Hip Instability and Spinal Pain: The Role of the Physiotherapist

Hip assessment and treatment have advanced greatly over the past two decades. Femoroacetabular Impingement Syndrome (FAIS) as defined by the Warwick Agreement in 2016 has facilitated a framework by which clinicians can navigate through the clinical reasoning process to assess conditions of the hip. Kalsivaart and Safaran (2015) described how hip microinstability, which can be caused by several factors including mechanical impingement, collagen disorders and muscular weakness to name a few, also highlighted the role of muscular strengthening. Bennell et al. (2016) described the role of local muscular control followed by global muscular strengthening as a way to treat patients following hip arthroscopy.

As clinicians, we must assess the full kinetic chain during function to improve quality of life for our patients. Therefore, to assess the hip appropriately, we must assess the lumbar spine and its links to the pelvis, the pelvis of the femur and finally the femur on the tibia and ankle.

Hip/Spine Posture is a simple term; however, the assessment is very complicated. It takes into account several elements, including resting position, muscular tone, motor control, strength and, finally, endurance. During my presentation, I will aim to highlight specific components relating to hip instability, risk factors, assessment techniques and finally one strategy to manage such patients presenting with hip/spine conditions.