Clinical Consult

Any recommendations in treatment intervention for a 48 yo male with early DJD ("Narrowing of the joint space, greatest in the superior aspect" on x-ray) of the L hip who primarily operates tow motor and increases his l hip px daily. He is 6' -230# endo/meso-morph, and he is a load for my 175# frame to mobilize.  He is utilizing static to dynamic stretching with flexband, and highly compliant with HEP. Suggestions??

Tim

Tim P. Thorsen  P.T., M.T.C.
586 Shepard Street
Rhinelander, WI 54501
www.spinesport.com
715-360-5258

Comments

[John Ware]

Tim,
Need more information regarding posture/ alignment, ROM, MMT, etc. in order to help you on this one. Does he have a capsular pattern? Any structural variations, e.g. LLI, ante- or retroversion. What movement of his L hip does he use predominantly when he is operating the tow motor? Any LBP hx? The radiographic findings you describe are very common in pt's with (and some without) hip pain.
John

[Erica Meloe]

Tim,
Agree that we need more information in order to help here. How does he operate the tow motor?
Erica

[Mark Boncser]

Tim, I don't know all the aspects of the hip condition as mentioned above by the other therapists but a couple years ago "articulations"
had an interesting clinical pearl. It described an caudad glide of the hip in standing. What they did was take an old shoe and nail it to a 2x4 and put the injurued extremity into the shoe and tied the shoe. They then anchored the board near something heavy or with the other foot and then the non-injuried LE extended the knee so the injuried LE was relatively glided inferiorly because it was tied into the shoe. I looked in some of my files to see if I could find the article for you but I could not find it. I have done this with a couple of patients and have reduced their clinical signs and symptoms up to 50%.