Skip to main content
SpringerLink
Log in
Book cover

Posterior Hip Disorders pp 327–340Cite as

Physical Therapy and Rehabilitation in Posterior Hip Pathology

  • Chapter
  • First Online:

  • 1299 Accesses

Abstract

A standard comprehensive physical examination should be performed for those with posterior hip pain to determine a diagnosis, classify individuals into treatment categories, and identify impairments that need to be addressed with physical therapy intervention. A physical therapy- based evaluation algorithm and classification-based treatment categories include considerations for the lumbosacral spine and intra-articular and extra-articular sources of hip posterior pain. Posterior impingement, musculotendinous pathologies, nerve entrapments, and boney impingement are sources of posterior hip pain that can be addressed with intervention directed at strength, range of motion, flexibility, neuromuscular control, and biomechanical deficits.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Martin RL, Enseki KR. Nonoperative management and rehabilitation of the hip. In: Sekiya JK, Safran MR, Ranawat AS, Leunig ML, editors. Techniques in hip arthroscopy and joint preservation surgery. Philadelphia: Elsevier Saunders; 2011. p. 67–73.

    Chapter  Google Scholar 

  2. Martin RL, Kivlan BR. Classification-based treatment of hip pathology in older adults. Top Geriatr Rehabil. 2013;29(4):218–26.

    Article  Google Scholar 

  3. Delitto A, Erhard RE, Bowling RW. A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther. 1995;75(6):470–85. Discussion 85-9.

    Article  CAS  PubMed  Google Scholar 

  4. Fritz JM, George S. The use of a classification approach to identify subgroups of patients with acute low back pain. Interrater reliability and short-term treatment outcomes. Spine. 2000;25(1):106–14.

    Article  CAS  PubMed  Google Scholar 

  5. Clohisy JC, Knaus ER, Hunt DM, Lesher JM, Harris-Hayes M, Prather H. Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res. 2009;467(3):638–44.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Johnston TL, Schenker ML, Briggs KK, Philippon MJ. Relationship between offset angle alpha and hip chondral injury in femoroacetabular impingement. Arthroscopy. 2008;24(6):669–75.

    Article  PubMed  Google Scholar 

  7. Maslowski E, Sullivan W, Forster Harwood J, Gonzalez P, Kaufman M, Vidal A, et al. The diagnostic validity of hip provocation maneuvers to detect intra-articular hip pathology. PM & R. 2010;2(3):174–81.

    Article  Google Scholar 

  8. Philippon M, Schenker M, Briggs K, Kuppersmith D. Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscopic decompression. Knee Surg Sports Traumatol Arthrosc. 2007;15:908–14.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sutlive TG, Lopez HP, Schnitker DE, Yawn SE, Halle RJ, Mansfield LT, et al. Development of a clinical prediction rule for diagnosing hip osteoarthritis in individuals with unilateral hip pain. J Orthop Sports Phys Ther. 2008;38(9):542–50.

    Article  PubMed  Google Scholar 

  10. Tannast M, Kubiak-Langer M, Langlotz F, Puls M, Murphy SB, Siebenrock KA. Noninvasive three-dimensional assessment of femoroacetabular impingement. J Orthop Res. 2007;25(1):122–31.

    Article  PubMed  Google Scholar 

  11. Paungmali A, O’Leary S, Souvlis T, Vicenzino B. Hypoalgesic and sympathoexcitatory effects of mobilization with movement for lateral epicondylalgia. Phys Ther. 2003;83(4):374–83.

    PubMed  Google Scholar 

  12. Tyler TF, Nicholas SJ, Campbell RJ, McHugh MP. The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players. Am J Sports Med. 2001;29(2):124–8.

    Article  CAS  PubMed  Google Scholar 

  13. Kivlan BR, Carcia CR, Clemente FR, Phelps AL, Martin RL. The effect of Astym(R) therapy on muscle strength: a blinded, randomized, clinically controlled trial. BMC Musculoskelet Disord. 2015;16:325.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. McCormack JR. The management of bilateral high hamstring tendinopathy with ASTYM(R) treatment and eccentric exercise: a case report. J Man Manipulative Ther. 2012;20(3):142–6.

    Article  Google Scholar 

  15. Looney B, Srokose T, Fernandez-de-las-Penas C, Cleland JA. Graston instrument soft tissue mobilization and home stretching for the management of plantar heel pain: a case series. J Manipulative Physiol Ther. 2011;34(2):138–42.

    Article  PubMed  Google Scholar 

  16. Martin HD, Shears SA, Johnson JC, Smathers AM, Palmer IJ. The endoscopic treatment of sciatic nerve entrapment/deep gluteal syndrome. Arthroscopy. 2011;27(2):172–81.

    Article  PubMed  Google Scholar 

  17. Schmid AB, Nee RJ, Coppieters MW. Reappraising entrapment neuropathies – mechanisms, diagnosis and management. Man Ther. 2013;18(6):449–57.

