Over the past 20 years as a physiotherapist, I've helped thousands of people recover from a wide variety of hip pain issues.

45-year-old nurse Emma had undergone surgery for torn cartilage in both hips, and her post-operative physiotherapy wasn’t going well despite the fact that she had been seeing her physio every week for months, and was working hard at her hip exercises in between sessions. She was taking strong painkillers – amitriptyline and gabapentin – but was still really struggling, and was unable to work. Emma was losing faith in her therapist, so her surgeon suggested that I might see if I could help her any further.

When I assessed Emma, the first things I noticed were that she had a twist between her ribcage and her pelvis, that the left side of her pelvis was very tight, and that she complained of pain in her left hip when she leant to the right. However, when I untwisted her ribcage and got her pelvis moving better, her pain and movement patterns improved immediately. It felt as though the ribcage and pelvis issues were overloading her hips. This was a moderately complex issue and I predicted that Emma would need a course of 12 sessions of treatment.

We based our initial treatment sessions around improving the flexibility and control of Emma’s thorax and pelvis, incorporating some visceral manipulation techniques as Emma’s descending colon (on the left side of her abdomen) felt restricted, as though it was gluing the ribcage and pelvis together.

After six sessions, we started to liaise with Emma’s GP about gradually reducing her painkillers and she was able to wean off the amitriptyline, though the gabapentin took longer. She was improving her thoracic control and practising hard, and although her hip control still wasn’t perfect, it was getting better. She was able to return to work for 3h at a stretch.

Emma had a big setback after 10 sessions, after she caught a nasty stomach infection and ended up in hospital for a week on a drip. This inevitably caused her to lose some of the muscle and control she’d worked so hard to regain; but within a couple more sessions she had got back on track, and after a total of 14 sessions, she was able to progress from physio to working with a rehabilitation specialist to strengthen her muscles and movement patterns.

Because of the damage to her hips, Emma knows that she will always need to maintain her strength and control; but she now has the tools to do this and is no longer in constant pain.