Straight From the Hip : Honest Conversations on Hip and Groin Pain

About Straight From the Hip : Honest Conversations on Hip and Groin Pain

Welcome to Straight from the Hip—the podcast where we cut through the noise and have honest, practical conversations about hip and groin pain and pathology. Hosted by Benoy Mathew and Callum East, hip specialists, this show is for all healthcare professionals who treat hip and groin cases in the real world—physiotherapists, osteopaths, sports therapists and strength coaches. We break down complex clinical presentations into actionable takeaways you can use in your clinic on Monday morning. Expect evidence-informed guidance without the academic jargon and real-world clinical reasoning.

Publisher

Benoy Mathew

Category

health & fitness

Language

en

Explicit

No

First episode

8 Jan 2026

Latest episode

4 Oct 2026

Latest episodes

10 episodes in the feed.

1. 

   4 Oct 2026

   𝐄𝐩𝐢𝐬𝐨𝐝𝐞 𝟏𝟐: 𝐑𝐢𝐠𝐡𝐭 𝐈𝐧𝐣𝐞𝐜𝐭𝐢𝐨𝐧, 𝐖𝐫𝐨𝐧𝐠 𝐒𝐭𝐫𝐮𝐜𝐭𝐮𝐫𝐞: 𝐌𝐚𝐩𝐩𝐢𝐧𝐠 𝐂𝐨𝐦𝐦𝐨𝐧 𝐇𝐢𝐩 & 𝐆𝐫𝐨𝐢𝐧 𝐈𝐧𝐣𝐞𝐜𝐭𝐢𝐨𝐧𝐬

   "𝐈 𝐡𝐚𝐝 𝐚𝐧 𝐢𝐧𝐣𝐞𝐜𝐭𝐢𝐨𝐧 𝐚𝐧𝐝 𝐢𝐭 𝐝𝐢𝐝𝐧'𝐭 𝐰𝐨𝐫𝐤." 𝐁𝐮𝐭 𝐰𝐡𝐢𝐜𝐡 𝐢𝐧𝐣𝐞𝐜𝐭𝐢𝐨𝐧, 𝐈𝐧𝐭𝐨 𝐰𝐡𝐚𝐭, 𝐚𝐧𝐝 𝐰𝐡𝐲? Many patients can't tell you what they were injected with, whether it was guided, or what it targeted. In this episode, Callum and Benoy go through the common hip and pelvis injections and show why the clinical reasoning around the needle matters more than the needle itself.

2. 

   5 Jul 2026

   FAI Syndrome - Facts vs Myths

   FAI Syndrome - Myth or Facts Q: FAI syndrome presents purely as anterior groin pain. 🔴 FALSE Presentation is variable. Lateral hip pain from coexisting GTPS — more common in women — and adductor-related groin pain — more common in men — frequently cluster with FAI. Some will present as more buttock pain. Q: Intra-articular Steroid injections have no role in FAI syndrome management. 🔴 FALSE US -guided intra-articular hip injections can assist pain control and facilitate rehabilitation in selected patients. They also carry diagnostic value. Q: FAI syndrome only affects high-level athletes. 🔴 FALSE It affects recreational athletes and active non-athletes too. Occupational loading, sport history, and habitual movement patterns all contribute — not just elite sport exposure. Q: Physiotherapy for FAI syndrome is just generic hip strengthening. 🔴 FALSE Effective conservative management requires load modification, movement pattern retraining, and addressing the specific demands driving impingement — not a one-size-fits-all glute programme. Q: FAI syndrome and hip dysplasia are mutually exclusive. 🔴 FALSE Combined morphology exists. Missing hip dysplasia in a patient with cam features is a clinically significant error — acetabular coverage must always be assessed. 𝐈𝐧𝐭𝐞𝐫𝐞𝐬𝐭𝐞𝐝 𝐢𝐧 𝐥𝐞𝐚𝐫𝐧𝐢𝐧𝐠 𝐦𝐨𝐫𝐞 𝐨𝐧 𝐭𝐫𝐢𝐜𝐤𝐲 𝐡𝐢𝐩𝐬, 𝐰𝐞'𝐫𝐞 𝐛𝐫𝐢𝐧𝐠𝐢𝐧𝐠 𝐭𝐡𝐞 𝐀𝐝𝐮𝐥𝐭 𝐇𝐢𝐩 𝐂𝐨𝐮𝐫𝐬𝐞 𝐭𝐨 𝐦𝐮𝐥𝐭𝐢𝐩𝐥𝐞 𝐥𝐨𝐜𝐚𝐭𝐢𝐨𝐧𝐬 𝐢𝐧 𝟐𝟎𝟐𝟔: 📍 London (October) 📍 Manchester (Sept) 📍 Holland (3-separate days format) - Nov 📍 Dubai Links below. If you're struggling with a complex hip case and based in London, I'm also available for second opinion consultations at London Bridge. UK Courses: https://lnkd.in/eZXPHg_3 International Courses: https://lnkd.in/gzdUx77V

3. 