    Article  PubMed  Google Scholar 

  18. Kassarjian A, Tomas X, Cerezal L, Canga A, Llopis E. MRI of the quadratus femoris muscle: anatomic considerations and pathologic lesions. AJR Am J Roentgenol. 2011;197(1):170–4.

    Article  PubMed  Google Scholar 

  19. Hatem MA, Palmer IJ, Martin HD. Diagnosis and 2-year outcomes of endoscopic treatment for ischiofemoral impingement. Arthroscopy. 2015;31(2):239–46.

    Article  PubMed  Google Scholar 

  20. Kivlan BR, Martin RL, Christoforetti JJ. Functional testing for hip dysfunction in the performing arts. International Society of Hip Arthroscopy, Boston, MA; 2012.

    Google Scholar 

  21. Lequesne M, Mathieu P, Vuillemin-Bodaghi V, Bard H, Djian P. Gluteal tendinopathy in refractory greater trochanter pain syndrome: diagnostic value of two clinical tests. Arthritis Rheum. 2008;59(2):241–6.

    Article  CAS  PubMed  Google Scholar 

  22. Kivlan BR, Carcia CR, Clemente FR, Phelps AL, Martin RL. Reliability and validity of functional performance tests in dancers with hip dysfunction. Int J Sports Phys Ther. 2013;8(4):360–96.

    PubMed  PubMed Central  Google Scholar 

  23. Sirca A, Susec-Michieli M. Selective type II fibre muscular atrophy in patients with osteoarthritis of the hip. J Neurol Sci. 1980;44(2–3):149–59.

    Article  CAS  PubMed  Google Scholar 

  24. Boren K, Conrey C, Le Coguic J, Paprocki L, Voight M, Robinson TK. Electromyographic analysis of gluteus medius and gluteus maximus during rehabilitation exercises. Int J Sports Phys Ther. 2011;6(3):206–23.

    PubMed  PubMed Central  Google Scholar 

  25. Simenz CJGL, Lutsch BN, Suchomel TJ, Ebben WP. Electromyographical analysis of lower extremity muscle activation during variations of the loaded step-up exercise. J Strength Cond Res. 2012;26(12):3398–405.

    Article  PubMed  Google Scholar 

  26. Distefano LJ, Blackburn JT, Marshall SW, Padua DA. Gluteal muscle activation during common therapeutic exercises. J Orthop Sports Phys Ther. 2009;39(7):532–40.

    Article  PubMed  Google Scholar 

  27. Webster KA, Gribble PA. A comparison of electromyography of gluteus medius and maximus in subjects with and without chronic ankle instability during two functional exercises. Phys Ther Sport. 2013;14(1):17–22.

    Article  PubMed  Google Scholar 

  28. Brandt M, Jakobsen MD, Thorborg K, Sundstrup E, Jay K, Andersen LL. Perceived loading and muscle activity during hip strengthening exercises: comparison of elastic resistance and machine exercises. Int J Sports Phys Ther. 2013;8(6):811–9.

    PubMed  PubMed Central  Google Scholar 

  29. Ekstrom RA, Donatelli RA, Carp KC. Electromyographic analysis of core trunk, hip, and thigh muscles during 9 rehabilitation exercises. J Orthop Sports Phys Ther. 2007;37(12):754–62.

    Article  PubMed  Google Scholar 

  30. Philippon MJ, Decker MJ, Giphart JE, Torry MR, Wahoff MS, LaPrade RF. Rehabilitation exercise progression for the gluteus medius muscle with consideration for iliopsoas tendinitis: an in vivo electromyography study. Am J Sports Med. 2011;39(8):1777–85.

    Article  PubMed  Google Scholar 

  31. Snijders CJ, Vleeming A, Stoeckart R. Transfer of lumbosacral load to iliac bones and legs. Part 1: Biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise. Clin Biomech (Bristol, Avon). 1993;8(6):285–94.

    Article  CAS  Google Scholar 

  32. Johnson MA, Polgar J, Weightman D, Appleton D. Data on the distribution of fibre types in thirty-six human muscles. An autopsy study. J Neurol Sci. 1973;18(1):111–29.

    Article  CAS  PubMed  Google Scholar 

  33. Queiroz BC, Cagliari MF, Amorim CF, Sacco IC. Muscle activation during four Pilates core stability exercises in quadruped position. Arch Phys Med Rehabil. 2010;91(1):86–92.

    Article  PubMed  Google Scholar 

  34. Jorgensen K, Nicholaisen T, Kato M. Muscle fiber distribution, capillary density, and enzymatic activities in the lumbar paravertebral muscles of young men. Significance for isometric endurance. Spine (Phila Pa 1976). 1993;18(11):1439–50.

    Article  CAS  Google Scholar 

  35. Mannion AF, Dumas GA, Cooper RG, Espinosa FJ, Faris MW, Stevenson JM. Muscle fibre size and type distribution in thoracic and lumbar regions of erector spinae in healthy subjects without low back pain: normal values and sex differences. J Anat. 1997;190(Pt 4):505–13.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sirca A, Kostevc V. The fibre type composition of thoracic and lumbar paravertebral muscles in man. J Anat. 1985;141:131–7.

