How I do physio for hips (and why it's different!)

I spend quite a lot of time hanging around with surgeons - probably more than most private practice physios I know. There are many reasons for that, but the biggest one is that the more they and I understand each other, the better we can help our patients.

The way I see it, the operating theatre is where the baton of care is passed over from surgeon to physio - and if I'm not there, it's an opportunity missed. An opportunity to see the exact state of the patient's tissues. An opportunity to see exactly what the surgeon's done and how the op went. An opportunity to discuss post-operative care with the surgeon and to plan the next few months. After all, I'm going to be the one seeing the patient over the next few months, not the surgeon - so if we do hit any snags, the more first-hand knowledge I have of the surgery, the better I can help my patients over the bumps in the path of rehab.

Anyway. Recently, I was asked to make a teaching video for a group of orthopaedic trainees at the South West London Elective Orthopaedic Centre, to explain how to do physiotherapy for common hip conditions such as arthritis, femoro-acetabular impingement and labral tear.

However - that's not how I work.

I don't treat the diagnosis, or even just the hip; I treat the whole patient.

I don't just want to make sure your hip works smoothly - I need to make sure that it can reintegrate with the rest of your body again, and that if you've developed compensation patterns while your hip was sore (as most people do) that we can get you back out of them again. I need to make sure that your new movement patterns - incorporating your hip - are robust, so that when you get back to your normal life, whether that includes climbing mountains, doing yoga or just popping to the shops, you've got the capacity to do that without the risk of breaking down again.

So this is the teaching video I made, explaining why I work in the way I do, how I do it, and why I think it's more thorough and more effective than just treating the hip.

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