   30 May 2026

   Episode 9 - 1 in 2 Physios Miss This Common Hip Condition. Let's Fix That

   Half of all physiotherapists are missing it. Are you? In Episode 9 of Straight from the Hip, Benoy and Callum tackle one of the most under-diagnosed conditions in active adults — hip osteoarthritis. Not in your 70-year-old patient shufflingtowards a hip replacement. In your 35-year-old male athlete. Your 42-year-old female runner. The patients who are quietly losing capacity, reducing their activity, and drifting towards inactivity — while being told it's tight hip flexors or weak glutes. This episode dismantles the myths, challenges the guidelines, and gives you the clinical tools to catch hip OA earlier — because earlier recognition means better outcomes, full stop. What you'll take away: •      Why the NICE guideline age cut-off of 45 is a guideline— not gospel •      The key subjective and objective features of early hipOA in active adults •      How to separate symptomatic OA from radiological OA(and why imaging may not change a thing) •      How hip OA, GTPS, and tendinopathy coexist — and what'sactually driving the presentation •      The labelling debate: when a diagnosis empowers, andwhen it terrifies •      Three clinical scenarios that actually warrant imaging Stop waiting for the limp and the walking stick. The patients you're missing look nothing like that.

4. 

   15 May 2026

   𝐄𝐩𝐢𝐬𝐨𝐝𝐞 𝟖 - 𝐓𝐡𝐞 𝐓𝐨𝐩 𝟓 𝐑𝐞𝐚𝐬𝐨𝐧𝐬 𝐏𝐚𝐭𝐢𝐞𝐧𝐭𝐬 𝐅𝐚𝐢𝐥 𝐂𝐨𝐧𝐬𝐞𝐫𝐯𝐚𝐭𝐢𝐯𝐞 𝐂𝐚𝐫𝐞 𝐢𝐧 𝐅𝐀𝐈 𝐒𝐲𝐧𝐝𝐫𝐨𝐦𝐞

   Conservative care fails FAI syndrome patients every day — but is it really the treatment that's failing, or the process surrounding it? In this episode, Benoy and Callum break down the five most common reasons why patients with femoroacetabular impingement syndrome don't respond to non-operative management. This isn't about blaming patients. It's about clinicians holding up a mirror and asking the harder questions. What we cover: 🔵 Misdiagnosis— The most common reason rehab doesn't work is that it was never targeting the right condition. Early OA, hip dysplasia, and proximal ITB syndrome are frequently mislabelled as FAI syndrome. The Warwick Agreement triad — symptoms,clinical signs, and imaging — must all be present before you can confidently diagnose. 🔵 Failure tomodify activity — Deep end-range loading in the gym, premature adductor rehab, and provocative sport-specific movements keep the joint constantly irritated. Relative load management isn't optional — it's foundational. 🔵 Severity of morphological deformity — A large cam lesion with restricted ROM creates a mechanical conflict that no amount of glute work will resolve. Recognising the ceiling of conservative care early leads to better conversations and better outcomes. 🔵 Inadequate or generic rehabilitation — If the programme was a generic lower limb circuit without baseline deficit assessment or meaningful progression, the patient hasn't had a genuine trial of conservative care. Full stop. 🔵 Psychological and cognitive factors — Fear-avoidance, catastrophising, low self-efficacy, and co-existing mental health conditions are still under-screened in hip patients. The bottom line: Before you refer on or label a patient as a conservative care failure, ask yourself whether you — and the system around them — gave them the best possible shot. 𝐏𝐞𝐫𝐟𝐞𝐜𝐭 𝐟𝐨𝐫: Physiotherapists, osteopaths, sports therapists,strength coaches, and any health care professional managing active patients with hip and groin complaints.

5. 

   22 Apr 2026

   Episode 6 - Morphology Isn't Destiny - Rethinking How We Manage FAI Syndrome

   Your patient has FAI Syndrome. They're in pain, frustrated, and wondering if they'll ever squat, sit comfortably, or train hard again. The answer? They almost certainly can — but only if we stop blaming morphology and start managing load. In this episode, we break down exactly how to modify everyday activity and gym exposure, so your patients keep moving, keep training, and actually start recovering. From the sitting habits silently driving flare-ups, to the squat, deadlift, and spin class tweaks that take the heat out of the anterior hip — this is the practical playbook you can take straight into clinic on Monday morning. What you'll learn: • Why FAIS is a cumulative compression problem, not a single-event injury • How to modify sitting, walking, stairs, car transfers, and sleep to calm an irritable hip • Gym adjustments for squats, deadlifts, lunges, leg press, and core work — without pulling strength training away from your patient • How CAM vs pincer morphology should shape your walking and loading advice • Saddle height, handlebar position, and cadence tweaks for cyclists and spin class regulars • The five clinician mistakes that keep FAIS patients stuck — including chasing perfect posture and over-restricting flexion Range isn't the enemy-unprepared range under load is. We modify to restore tolerance, not to protect forever. Tune in, take notes, and share it with a colleague who's still telling their FAI patients to avoid the squat rack.

6. 

   22 Mar 2026

   Episode 5 - Why Sex and Morphology Change Everything in FAI Syndrome

   A 22-year-old male footballer with a CAM lesion and a 28-year-old female runner with a pincer pattern — same diagnosis, completely different clinical pictures. So why are so many clinicians still assessing and rehabbing them the same way? In this episode, we unpack how sex and morphology shape everything from presentation to rehab strategy in FAIS. We cover why males typically present with reduced ROM and sharp anterior groin pain, while females often have full — or even excessive — range yet still can't tolerate load at end-range. We explore the key strength and movement strategy differences, why "chasing flexibility" can be a trap in pincer-dominant patients, and how surgical considerations differ between morphology types. If you've ever wondered why some FAIS patients plateau despite doing "all the right things," this episode might change how you approach your next hip assessment. Same diagnosis doesn't mean same patient — treat the person, notthe scan.

7. 

   8 Feb 2026

   FAI Mimickers - Episode 3 Trailer

   Misdiagnosed Hip Impingement? These 6 Conditions Could Be the Real Culprit (JUST RELEASED) 𝐘𝐨𝐮𝐫 𝐅𝐀𝐃𝐈𝐑 𝐭𝐞𝐬𝐭 𝐢𝐬 𝐩𝐨𝐬𝐢𝐭𝐢𝐯𝐞. 𝐘𝐨𝐮𝐫 𝐩𝐚𝐭𝐢𝐞𝐧𝐭 𝐢𝐬 𝐲𝐨𝐮𝐧𝐠 𝐚𝐧𝐝 𝐚𝐜𝐭𝐢𝐯𝐞. 𝐈𝐭 𝐦𝐮𝐬𝐭 𝐛𝐞 𝐅𝐀𝐈… 𝐫𝐢𝐠𝐡𝐭? 𝐍𝐨𝐭 𝐬𝐨 𝐟𝐚𝐬𝐭.I In this episode of Straight from the Hip, Benoy and Callum break down six conditions that can masquerade as hip impingement — and why getting it wrong could mean missed red flags, delayed treatment, or unnecessary interventions. From femoral neck bone stress injuries that demand urgent action, to hip dysplasia hiding behind hypermobility, to the often-overlooked ischio-femoral impingement — we walk you through the key clinical features, risk factors, and distinguishing signs that separate FAI from its mimickers. In this episode, we cover: 🔹 Why FAI clinical tests lack specificity — and what that means for your diagnosis 🔹 Three common mimickers: bone stress injuries, hip dysplasia, and early hip OA 🔹 Three less common but crucial differentials: proximal ITB syndrome, ischiofemoral impingement, and avascular necrosis 🔹 The red flags you can't afford to miss 🔹 How history, risk factors, and imaging correlation can sharpen your clinical reasoning. Whether you're an early-career physio or a seasoned clinician, this episode will challenge how you approach hip pain and give you the tools to look beyond the impingement label. Don't let a positive test become a diagnostic dead end. 𝐏𝐞𝐫𝐟𝐞𝐜𝐭 𝐟𝐨𝐫: Physiotherapists, osteopaths, sports therapists, strength coaches, and any health care professional managing active patients with hip and groin complaints.

8. 

   8 Feb 2026

   Episode 3: Misdiagnosed Hip Impingement? These 6 Conditions Could Be the Real Culprit

   Your FADIR test is positive. Your patient is young and active. It must be FAI… right? Not so fast. In this episode of Straight from the Hip, Benoy and Callum break down six conditions that can masquerade as hip impingement — and why getting it wrong could mean missed redflags, delayed treatment, or unnecessary interventions. From femoral neck bone stress injuries that demand urgent action, to hip dysplasia hiding behind hypermobility, to the often-overlooked ischio-femoral impingement — we walk youthrough the key clinical features, risk factors, and distinguishing signs that separate FAI from its mimickers. In thisepisode, we cover: 🔹 Why FAI clinical tests lack specificity — and what that means for yourdiagnosis 🔹 Three common mimickers: bone stress injuries, hip dysplasia, and early hip OA 🔹 Three less common but crucial differentials: including a red flag 🔹 The red flags you can't afford to miss 🔹 How history, risk factors, and imaging correlation can sharpen your clinical reasoning Whether you're an early-career physio or a seasoned clinician, this episode will challenge how you approach hip pain and give you the tools to look beyond the impingementlabel. Don't let a positive test become a diagnostic dead end. 𝐏𝐞𝐫𝐟𝐞𝐜𝐭 𝐟𝐨𝐫: Physiotherapists, osteopaths, sports therapists,strength coaches, and any health care professional managing active patientswith hip and groin complaints. Self-rated joint hypermobility: the five-part questionnaire https://pmc.ncbi.nlm.nih.gov/articles/PMC7079417/

9. 

   23 Jan 2026

   Episode 2: Beyond the Impingement Test - What Your Hip Assessment is Missing

   You've taken a thorough subjective history and FAIS is sitting high on your differential list—but how do you confirm it objectively? In this episode, we break down the essential clinical examination findings that separate FAI syndrome from other hip pathologies. Discover the five critical objective markers you should be looking for: from restricted hip range of motion to the most sensitive clinical tests. We'll show you what to watch for in functional movement patterns—why your male patients prefer wider squat stances, toe out, and compensate through spinal flexion. But here's where most clinicians get it wrong: That "weakness" you're finding in strength testing? It'slikely pain inhibition, not true structural weakness. FAIS doesn't cause primary muscle weakness, but pain, fear, and central sensitisation absolutely inhibit function. Most importantly, we challenge you to step back. Don't just examine the hip in isolation—assess the entire kinetic chain. As we say: "If you're looking solely at the planet, step back and look at the universe." Because behind every hip impingement is a human being with unique movement patterns, beliefs, and compensatory strategies. Key Topics: ·      The FADDIR and FABER tests: sensitivity vs specificity ·      Why prone IR testing gives you more accurate ROM measurements ·      Functional testing that reveals real-world limitations ·      Understanding pain inhibition vs true weakness ·      The whole-system approach to FAIS assessment Whether you're an experienced MSK clinician or refining your hip assessment skills, this episode gives you the practical clinical framework to confidently evaluate FAIS. For further insights and clinical tips, Follow Benoy Mathew @function2fitness Callum East @hiprehablab

10. 

    8 Jan 2026

    Episode 1: The C-Sign and Subjective Clues - Recognising FAI Syndrome From Patient History

    Think you know how to spot FAI syndrome in your clinic? Think again. In this episode, we break down the seven key subjective indicators that should immediately raise your clinical suspicion for FAIS—before you've even laid hands on your patient. You'll learn how to recognise the classic demographic profile (hint: it's not just elite athletes), which sporting backgrounds scream "CAM morphology risk," and why that patient complaining their hip flexors feel "constantly tight" might be telling you something far more significant. We dive into the pathognomonic C-sign, decode the difference between primary anterior hip pain and secondary referral patterns, and explore why FAIS patients describe suchspecific aggravating factors—from getting out of the car to that familiar pinch at the bottom of a squat. What You'll Take Away: ✅ The exact age range and activity profile most at risk ✅ Which sports and training patterns during adolescence predispose to FAIS ✅ How to differentiate FAIS pain from other hip and groin pathologies based on history alone ✅ The functional limitations your patients describe that point directly to impingement ✅ Why gradual onset with load-related flares is the pattern you're looking for Whether you're assessing a 22-year-old footballer with groin pain or a 35-year-old gym-goer who "just can't squat anymore," this episode gives you the clinical framework to start building your FAIS hypothesis from the moment they walkthrough your door. Perfect for: Physiotherapists, osteopaths, sports therapists, strength coaches, and anyone managing active patients with hip and groin complaints.

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5.0 / 5

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Spotify

5.0 / 5

6 ratings

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