Sydney groin and hip specialists

[injuryupdate]

This is by no means meant to be an exhaustive list, but a guide to some of the specialists who see exclusively or mainly groin or hip problems in Sydney. Depending on the problem, you may need to see a different type of specialist surgery-wise, as the surgeons who operate on hips versus groins don't overlap very much.

Hip surgeons:
Michael O’Sullivan, 02 8920 3399*
Bill Walter, 445 Victoria Ave Chatswood, 99691989
Warwick Bruce, 160 Belmore Rd Randwick, 93995333
James Sullivan, 116 Macquarie St Parramatta, 98938778
Bernard Zicat, 3/100 Bay Rd Waverton, 89201200
Michael Neil, St Vincent’s Clinic, 93326912

Groin surgeons:
John Garvey, General Surgeon, 111 Anzac Pde Kensington, 96635999
Neil Halpin, 39 Grose St Nth Parramatta, 96307222

If anyone knows of others who are experts in hip and groin injuries in Sydney, please add to the list (or start another thread if you know of others in a different state).

[injuryupdate]

Of the above 'surgeons' listed, Neil Halpin deserves a special mention, for clarification purposes and also because his practice is very interesting.

Neil is not trained as a surgeon and has specialist qualifications only as a sports physician. He has been doing groin surgery however for approx. 15 years, which came about almost accidently. One of his friends who was a rugby player with chronic groin pain insisted that Neil try this procedure on him (called adductor tenotomy) that he had read about in a Scandinavian sports medical journal, despite the fact that Neil had no experience in surgery. The reason why the friend was so insistent was that all other surgeons in Sydney he had spoken to would not contemplate doing the procedure. Anyway, the operation was a big success and then teammates of the first patient came to see Neil for groin problems. Neil now only operates on chronic adductor tendon injuries, but has done 2000-3000 of these procedures, on athletes from all over Australia. In particular, many of the Brisbane Lions and Adelaide Crows players fly in to have Neil do adductor releases. He wouldn't ever be able to operate on a hip as he isn't qualified, but for anyone suffering from a footballers' chronic groin injury in the Sydney or Newcastle region, Neil may be the expert you are looking for.

[injuryupdate]

To search for sports physicians in NSW, you can visit:

http://www.acsp.org.au/pages/publiclist.php?keyloc=NSW&submitButton=Find

To search for sports physiotherapists in NSW, you can visit:

https://apa.advsol.com.au/scriptcontent/fap_index.cfm?section=foryou

Neither of these have searches by areas of expertise, but both of them list areas of interest next to the practitioner.

[Snuffy]

I'm told that when it comes to groin specialists a Miss Candy on Darlinghurst Rd, Sydney is highly recommended. This is by no means meant to be an exhaustive list, but a guide to a specialist who sees exclusively or mainly groin problems in Sydney. Depending on the problem, you may need to see a different type of specialist, or even multiple specialists, as the specialists don't overlap very much in terms of technique, hands on therapy and instruments.

If anyone knows of others who are experts in groins in Sydney, please add to the list (or start another thread if you know of others in a different state eg: Hindley St, SA etc).

[Unregistered]

O.K. You guys seem to know what you are talking about in an area that is convoluded and not black and white.

I'm located in the U.S. (California, on the coast near Stanford Medical School and Center and south of San Francisco).

I'm 40 years old, female, with a strong athletic build but not a history of knowing how to train correctly or of sports participation. Used to backpack a lot and ride my bike. I'm 5ft tall.

At age 21 (no injuries) I started a martial art. Lots of kicking, back/hip twisting and heavy impact, joint twisting, etc. I practiced for almost 5 years - very hard, as I do almost everything. Several injuries from the get go - mostly severe wrist trauma and also back started to hurt. Had to stop due to wrist injury.

I do tend to injure myself and I am always under a lot of stress. Very high achiever so to speak. Past diagnosis of sinotendonitis of wrist (had surgical release), fibromyalgia (doesnt bother me anymore too much just a bit), and various pulls and strains of shoulder, broken foot, injured disc in back, etc. Oh yes, i am very flexible (or used to be).

Main issue at this time:

8 years ago (2 days before wrist release) I was walking home after doing some greek dancing (lifting right leg/thigh up towards left shoulder). While walking (no stumble or anything) suddenly there was a sharp twang in my right groin area and simultaneously above my right knee. By the time I got home (2 blocks) I couldnt stand due to the pain. I am right handed and also have very tight illiotibial band on right side (my kicks were very powerful).

I was told I pulled my groin and had ice, ultrasounds, acupuncture, physical therapy. RIght leg/thigh continued to hurt terribly. Leg would give way accompanied by sharp and severe pain - I mean give way COMPLETELY. Like it was not attached to body. COuld not stand, could not walk. Pain went from groin through my thigh to top o fknee and stopped there. Not really a shooting pain - throbbing and sharp.

And guess what? Eight years later, after a shot of cortisone in groin, one in hip area, epidurals in lower back for injured disk, more physical therapy, I STILL HAVE THE PAIN. I feel it a lot in the front of thigh, in the hip, and just above the knee.

It sometimes hurts constantly and sometimes goes away except for a sense of background discomfort. Goes away on my doctor visits. Still gives way particularly after sitting or sleeping. I go to stand and cannot. Just can't. It hurts all night long - on my back or either side. It's difficult to rollover or sit up.

Just had an arthogram and MRI. Seems to show nothing but I understand it can be false. Oh yes, I have no nerve damage and still have muscle strength although I am getting a bit fatter and very unhappy. I can't exercise.

Any ideas? Or recommendations of doctors in my area? I finally went to Standford to see a sports doctor and he was the first one to suggest and MRI of my hip. Says its not a groin pull issue. ANohter doc (a neurologist) thinks I have inflammation of the thigh area.

Thanks,

Linda

Recent issues is this:

[lindam]

I just registered. I wrote the last message. One more thing - I weigh 115 lbs so not too fat. But when you are not tall...




O.K. You guys seem to know what you are talking about in an area that is convoluded and not black and white.

I'm located in the U.S. (California, on the coast near Stanford Medical School and Center and south of San Francisco).

I'm 40 years old, female, with a strong athletic build but not a history of knowing how to train correctly or of sports participation. Used to backpack a lot and ride my bike. I'm 5ft tall.

At age 21 (no injuries) I started a martial art. Lots of kicking, back/hip twisting and heavy impact, joint twisting, etc. I practiced for almost 5 years - very hard, as I do almost everything. Several injuries from the get go - mostly severe wrist trauma and also back started to hurt. Had to stop due to wrist injury.

I do tend to injure myself and I am always under a lot of stress. Very high achiever so to speak. Past diagnosis of sinotendonitis of wrist (had surgical release), fibromyalgia (doesnt bother me anymore too much just a bit), and various pulls and strains of shoulder, broken foot, injured disc in back, etc. Oh yes, i am very flexible (or used to be).

Main issue at this time:

8 years ago (2 days before wrist release) I was walking home after doing some greek dancing (lifting right leg/thigh up towards left shoulder). While walking (no stumble or anything) suddenly there was a sharp twang in my right groin area and simultaneously above my right knee. By the time I got home (2 blocks) I couldnt stand due to the pain. I am right handed and also have very tight illiotibial band on right side (my kicks were very powerful).

I was told I pulled my groin and had ice, ultrasounds, acupuncture, physical therapy. RIght leg/thigh continued to hurt terribly. Leg would give way accompanied by sharp and severe pain - I mean give way COMPLETELY. Like it was not attached to body. COuld not stand, could not walk. Pain went from groin through my thigh to top o fknee and stopped there. Not really a shooting pain - throbbing and sharp.

And guess what? Eight years later, after a shot of cortisone in groin, one in hip area, epidurals in lower back for injured disk, more physical therapy, I STILL HAVE THE PAIN. I feel it a lot in the front of thigh, in the hip, and just above the knee.

It sometimes hurts constantly and sometimes goes away except for a sense of background discomfort. Goes away on my doctor visits. Still gives way particularly after sitting or sleeping. I go to stand and cannot. Just can't. It hurts all night long - on my back or either side. It's difficult to rollover or sit up.

Just had an arthogram and MRI. Seems to show nothing but I understand it can be false. Oh yes, I have no nerve damage and still have muscle strength although I am getting a bit fatter and very unhappy. I can't exercise.

Any ideas? Or recommendations of doctors in my area? I finally went to Standford to see a sports doctor and he was the first one to suggest and MRI of my hip. Says its not a groin pull issue. ANohter doc (a neurologist) thinks I have inflammation of the thigh area.

