RE: Treatment for hip capsulitis

September 15, 2004

Have you considered leaving her alone from activities. No stretching for a

week, use ice and/or heat and maybe an NSAID. Just an idea. Norton

Alice wrote:

I am an outpatient PT, and lately I've a patient complained of hip

pain after her yoga class. She only has pain when she performs a

groin stretch (indian sitting) near end-range. She also complained

of mild discomfort with test. We've tried ultrasound, heat,

and hip inferior and posterior glide for 2 sessions. Home Exercise

program included gentle hip flexor stretch and groin stretch after

the application of heat, as well as lumbar stabilization exercises

such as unilateral bridging. So far she reported very minimal

improvement of pain. Any other suggestions?

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September 15, 2004

Alice wrote:

>I am an outpatient PT, and lately I've a patient complained of hip

>pain after her yoga class. She only has pain when she performs a

>groin stretch (indian sitting) near end-range. She also complained

>of mild discomfort with test. We've tried ultrasound, heat,

>and hip inferior and posterior glide for 2 sessions. Home Exercise

>program included gentle hip flexor stretch and groin stretch after

>the application of heat, as well as lumbar stabilization exercises

>such as unilateral bridging. So far she reported very minimal

>improvement of pain. Any other suggestions?

>

>Looking to start your own Practice?

>Visit www.InHomeRehab.com.

>Bring PTManager to your organization or State Association with a professional

workshop or course - call us at 313 884-8920 to arrange

>PTManager encourages participation in your professional association. Join and

participate now!

>

September 15, 2004

Alice, I am curious to how her passive IR checks out.

I think for capuslitis I should see somewhat of a

capuslar pattern, similar to the shoulder. For the

hip that is IR>ABD>FLEX with flexion being the most

limited in some cases. Would Moist heat penetrate

deep enough for the capsule? How old is the patient,

deg changes? Is the patient overweight, smoker,

diabetic? I see you tried some stabilization

exercises, any lumbar provocation.

If it is a true hip problem, capsulitis, I feel that

long axis distraction mob/manipulation is quite

effective combined with other hip mobs. I perform

this in the open packed position 30 flex, 30 abd, 20

ER with a belt stabilizing the groin as I use the shin

above the ankle to apply the distraction. I have

heard of some clinics nailing an old shoe to a board

to allow the patient to perform this independently.

Sorry, if I overanalyzed this and gave you more info

than you wanted. Good luck and I hope you patient

improves.

Shane

--- Alice wrote:

>

> I am an outpatient PT, and lately I've a patient

> complained of hip

> pain after her yoga class. She only has pain when

> she performs a

> groin stretch (indian sitting) near end-range. She

> also complained

> of mild discomfort with test. We've tried

> ultrasound, heat,

> and hip inferior and posterior glide for 2 sessions.

> Home Exercise

> program included gentle hip flexor stretch and groin

> stretch after

> the application of heat, as well as lumbar

> stabilization exercises

> such as unilateral bridging. So far she reported

> very minimal

> improvement of pain. Any other suggestions?

>

> Looking to start your own Practice?

> Visit www.InHomeRehab.com.

> Bring PTManager to your organization or State

> Association with a professional workshop or course -

> call us at 313 884-8920 to arrange

> PTManager encourages participation in your

> professional association. Join and participate now!

>

September 15, 2004

First off, are you sure it is hip capsulitis? Just a suggestion, but I might

look at the alignment of the ilium. If it is in an anterior position, your

patient may be experiencing compression symptoms. If this is the case, some

isometric anterior/posterior exercises or ilial mobilization may offer

relief.

Hope this helps you.

Sonnier, PT, CEAS

Back In Business Onsite Physical Therapy

9181 Fletcher Wood Drive

Cordova, TN 38016

Phone:

Email: sonnier2@...

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Re: Treatment for hip capsulitis