Mehmet Gem | The Hip Physio @TheHipPhysio Twitter profile

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Mehmet Gem | The Hip Physio

3 months

❌Derby date sold out and now full. ✅London date half full already so only a few places left for that one. Hips Hips Hips Hips

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Process of fracture healing It’s actually ridiculous how fascinating the human body is.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

If you want to show your patients how a new hip gets done, this is probably less graphic then an actual video.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Amazing demo of the powerful suction seal of the hip! 🤝Video from @jachahla ’s IG page.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

9 months

Some of the deeper muscles of the pelvis @SciePro

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

I love this picture. Such a clear illustration of just how many structures there are around deep gluteal space, each of which could potentially be a culprit for posterior hip/leg symptoms.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

🟢Hip flexor power variations…. At the beginning of the sprint, it is important to produce great force/power and generate high velocity in the block and acceleration phases. Hip flexion & trunk synergy can be often overlooked. Credit to trainer @ADODenHaag

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Just wanted to add my own expert guidance on how to do a psoas release properly. Let me know if your technique is the same. Thanks.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

When normal lunges just aren’t enough, add on either a dumbell on either side, or have a foot on a rowing machine whilst holding the actual squat rack. But don’t drop the knee too far forward over your toes just in case it’s unsafe.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

11 months

Not sure it’s just the Piriformis in there!

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Pelvic ligaments 😍

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

🧠Adductors🧠 🟢When the hip is in >60° flexion all have an EXT moment arm 🟢Add.Mag - strong hip EXT when in 45° hip flexion 🟢Add.Long - strong hip flexor when the hip is in EXT 🟢Working though FLEX in various planes & angles essential 4 rehab. Only Copenhagens won’t suffice.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

No you can’t palpate the psoas, (Every human body et al, since forever)

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Annotated Hip x-ray. One to save and refer back to easily. Love it. Credit to @radiologistpage

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Mehmet Gem | The Hip Physio

@TheHipPhysio

9 months

Hamstring strain injury (HSI) is one of the most common injuries in sports involving high-intensity sprinting, acceleration, and decelerations. Injury rates of the hamstring muscles ranges from 6% to 29% of all injuries in track and field, soccer, Australian football, rugby,

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

People trying to blame 3mm leg length discrepancy or a 4degree rotate pelvic inominate for hip pain….then you have this hero

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

A nice cadaveric demo of a CAM morphology that may or may not cause someone’s hip pain. ***disclaimer- I think this one is asymptomatic**

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Mehmet Gem | The Hip Physio

@TheHipPhysio

7 months

🧠 Adductor Magnus 🧠 More than just an adductor. ❇️Distal attachment of the adductor portion blends with short head of Biceps Fem to act as a femoral stabiliser. ❇️Adductor portion adducts & flexes ❇️Hamstring portion adducts & extends

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Avulsion fractures can occur at any muscular of ligamentous site. Apophyseal avulsions are highly prevalent in the adolescent population and must be high on your index of suspicion when assessing. Don’t think tendinopathy this age group, think apophysitis/# until otherwise.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

11 months

The hips suction seal. It’s stronger than you think. @MaldonadoMD_

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

HAMSTRING INJURY A CLINICIAN’S GUIDE Anthony G Schache, Australia, and Rod Whiteley, Qatar @Aspetar

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

‘Don’t have a hip replacement yet you’re too young, you’ll need a replacement after 10 years…’ THR survivorship rates: 97% up to 22 years - (Kiran et al., 2019) 75-100% 15 years (Hart et al., 2019) 75% up to 22 years – Keeling et al 2020 58% up to 25 years (Evans et al.,2019)

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

For anyone commenting on this post with all the standard BS ‘keep your back straight… weights too heavy…it’s bad for you…necessarily dangerous for your spine etc….’ There is a reason you aren’t her physio or coach.

