Ask an Expert with Dr. Paolo Sanzo - Complex Hip & Pelvic Case Discussions

Overview

This advanced case-based session explores a series of challenging hip and pelvic presentations frequently encountered in musculoskeletal physiotherapy practice. Through in-depth expert discussion with Dr. Paolo Sanzo and a clinical panel, participants will deepen their clinical reasoning and expand their management strategies for complex, multifactorial conditions.

From post-fall hip pain with neurological symptoms to snapping hip in hypermobile dancers, greater trochanteric pain syndrome, tendon disorders and red-flag vigilance — this session provides valuable insights into assessment, load management, manual therapy dosing, exercise progression, and when to refer for additional investigation. Clinicians leave better equipped to tailor individualized, evidence-informed treatment plans rather than rely on one-size-fits-all protocols.

Case Studies & Topics Covered

• Complex Post-Fall Hip Pain with Neurological Features — A middle-age woman with persistent right hip/buttock pain, night pain, leg giving way, but negative x-rays. Case illustrates how sacroiliac dysfunction, micro-fractures, or lumbar referral should be considered even when imaging is unremarkable.

• Manual Therapy Dosing — When “Less is More” — Demonstration of low-grade mobilizations (Grade I–II) to ease neurophysiological pain modulation without provoking irritation or compression.

• Load vs Compression — Relaxation Over Activation — Insight into why overactivation of muscles in compressive hip/pelvic conditions may worsen symptoms, advocating for gentle traction, unloading, and relaxation-based approaches.

• Greater Trochanteric Pain Syndrome (GTPS) — Practical discussion on progressive gluteal strengthening (from non–weight-bearing to functional), muscle imbalance correction, and appropriate use of modalities (e.g., therapeutic ultrasound) to complement rehabilitation.

• Snapping Hip in Hypermobile Dancers / Athletes — Case-based reasoning on anterior snapping hip, hypermobility, and the balance between flexibility and stability. Includes guidance on posterior chain strengthening, motor control, and use of supportive strategies (e.g., taping).

• Pelvic Floor Considerations in Hip & Pelvic Pathology — Highlighting the role of the pelvic floor in core stability, and when to consider referral to pelvic-health specialists in unresolved or recalcitrant cases.

• Red-Flag Awareness — When to Escalate Care — A powerful real-life example where recurrent low back and leg pain ultimately revealed a distal femur osteosarcoma. Emphasizes importance of thorough neurological assessment, broad differential diagnosis, and vigilance even with “normal” imaging.

• Proximal Rectus Femoris Tendinopathy in Athletes — Evidence-informed loading strategies: starting with low-load isometric holds, gradual functional loading, and when adjunct treatments (e.g., shockwave therapy) may be indicated.

Who Should Enroll

Physiotherapists, rehabilitation professionals, and other clinicians who treat:

• Hip, pelvic, and sacroiliac disorders

• Post-fall musculoskeletal injuries

• Lateral hip pain, gluteal tendinopathy, GTPS

• Dancers or hypermobile athletes with hip complaints

• Hip flexor / proximal tendon disorders

• Complex or non-resolving lower extremity cases requiring advanced clinical reasoning

This course is suitable for both early-career therapists wanting to broaden their reasoning repertoire and experienced clinicians seeking to refine assessment and treatment strategies for complex cases.

Why Enroll?

This course is not a “cookbook.” Instead, it cultivates critical thinking, encourages individualized care, and helps you navigate complex patient presentations with confidence. Whether you treat post-traumatic hip pain, chronic tendon problems, or care for dancers and athletes, you’ll walk away with practical, immediately applicable tools — and a deeper understanding of when to push, when to ease, and when to refer.

The Expert: Dr. Paolo Sanzo, DSc, MSc, BScPT, FCAMPT, CAFCI

Paolo Sanzo is an Instructor and Examiner (past Lead Examiner) for the Advanced Integrated Musculoskeletal (AIM) program of the Orthopaedic Division of the CPA. He is an Associate Professor in the School of Kinesiology at Lakehead University and at the Northern Ontario School of Medicine University.  He is also the Director of Active Potential Rehabilitation Services and MSK Academy.  He is a Technical Consultant for World Physiotherapy, a designated Clinical Specialist (Musculoskeletal) Physiotherapist, and Paolo is also currently the President of the International Federation of Manual and Musculoskeletal Physical Therapists (IFOMPT).