    PubMed  PubMed Central  CAS  Google Scholar 

  37. Kim JS, Kang MH, Jang JH, Oh JS. Comparison of selective electromyographic activity of the superficial lumbar multifidus between prone trunk extension and four-point kneeling arm and leg lift exercises. J Phys Ther Sci. 2015;27(4):1037–9.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Vigotsky AD, Harper EN, Ryan DR, Contreras B. Effects of load on good morning kinematics and EMG activity. PeerJ. 2015;3:e708.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Reid DA, McNair PJ. Passive force, angle, and stiffness changes after stretching of hamstring muscles. Med Sci Sports Exerc. 2004;36(11):1944–8.

    Article  PubMed  Google Scholar 

  40. Taylor DC, Dalton JD Jr, Seaber AV, Garrett WE Jr. Viscoelastic properties of muscle-tendon units. The biomechanical effects of stretching. Am J Sports Med. 1990;18(3):300–9.

    Article  CAS  PubMed  Google Scholar 

  41. Behm DG, Chaouachi A. A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol. 2011;111(11):2633–51.

    Article  PubMed  Google Scholar 

  42. Kokkonen J, Nelson AG, Cornwell A. Acute muscle stretching inhibits maximal strength performance. Res Q Exerc Sport. 1998;69(4):411–5.

    Article  CAS  PubMed  Google Scholar 

  43. Young WB, Behm DG. Effects of running, static stretching and practice jumps on explosive force production and jumping performance. J Sports Med Phys Fitness. 2003;43(1):21–7.

    PubMed  CAS  Google Scholar 

  44. Fletcher IMJB. The effect of different warm-up stretch protocols on 20 meters sprint performance in trained rugby union players. J Strength Cond Res. 2004;18(4):885–8.

    PubMed  Google Scholar 

  45. Hough PA, Ross EZ, Howatson G. Effects of dynamic and static stretching on vertical jump performance and electromyographic activity. J Strength Cond Res. 2009;23(2):507–12.

    Article  PubMed  Google Scholar 

  46. Torres EM, Kraemer WJ, Vingren JL, Volek JS, Hatfield DL, Spiering BA, et al. Effects of stretching on upper-body muscular performance. J Strength Cond Res. 2008;22(4):1279–85.

    Article  PubMed  Google Scholar 

  47. Jaggers JR, Swank AM, Frost KL, Lee CD. The acute effects of dynamic and ballistic stretching on vertical jump height, force, and power. J Strength Cond Res. 2008;22(6):1844–9.

    Article  PubMed  Google Scholar 

  48. Gribble PA, Guskiewicz KM, Prentice WE. Effects of static and hold-relax stretching on hamstrings range of motion using the flex LE1000. J Sport Rehabil. 1999;8(3):195–208.

    Article  Google Scholar 

  49. Magnusson SP, Simonsen EB, Aagaard P, Dyhre-Poulsen P, McHugh MP, Kjaer M. Mechanical and physical responses to stretching with and without preisometric contraction in human skeletal muscle. Arch Phys Med Rehabil. 1996;77(4):373–8.

    Article  CAS  PubMed  Google Scholar 

  50. Moore MA, Hutton RS. Electromyographic investigation of muscle stretching techniques. Med Sci Sports Exerc. 1980;12(5):322–9.

    Article  CAS  PubMed  Google Scholar 

  51. Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech (Bristol, Avon). 2006;21(1):89–98.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA

    RobRoy L. Martin PhD, PT, CSCS & Benjamin R. Kivlan PhD, PT, OCS, SCS

  2. Centers for Sports Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    RobRoy L. Martin PhD, PT, CSCS

  3. Rangos School of Health Sciences, Rehabilitation Sciences, Duquesne University, Pittsburgh, PA, USA

    Ryan P. McGovern MS, ATC

  4. Hip Preservation Center, Baylor University Medical Center, Dallas, TX, USA

    Ricardo Gonçalves Schröder PT

Authors
  1. RobRoy L. Martin PhD, PT, CSCS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryan P. McGovern MS, ATC
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ricardo Gonçalves Schröder PT
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Benjamin R. Kivlan PhD, PT, OCS, SCS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to RobRoy L. Martin PhD, PT, CSCS .

Editor information

Editors and Affiliations

  1. Medical and Research Director, Hip Preservation Center, Baylor University Medical Center, Dallas, TX, USA

    Hal D. Martin

  2. International Consultant, Hip Preservation Center / Baylor Scott and White Research Institute, Baylor University Medical Center, Dallas, TX, USA

    Juan Gómez-Hoyos

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Martin, R.L., McGovern, R.P., Schröder, R.G., Kivlan, B.R. (2019). Physical Therapy and Rehabilitation in Posterior Hip Pathology. In: Martin, H., Gómez-Hoyos, J. (eds) Posterior Hip Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-78040-5_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-78040-5_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-78038-2

  • Online ISBN: 978-3-319-78040-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation