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Femoro Acetabular Impingement

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Femoro Acetabular Impingement
School for FM Alexander Studies
2015

Video links:
Ultimate frisbee highlights: https://www.youtube.com/watch?v=HhUays2ehyI
Ultimate frisbee throwing: https://www.youtube.com/watch?v=r0xNV5AYfCA
FAI surgery: https://www.youtube.com/watch?v=KgU_dOeQLQM

Published in: Health & Medicine
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Femoro Acetabular Impingement

  1. 1. FEMORO-ACETABULAR IMPINGEMENT James Kingsmill 2015
  2. 2. BACKGROUND INFO
  3. 3. 0:05 3:00
  4. 4. OUTLINE Anatomy Causes Symptoms Treatments Where does AT fit in?
  5. 5. ANATOMY OF A HIP
  6. 6. Acetabulu Femoral Head Labrum Cartilage Ligamentu Teres
  7. 7. TYPES OF FAI Cam Pincer Mixed
  8. 8. CAUSES
  9. 9. ...CORRECTION
  10. 10. PREDISPOSING FACTORS YOUNG ...often ACTIVE ...usually MALE ...mostly
  11. 11. ACTIVITIES Football Dancing Martial Arts
  12. 12. MEANING... Large Hip ROM Axial Loading of Hip Torsional Forces
  13. 13. SYMPTOMS
  14. 14. WALKING PATTERNS
  15. 15. ANTALGIC GAIT
  16. 16. TRENDELENBURG GAIT
  17. 17. BRANDENBURG GATE
  18. 18. POSITIVE IMPINGEMENT TEST 90% of FAI sufferers test positive Volunteer?
  19. 19. FALSE POSITIVES (OTHER POSSIBLE CAUSES) Hip dysplasia Avascular necrosis You mean when your mentor turns into a zombie? No, that's avuncular necrosis. Slipped Capital Femoral Epiphysis Is that a thing? Legg-Calvé-Perthes Disease Stop making these up.
  20. 20. DIAGNOSIS
  21. 21. XRAY MRI MRA CT SCAN
  22. 22. DAMAGE Cartilage damage Labral tears Osteoarthritis
  23. 23. TREATMENTS
  24. 24. NON-SURGICAL NSAIDs Cortisone Physiotherapy Massage Root cause?
  25. 25. SURGICAL Joint Reshaping Labral Repair Cartilage Regrowth Ligament Repair
  26. 26. TYPES OPEN SURGERY ARTHROSCOPY
  27. 27. OPEN SURGERY Turn away now if you're squeamish
  28. 28. Seriously
  29. 29. ARTHROSCOPY It's not any more pleasant
  30. 30. POST-OPERATIVE TREATMENT Motor Control Strategies Hip Weakness Postural Misalignment
  31. 31. INITIAL REGIME IMPROVING ROM Light stretching CORE STABILISATION TrA, Pelvic Floor GLUTEAL ACTIVATION Bridging, Clams, Mule Kicks, Drinking Bird
  32. 32. ADVANCED REGIME FUNCTIONAL MOVEMENTS Squats, Lunges STABILITY EXERCISES Wobble Boards, Dynadiscs IMPACT EXERCISES Hopping, Landing
  33. 33. WHERE DO WE COME IN?
  34. 34. DIAGNOSIS AND REFERRAL
  35. 35. REHABILITATION "Generally, motor control retraining is more important than strength or power of individual muscles." - Fowler Kennedy Sports Medicine Clinic
  36. 36. AT TEACHERS ARE EXPERTS AT: Observing movement patterns Retraining motor control Rewiring the software
  37. 37. WHAT ARE WE NOT EXPERTS AT?
  38. 38. CONCLUSION QUESTIONS?
  39. 39. REFERENCES Femoral Acetabular Impingement, Pate (http://dcpracticeinsights.net/mpacms/dc/article.php?id=53605) Femoroacetabular Impingement, Magill et al (http://benthamopen.com/contents/pdf/TOSMJ/TOSMJ-4-75.)pdf Surgical Treatment of Femoroacetabular Impingement, AMA (http://www.bcbsks.com/customerservice/Providers/MedicalPolicies/policies/policies/SurgicalTreatment_FemoroacetabularImpingement_2014-10-15.pdf) Radiographic Prevalence of Femoroacetabular Impingement in a Young Population with Hip Complaints Is High, Ochoa et al (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049607) Current concepts in management of femoroacetabular impingement, Wilson et al (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557322) Hip Arthroscopy Protocol for Femoroacetabular Impingement, Fowler Kennedy Sports Medicine Clinic (http://fowlerkennedy.com/wp- content/uploads/2013/04/Hip_Protocol_for_Arthroscopy_of_Femoroacetabular_Impingement.pdf) Femoro-acetabular Impingement (FAI), running-physio.com (http://www.running-physio.com/femoro-acetabular-impingement-fai) Hip FAI and Labral Tear: Diagnosis to Treatment (https://hipfai.wordpress.com) Femoroacetabular Impingement – Etiology, Diagnosis, and Treatment of FAI, Reinold (http://www.mikereinold.com/2011/03/femoroacetabular-impingement- etiology-diagnosis-and-treatment-of-fai.html) FemoroAcetabular Impingement (FAI), Park Clinic Orthopaedics (http://www.parkclinic.com.au/home/conditions-treatment/hip/femoroacetabular-impingement- fai) Slipped capital femoral epiphysis, Wikipedia (http://en.wikipedia.org/wiki/Slipped_capital_femoral_epiphysis) Legg–Calvé–Perthes disease, Wikipedia (http://en.wikipedia.org/wiki/Legg%E2%80%93Calv%C3%A9%E2%80%93Perthes_disease) Septic Arthritis, Wikipedia (http://en.wikipedia.org/wiki/Septic_arthritis) Hip Dysplasia (Human), Wikipedia (http://en.wikipedia.org/wiki/Hip_dysplasia_(human))

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