Physical therapists' experiences treating patients with hip joint–related pain: Facilitators and barriers to rehabilitation

BACKGROUND: Rehabilitation for hip joint-related pain (HRP) is challenging to navigate and often leads to suboptimal clinical outcomes and frustration for both clinicians and patients. OBJECTIVE: To determine physical therapist (PT)-identified facilitators and barriers to rehabilitation for patients with HRP to inform strategies for improving rehabilitation. DESIGN: Qualitative; focus groups. SETTING: Academic and clinical. PARTICIPANTS: Licensed PTs who treat patients with HRP (N = 20; 12 female/8 male) participated in virtual focus groups (N = 4 groups; 4-6 PTs per group). MAIN OUTCOME MEASURE(S): PTs reported demographics (age, gender, race, ethnicity), number of years practicing, practice setting, and additional certifications. We used a hybrid deductive-inductive thematic analysis to determine PT-identified facilitators and barriers to rehabilitation for HRP. RESULTS: PTs reported treating an average of 15 patients with HRP per month. Thematic analyses revealed five main facilitators to rehabilitation: (1) patient education, (2) patient empowerment, (3) traditional biomedical rehabilitation interventions, (4) collaborative model, and (5) therapeutic alliance and patient-centered care. Barriers to rehabilitation included (1) patients' mood, (2) treatment expectations, (3) structural or logistical challenges, (4) lack of physician support, and (5) pain perception. CONCLUSIONS: Improving interprofessional communication, setting realistic treatment expectations, and considering biopsychosocial contributors to hip pain may be opportunities to improve rehabilitation engagement and outcomes for patients with HRP. Future work examining the efficacy and dose-response of movement retraining and postural correction is warranted, as physical therapists reported relying heavily on these rehabilitation interventions.