Hip Instability may be described as a direction-specific sensorimotor disorder of the hip and has emerged as a common condition in hip pain patients. Despite the anecdotal disability for this subgroup, active research is lacking in this area to guide diagnosis and treatment. This course will cover the clinical process of diagnostic distinction of those with frank instability of the hip and those who present with a direction-specific sensorimotor disorder, previously termed micro-instability. The specific management planning and execution for these different presentations will be reviewed. Leanne Rath (FACP) will present a three stage objective battery of tests, which can help identify the direction-specific sensorimotor disturbance and the active entry point for rehabilitation. Generous practical time will be allocated to practice the assessment process and to practice each entry-level exercise specific to each clinically identified direction. Information regarding presenting symptoms, adaptation to prolonged symptoms, adaptation to pain and potential course of resolution will be discussed based on exposure to this subgroup of hip pain patients clinically. Clinical Reasoning Tasks will be incorporated to consolidate learning.



At the end of the course, the Physiotherapist will be expected to be able to:

  1. List the related contexts for the development of instability of the hip or direction-specific sensorimotor disorder of the hip
  2. Develop special questions in the subjective examination in a direction-specific sensorimotor disturbance or of hip instability
  3. Describe the varied presenting symptoms on the sensorimotor disturbance continuum up to hip instability
  4. Read the radiological signs that link to instability on MRI and Xrayeg acetabular dysplasia
  5. Understand the facts of hip joint centre translation relative to direction-specific sensorimotor disorder of the hip and hip instability
  6. Perform clinical assessment to rule in or rule out the potential for instability
  7. Determine the possible contributing directions of instability / sensorimotor disturbance disorder
  8. Determine entry level active rehabilitation and facilitate this
  9. Identify who requires joint protection in the form of restricted WB, tape etc
  10. Plan a rehab programme
  11. Understand the limitations of evidence and areas for research in these presentations
  12. Identify who has other co-existing co-morbidities