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Chiropractic Journal of Australia : CJA December 2012
130 Chiropractic Journal of Australia Volume 42 Number 4 December 2012 from 5° to 30°. Figure 8 demonstrates the radiographic changes following arthroscopic treatment. After six sessions of multi-modal chiropractic treatment (two prehabilitation and four rehabilitation sessions), all resisted muscle testing was graded 5/5 and range of motion had improved with Thomas test being 0° bilaterally, SLR 85° bilaterally, and hip abduction was 45° bilaterally. The anterior impingement, FABERE and Log Roll tests were all negative, i.e. no groin pain was reproduced. The PHE test demonstrated improved lumbopelvic-hip motor control with normal gluteus maximus contraction and stabilisation of the lumbar spine. The patient reported his hip was 100% better from the initial evaluation, stating he “wished he had the surgery fve years ago.” The patient returned to running following the tenth treatment session, but made a decision not to compete as a professional sprinter to avert further pathological deterioration of his hip. He continued to perform corrective exercises two to three times per week as a preventative measure. Patient 2 received seven treatment sessions over 11 weeks, which included the multi-modal management approach outlined above and corrective exercises (Table 1). After seven sessions of treatment all resisted muscle testing was graded 5/5 and hip fexor mobility had improved with Thomas test being 0° bilaterally. The PHE test demonstrated normal gluteus maximus contraction and stabilisation of the lumbar spine. Right hip fexion range of motion had improved (120°). However, internal rotation remained restricted (15° Figure 6: SB squat with resisted hip abduction. The patient stands with a SB in the small of the back, feet shoulder-width apart (with a band around the thighs); fnds a neutral spine posture, performs an abdominal brace, squats down by bending the hips (hip-hinge) and knees (not lower than 90°) while slightly pushing the thighs into the band. Figure 7: Single leg step-down. The patient stands on a low stable object; fnds a neutral spine posture, performs an abdominal brace, slowly bending at the hip (hip-hinge) and knee, to touch the toe on the ground (not putting weight onto the toe). FEMOROACETABULAR IMPINGMENT JAROSZ
CJA September 2012
CJA March 2013