 2016. A combination of initial and follow-up physiotherapist examination predicts physician-determined time to return to play after hamstring injury, with no added value of MRI.
  • Järvinen et al. 2007. Muscle injuries: optimising recovery.
  • Mendiguchia et al. 2017. Hamstring rehab for football players.
  • Silder et al. 2013. Clinical and Morphological Changes Following 2 Rehabilitation Programs for Acute Hamstring Strain Injuries: A Randomized Clinical Trial