Ask an Expert

Overview

Ask an Expert is an interactive clinical education session designed for physiotherapists and rehabilitation professionals who want to sharpen their clinical reasoning in real-world orthopedic cases.

In this session, experienced physiotherapist Christine Balkwill leads a dynamic case-based discussion centered on complex lower extremity presentations, including:

• Greater Trochanteric Pain Syndrome (GTPS)

• Gluteal tendinopathy

• Anterior hip pain post-hip replacement

• Achilles tendinosis

Through live case analysis, differential diagnosis, rehabilitation planning, and load management strategy discussions, participants gain practical tools that can be implemented immediately in clinical practice.

This orthopaedic course bridges evidence, clinical experience, and patient-centered care to help you confidently manage persistent tendon and hip-related pain.

Learning Objectives

By the end of this course, participants will be able to:

1. Differentiate Greater Trochanteric Pain Syndrome from other causes of lateral hip pain.

2. Identify key contributing factors in middle-aged patients with bilateral hip pain, including biomechanical and hormonal influences.

3. Design a progressive gluteus medius strengthening program beginning with isometrics and advancing to functional loading.

4. Apply load management principles to gluteal and Achilles tendinopathies.

5. Educate patients on movement modification strategies to reduce compressive and tensile tendon load.

6. Integrate adjunctive strategies such as cryotherapy and shockwave therapy appropriately.

7. Recognize and manage anterior hip pain presentations following anterior hip replacement.

Audience

This course is ideal for:

• Physiotherapists

• Orthopedic manual therapists

• Sports physiotherapists

• Chiropractors

• Athletic therapists

• Rehabilitation professionals working with active adults

It is particularly relevant for clinicians treating middle-aged, active patients with chronic tendon-related hip and lower limb pain.

Why This Course Matters

Greater Trochanteric Pain Syndrome is highly prevalent in women aged 45–70 and frequently presents bilaterally with night pain. Yet many contributing factors are overlooked in routine assessment.

This course goes beyond textbook protocols and explores:

• The role of perimenopause in tendon health

• Mattress quality and sleep positioning as drivers of night pain

• The balance between rest and progressive loading in Achilles tendinosis

• The importance of motor control in post-hip replacement anterior hip pain

Participants leave with clear, practical strategies for:

• Exercise progression

• Tendon load dosing

• Patient education that improves compliance

• Reducing recurrence and preventing rupture

The emphasis on individualized, patient-centered care ensures that you can adapt these principles to complex real-world presentations.

Clinical Highlights Covered

• Stepwise gluteus medius strengthening (isometrics → theraband → weight-bearing progression)

• Movement modifications to reduce tendon compression (avoiding leg crossing, provocative stretching)

• Practical nocturnal pain strategies (ice application techniques)

• Post-anterior hip replacement rectus femoris tendinopathy assessment

• Achilles tendinosis: individualized load tolerance and rupture risk mitigation

About the Presenter

Christine Balkwill BScPT, FCAMPT, Certified Yoga Instructor, CPA

Christine graduated from Queen's University in 1990 with a BScPT and then headed west to BC where she worked briefly in public practice before moving to Treloar Physiotherapy clinic in 1994 where she continues to work 4 days a week.  She treats a varied caseload but with a heavy lean toward the lower quadrant and would prefer to field questions in this area.  The hip is the largest part of her caseload and colleagues often consult on their tricky GTPS and anterior hip pain patients, many of which are complicated by lumbar spine involvement.  She enjoys navigating combined lower quadrant pathologies such as "overuse" or activity related knee strain with multiple factors, including hip and foot function and muscle imbalance. She is a Certified Yoga Instructor and is registered to practice dry needling in BC.

Christine completed her Diploma of Advanced Manual and Manipulative Therapy in 1998 and joined the instructor roster immediately.  She continues to teach Level 2 and 3 courses in the AIM program and help to credential new instructors for those teaching roles.  She enjoys her mentorship role, both informally in the clinic and formally through providing structured learning opportunities for AIM exam candidates.  In 2007 Christine received the PABC Award of Excellence in the area of Education.

Christine looks forward to assisting you with your clinical reasoning questions and cases.