Emma Raducanu

@EmmaRaducanu

2 years

finishing the week strong w some good facials🙈& a nice round number😈🐛. happy weekend.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

7 months

Biceps Femoris Activation during Hamstring Strength Exercises: A Systematic Review Luis Llurda-Almuzara et al 2021

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

📝MRI Findings in PAIN FREE elite rowers: ❇️95% had at least 1 hip with a labral tear ❇️75% of all hips had a labral tear ❇️85% unilateral CAM morphology ❇️65% bilateral CAM morphology ❇️72.5% of all hips met criteria for a CAM morphology @ThaminduW

Association between hip joint impingement and lumbar disc disease in elite rowers - PubMed

Rowers have a high prevalence of labral tears, cam morphology and lumbar disc disease. There is a possible association between cam morphology and radiological lumbar degenerative disc disease,...

pubmed.ncbi.nlm.nih.gov

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Honestly ballerinas and dancers are the boss level at the end when it comes to hip stability.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Don’t run with a hip resurfacing….👀 ……… @andy_murray

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Lovely pelvic X-ray annotation here by @drdevrad who has made it all the better with the lovely colours!

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

The iliopsoas is a mammouth muscle. I can’t believe Bruno has proven to us that it can be palpated after all. Thanks Dr Feliz.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Sometimes hip just click…

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

6 X-ray anatomical acetabular lines 2️⃣Posterior acetabular wall 3️⃣Acetabular roof 4️⃣Iliopectineal line 5️⃣Ilioischial line 6️⃣Tear drop

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

🍑 Glute Max Exercises 🍑 •The step-up and its variations may elicit the highest level of Gmax activation possibly to the stabilization requirement of the exercise.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

🧠Hip & Pelvis Muscle attachment points🧠 ❇️ Avulsion fractures can occur at any muscular of ligamentous site. Apophyseal avulsions are highly prevalent in the adolescent population and must be high on your index of suspicion when assessing. Don’t think tendinopathy this age

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Mehmet Gem | The Hip Physio

@TheHipPhysio

10 months

💥Inguinal Related Groin Pain💥 Just a select few potential causes of where the issue could be starting. Vuckovic, Zarko, Andreas Serner, Willem MP Heijboer, and Adam Weir. "Inguinal-related groin pain in athletes: a pathological potpourri." BMJ Open Sport & Exercise Medicine

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

My thoughts on the SIJ in 65 seconds.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

10 months

Magical bone healing 😍🥰

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

1️⃣ Sciatic nerve 2️⃣ Piriformis 3️⃣ Sacrotuberous ligament 4️⃣ Hamstring origin 5️⃣ Gemelli-obturator internus complex 6️⃣ Quadratus femoris 7️⃣ Lesser trochanter 8️⃣ Greater trochanter Martin, H. D., Reddy, M., & Gómez-Hoyos, J. (2015). Deep gluteal syndrome. Journal of hip pres..

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Fact.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Ever look at pelvic AP X-rays and wonder what’s what? Love this from @radiologistpage as a quick reference point if you’re wanting to refresh / learn up on anatomical landmarks.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Why I’m not a fan of jamming the hip into end range rotation drills without a sound understanding first of what may be normal (and limited ROM) for that hip.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

8 months

Gluteal Muscle Forces during Hip-Focused Injury Prevention and Rehabilitation Exercises (Collings et al 2023) This study aimed to compare and rank gluteal muscle forces in eight hip-focused exercises performed with and without external resistance and describe the underlying

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Great post here reposted from @jachahla In symptomatic patients with pain or dysfunction attributable to a tear of the labrum, retention of the labrum through a repair (if possible) is important to improve symptoms and restore joint stability.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Piriformis syndrome? More like, could be anything syndrome. Look at the proximity here of everything. Love the work @jachahla does.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

For those who suffer with persistent hip pain without any clarity as to what is actually going on, it’s seldom going to be because; • Hip Flexors are too tight • Tight hip internal rotation • Anterior pelvic tilt • Pelvis is out of alignment • SIJ is stiff • Weak glutes

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Surgeon preparing a fruit salad has got me gripped.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Immense video here from Dr Bruno Capurro on the Iliopsoas. This is how you can palpate it easily.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Sorry. Trigger warning. 🤝

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

An anterior pelvic tilt is not a bloody diagnosis.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Pelvic tilts, asymmetries & leg length differences can on the whole be benign with no need for concern. Here is the evidence. (Some of it anyway). An actual 🧵this time.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Quick anatomy recap for the hip - thanks Dr Capurro for this. a.- Coxal bone and inside is the cotyloid cavity⁣ b.- Proximal femur⁣ c.- Labrum⁣ d.- Joint capsule⁣ e.- Femoral head⁣ f.- Femoral neck⁣

