Dr Dilani Mendis

2007 grant recipient

Joanna DiongDr Dilani Mendis graduated from The University of Queensland with a Bachelor of Science and a Bachelor of Physiotherapy with first class Honours. She went on to work in hospital and private practice settings in the areas of musculoskeletal, neurological and cardiorespiratory physiotherapy. While Dilani was working in private practice treating patients post-hip arthroscopy for labral tears, she noticed a lack of evidence for physiotherapy treatment of this condition and so was inspired to pursue a PhD.

Dilani received an NHMRC Biomedical Postgraduate Scholarship to complete her doctoral studies at The University of Queensland. Her PhD studies investigated hip flexor muscle size and function in response to reduced activity (prolonged bed rest), increased activity (professional football), and joint pathology (acetabular labral tears) using magnetic resonance imaging, real-time ultrasound imaging and clinical physiotherapy tests.

After her PhD, Dilani took up an academic position at the School of Physiotherapy at the Australian Catholic University. Currently she is working as a Research Fellow in the Centre for Musculoskeletal Research at the Mary Mackillop Institute for Health Research, ACU. Dilani’s current research focuses on investigating the relationship of hip muscle morphology and function to hip joint pathology and lower limb injury.

Research areas and findings

Hip osteoarthritis incurs significant costs to the individual and the healthcare system in Australia. Cartilage tears of the hip (hip labral tears) are thought to lead to hip osteoarthritis. With the diagnosis of hip labral tears becoming more common, there is an increasing need for physiotherapy management of this population. However, the most effective rehabilitation program is yet to be established. To design an effective exercise program, a better understanding of hip muscle function is required. The muscles at the front of the hip (hip flexors) are thought to contribute to hip joint stability and protection, however, little research has been done on these muscles.

Therefore Dilani’s aim of this PRF funded project was to investigate the size, strength and recruitment pattern of the hip flexor muscles in subjects with hip labral tears compared to matched healthy subjects with no hip pathology.

Twelve participants with a diagnosis of a hip labral tear were recruited from the patient list of an orthopaedic surgeon and were matched with twelve healthy participants, with no history of hip pathology/surgery. Questionnaires were administered to collect information on age, height, weight, relevant past medical and surgical history, dominant leg and level of physical activity. Hip flexion muscle strength was measured by a hand-held dynamometer and hip flexor muscle size was measured by magnetic resonance imaging (MRI).

Muscle functional MRI was used to investigate the activation pattern of the hip flexor muscles during a resisted hip flexion exercise task. Hip flexor muscle strength was decreased in patients with hip labral pathology compared to healthy subjects. No difference in hip flexor muscle size or recruitment pattern was found between groups. Dilani found that decreased hip flexor muscle strength may contribute to altered gait patterns and affect physical function in patients with hip labral pathology. Hip flexor muscle strength should be assessed in this patient population and clinical rehabilitation of these patients may need to include strengthening exercises for these muscles.

Publications from research

Mendis MD, Wilson SJ, Hayes DA, Watts MC, & Hides JA. (2014). Hip flexor muscle size, strength and recruitment pattern in patients with acetabular labral tears compared to healthy controls. Manual Therapy, 19:405-410.

Mendis, MD, Wilson, SJ, Hayes, DA, & Hides, JA. (2012). Specific hip muscle atrophy with acetabular labral tears. Journal of Science and Medicine in Sport, 15(6), S112.

Mendis, MD, Wilson, SJ, Hayes, DA, Watts, MC & Hides, JA. (2011). Hip flexor muscle strength but not size is reduced in patients with hip labral tears. Journal of Science and Medicine in Sport, 14(7), S20.

Mendis MD, Wilson SJ, Hayes DA, Watts MC, Hides JA (2011). Hip muscle size in the presence of acetabular labral joint pathology. Physiotherapy. 97(S1): eS801-2.

Important areas for development in physiotherapy

Dilani is passionate about investigating the musculoskeletal deficits that occur with hip joint pathology and investigating the risk factors that may predispose to injury. She believes further research in this area is greatly needed to assist in the design of effective physiotherapy rehabilitation programs for people with hip joint pathology.