There is no passion to be found in playing small- in settling for a - PowerPoint PPT Presentation

IT’S ALL ABOUT THE FAI! (IF IT’S NOT THE GROIN . . OR BOTH!) John J Christoforetti, MD Pittsburgh, Pennsylvania

There is no passion to be found in playing small- in settling for a life that is less than one is capable of living. - Nelson Mandela

Functional Demand Mechanical Structure Genetic/Biomaterial

Conflict of Interests? Image: British Journal of Sports Medicine 2016

“red zoning” in sport Conflict-Free Hip Joint ROM Adjacent Adjacent segment strain! segment injury Sport-Required ROM

Identification of Symptom Generator  Physical Exam !!:  ?Limited hip motion relative to sport  ?structural FAI  Femoral version anomaly  Normal hip ROM with excessive ROM sport?  Hockey, soccer  Palpable inguinal or boney pelvic tenderness at muscular origins?  Sit-up test?  Valsalva? Bisciotti GN et al. BMJopenSport&Exercise.2017

My Treatment Algorithm Ultrasound Guided HIP “Redzone” Exam c/w Hip Intraarticular Injection & plus FAI? Pain? Reexamination! Exam C/W Reduce Groin/Abdominal Sports Redzoning Injury? Possible? Correct FAI Treat Reduce ?! Groin Redzoning

Conclusions? Meaningful symptoms and disability from the hip require hip diagnosis and treatment. Meaningful symptoms and disability from the groin or abdomen require treatment of the groin or abdomen. Combinations of symptoms are common and require systematic approach and common sense judgements- primum non nocere!

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