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

This visual of the hip from @AnatomyStandard is something else.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Adductor Magnus. So much more than just an adductor. 😍

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

⬆️ ++++ years qualified does not always = a better Physio.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

🟢Range of motion and muscle strength differed in hips with different femoral versions. The hip rotation index was a strong femoral version predictor. 🟢Hip internal rotation range of motion is maximized in anteverted hip patients.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Provocative hip positions for those with FAIS. Quite a clear and simple reason why hip mobility end range pushing isn’t desirable for these patients.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Jesus, someone get the guy a heel raise and a course of mobility to improve his pelvic alignment. All that twisted spine and pelvis cannot be healthy. Quick!!

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Right let’s just clarify this… • A twisted pelvis • Uneven hips • Leg length issues • Anterior tilted pelvis’ • Tight hip flexors tilting the pelvis • Tight hamstrings tilting the pelvis Are not causes of hip pain. Plus most of the time all of these are normal!

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Things I say multiple times in each clinic: • Jump on the plinth and lay on your back… no your other back’.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

7 months

This is why I get so frustrated when I see people post rubbish about persistent hip pain being driven by tightness in muscles, or mobility issues, or because they have switched off glutes. It’s so much more complex. I’d like to think I’m at the coal face of dealing with

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

🧠 WHAT IS PLAC?! 🧠 Pyramidalis–anterior pubic ligament–adductor longus complex (PLAC). The pyramidalis is a small triangular muscle, located anterior to the rectus abdominis in the midline and the only abdominal muscle that lies anterior to the pubic bone @e_schilders

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

FAI Syndrome: ❇️Don’t jump to clinical tests to try and get a diagnosis. ❇️Most tests / all tests have poor specificity (cannot rule pathology in). ❇️Don’t rely just on imaging either. ❇️Don’t forget to assess the ‘person’ not the ‘hip’.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Calling all Junior Physio’s & Student Physio’s. Loads of followers on social media does not = a good clinician. You’ll find plenty with 100k-1mil followers often chatting absolute 💩 with so much certainly.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

🧠 Hip Pain Differentials 🧠 ❇️Don’t to the physical examinations. Take your time. Listen. Look out for those different patterns of presentations and get into the physical exam with a strong idea of what you may be looking for.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Knee pain? Check the hip Back pain? Check the hip Shin pain? Check the hip Buttock pain? Check the hip Hip pain? Check the hip

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Is running bad for your hips? No. Horga et al (2021) ‘The number of hip joint MRI abnormalities was not significantly different among inactive non-runners, moderately active runners and highly active runners in most structures’.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

And yes….. before the pain brigade pipe up, I know it’s not always a case of blaming a structural cause bla bla bla. I’m my world sometimes it is and to educate these issues we need to know what’s what’s first and foremost.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

My new spot for seeing my hip patients in #Exeter 😍

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Iliopsoas………So much more than just a hip flexor. Credit: Dr Bruno Cappuro

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

I’ve done something to my neck and it’s probably been painful for about a week and all I can think about is getting a massage 🤣🤣 I’m literally every patient cliche that I’ve ever had.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

4 years

2 kids, 2 jobs and relocating across the country during the 5 and a bit years it’s taken me to finish this, I’m actually bloody proud of this little certificate from @UniHertsPhysio

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Mehmet Gem | The Hip Physio

@TheHipPhysio

9 months

ℹ️ What does the labrum do? 1 provides a suction seal to the femoroacetabular articulation 2 increases socket depth and joint congruity, which leads to increased stability primary aim of labral surgery should be to anatomically restore its form and preserve its function. 3

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

I’ve been giving out clamshells and bent knee calf raises all day just to see what happens.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

THE HIP CAPSULE 1️⃣The IF reinforces the capsule during ext rot. & extension. 2️⃣The PF reinforces the inf. capsule to restrict excessive abd & ext rot during hip ext 3️⃣The IschF reinforces capsule during int rot in neutral positions as well FADDIR

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

If a patient has had questionable treatment elsewhere before seeing you, it’s far more powerful to be classy about it and not slag off other clinicians but just to demonstrate your thoughts in a subtle, more educational way for patients.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Added my own spin to this excellent demonstration on how to palpate the psoas. It’s actually quite easy.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Hip Anatomy whistle-stop tour: a.- Coxal bone (Ilium/Pubis) b.- Proximal femur⁣ c.- Labrum⁣ d.- Joint capsule⁣ e.- Femoral head⁣ f.- Femoral neck⁣ Credit: Dr.Feliz

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Wow. This has absolutely killed me 🤣🤣🤣 @coleandersonJ

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Mehmet Gem | The Hip Physio

@TheHipPhysio

9 months

Madness! Crazy how agile and strong some hips are!

