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Jo Kemp appearing at end-of-year breakfast

Emma Breheny
30 September 2016

Femoroacetabular impingement (FAI) has come to light in the last six to seven years as a clinical conundrum for physiotherapists, with little evidence on pathology, the best way to assess the problem and strategies for management.

APA Sports Physiotherapist Dr Joanne Kemp has spent the last 10 years pondering FAI as both a clinician and researcher. She’s hoping to impart her knowledge of the latest evidence to physiotherapists who attend the end-of-year VIC Breakfast.

While the problem is linked to both genetic factors and the type of sport individuals play between 11 and 14 years of age, there’s no defined cause.

‘Certain people have a particular shape of the hip that pre-disposes them to get pinching or impingement in their hip. That covers about 25 per cent of the population but only about a quarter of those people actually get pain,’ Jo says.

But, the effects can be devastating for those who do develop pain, with effects on their ability to work, participate in physical activities, play sport and fulfil family commitments. Many people with FAI are only in their 30s or 40s.

In the longer-term, FAI can lead to hip osteoarthritis, which may require hip replacement surgery and further time off work. At this point, the effects can become even more far-reaching as productivity declines and demand for hospital services increase.

‘If people can’t do physical activity and play sport, they’re at a much higher risk of developing other diseases, like certain cancers, cardiovascular disease and diabetes,’ Jo explains.

Today, the biggest challenge for clinicians treating FAI patients is the lack of evidence on what’s still a relatively new condition.

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‘We still don’t have that level one randomised control evidence. So what we try and do instead is use an impairments-based model for treatment,’ Jo says. ‘We know that these people have weakness in their hip muscles, and impairments in their core trunk back muscles, so we try and target those areas with strengthening exercises.’

Other strategies might include education, stretching and manual therapy techniques. It’s also important for physiotherapists to know when it’s time to refer on to another professional.

‘It’s important to know what the most effective ways are for managing the problem but also, more broadly, what are the other sorts of treatment that could be effective?’

Jo is currently involved in two randomised control trials: one is a pilot physiotherapy trial by La Trobe and Federation universities, while the other is a surgical trial led by Oslo University Hospital with sites in six countries.

‘One of the most important things for us to find out is how we can improve the function of people who have the problem so we stop them going down that pathway to arthritis in later life,’ Jo says.

The VIC Branch End-of-Year Breakfast is happening on Friday 18 November. Find out more and register.


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