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Mehmet Gem | The Hip Physio

@TheHipPhysio

9 months

I detest shite like this. Trivialising pain in a tweet. As if it’s ever that simple. The exercises are great, but the first sentence is dog.

Brett Boettcher

@brettboettcher1

9 months

Your back hurts because you have a weak core, tight hamstrings, and weak glutes. Here are 10 exercises you can do in 10 minutes to undo hours of sitting at the desk:

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

This is by no means exhaustive. However we need to be just as equally vigilant of red flags for our hip patients. Lamb et al( 2019) AVN of the hip. BMJ: British Medical Journal, 365 (8201). Afonso et al (2019, June). Hip and Pelvis Bone Tumors: Can You Make It Simple?.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Neto, W. K., Soares, E. G., Vieira, T. L., Aguiar, R., Chola, T. A., de Lima Sampaio, V., & Gama, E. F. (2020). Gluteus maximus activation during common strength and hypertrophy exercises: A systematic review. Journal of sports science & medicine, 19(1)

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

There is a reason why generic hip mobility / end range drills driving into internal rotation end ranges can be provocative for the painful hip. A lot comes down to understanding the type of hip that you’re dealing with. Link to article below.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Wall art ready for… the wall..

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

Love this from @radiologistpage Snapshot view of some hip/pelvic X-ray landmarks.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

9 months

So much for ‘releasing the psoas’ 😅🙄

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

If you’re wondering what each hip ligament does and whether there is something nice looking out there for you to save and reference. Look no further. Martin et al The function of the hip capsular ligaments: a quantitative report. Arthroscopy. 2008 Feb;24(2):188-95.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

🧠 HIP PAIN DIFFERENTIALS 🧠

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Was just about to film myself doing this as an example for a patient and then found this. Glad it saved me the time.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

6 months

❇️Adductor Magnus Rehab Implications for practice •Adductor magnus (AM) is an important hip extensor across a range of functional tasks. •AM can be anatomically divided into four portions (AM1-4) and functionally divided into two (Anterior and posterior). •AM clinical testing

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Listen right, if someone’s telling you your hip pain is specifically because of a tight Psoas, weak glutes, rotated pelvis, underactive glute, stiff SIJ, weak hip flexors, misaligned pelvis… what they really probably mean is they have no clue what’s going on.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

8 months

More than just Piriformis hey @thomas_jesson ☺️ Credit : @SciePro

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Some of my 5 quick tips when assessing hips: ⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️

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Mehmet Gem | The Hip Physio

@TheHipPhysio

3 years

Physio Twitter. It’s ok to have different opinions. That’s life. There’s more to life than physio 👊🏻🙏❤️ No need to get OTT in order to get your points across. #relax 🙂

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Mehmet Gem | The Hip Physio

@TheHipPhysio

4 years

FAIs and MRI findings. Nothing in particular that we don’t already know but something I’ve just put together. Hope it comes in useful for some 👍

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

IFIs- Common Signs: Presents with pain in the buttock / inner thigh without a injury Possibly snapping / clunking Pain with long stride walking Reproduced by a combination of extension, adduction & external rotation of the hip.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

1 year

Pelvic AP annotation from @drdevrad - Screenshot ☑️ Saved ☑️ These are never not satisfying to look over.

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

"In conclusion, our study provides evidence about the anatomical relationship between the sciatic nerve and the gemelliobturator internus complex, as well as about the dynamic behavior of the characteristic and reproducible sciatic nerve during passive rotation of the hip. I

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Mehmet Gem | The Hip Physio

@TheHipPhysio

2 years

💥Clicking Hips- What is it?💥 😟Many people get concerned when joints and in particular hips click. More often that not it is not an indicator or anything serious and as per the infographic, a lot of time these are benign issues.

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