Thanks,

Linda

Recent issues is this:

[injuryupdate]

Can actually recommend a specialist in the Stanford/Paolo Alto area - Gordon Matheson who is the editor of Physician SportsMedicine.

Agree that you have a diagnostic problem - 8 years of pain and still doctors can't tell you where the pain is coming from.

A possible way to solve it is to have a doctor order a long-acting local anaesthetic injection into your hip joint (needs to be done under X-ray). This will block any pain coming from your joint for 4-6 hours. Then you can go out and exercise, doing something that would usually cause you pain. If it is pain free, then the pain is coming from the hip joint. MRI scans can fail to show cartilage tears in the hip and they can possibly be fixed by a hip arthroscope.

Good luck.

[lindam]

Thanks. I do appreciate your reply. I actually think that Gordon Matheson works in the same office as the doctor I saw at Stanford, Dr. Frederickson - but Fred is a rehab physiatrist and MAtheson is a surgeon. I'm sure they must work together and consult but I just called and left a message about it... I'll tell Gordon a guy from Austrailia sent me!!

I agree that injection would be useful. And perhaps also a shot in the bursa as well. (and maybe a few shots of Jack Daniels as well)

I'm sure they would agree. Very frustrating. Perhaps part of the problem is that I learned to put up with pain. I think a lot of people do and so years go by. But also many physicians just don't do the right tests - took 8 years for anyone to even suggest an MRI, for what it's worth. I've been dealing with several local physicians.... And no-one really focused on my hip just on the groin. So Stanford it is. And perhaps Gordon can give me his 2 cents as well....

[Dr J]

BTW can you send me a photo. I will be in Denver next year for the ACSMS conference.

[hhh]

It sounds to me like a acetabular labrum injury. The acetabular labrum is increasingly being recognized as a source of hip pain, particularly in athletes. Hip pathology produces a referred pain phenomenon down the medial thigh to the knee. A patient presenting with groin pain and painful clicking as a result of a pivoting or twisting injury should represent a high clinical suspicion of a labral tear. Your symptoms sound like an intra-articular derrangement, particularly the giving way. Conventional MRI is not thought to be of use in the visualization of labral tears, while arthroscopy is currently the gold standard for diagnosis and treatment. Most non-operative interventions fail and patients report continued symptoms of painful catching particularly with activities. However, conservative treatments often fail because diagnosis is on average 2-3 years after injury. However, any physician worth his salt should have included this high in there list of differential diagnoses and I would be very suprised if a scouring type of orthopaedic test hasn't been performed. But by the sounds of it the physicians you've consulted are Barry Crockers.

[lindam]

Unfortunately, although a few of the docs I've seen have been brilliant in their own right like the neurologist I saw, I do think most of them have been graduates of a cooking school. There is nothing, NOTHING, like a great doctor who knows his stuff and is willing to admit when he doesnt - and who is openminded as well. But sadly enough there are not many who are like that. The ones that are are like gold. Stanford medical school is where I'm going to focus my energies - I'll bring up arthroscopy. Time to do it it appears.

Don't have any "clicking" so to speak like my wrist sometimes does - click click click. THe only "catching" I can think of is when I go to stand - like last night - and get up and it hits me like a knife. I can't move or put any weight on my leg. I hobble horribly if I need to get anywhere. ANd I can tell this is happening before I even go to stand. The hobbling happens a lot at night. All night long if I get up to use the restroom or do anything. OR if I get up from sitting. Happens during the day periodically also. It's also hard to lift my leg up or side to side - very weak and also painful. The pain last night was very focused - it started at the top of my thigh about 1.5 inches below the front hip bone and went down the front of the thigh almost in a line. Even now, sitting at my computer, I stand up - and feel the odd weakness and the pain in my thigh, groin and hip area. BUt sometimes I walk fine also (usually when I see the doctors and they ask me to stand and walk!). I'm, even wondering if I "pulled my groin" years ago or if something else happened. When one pulls a groin does it also hurt at the knee?

Question: do you have any idea why I would also get pain right above/at the knee? Sometimes there is a simultaneous throbbing of pain right at the hip/groin area and the right at the knee area. That puzzles me. I mean I can understand the radiation of pain throughout the thigh, and in all the related areas but why sometimes in 2 isolated areas? Something to do with insertion points? Maybe what I did 8 years ago was not a "groin pull" but something else.

One more thing: After I get through this, if anyone can recommend a capable, knowledgable TRAINER in my area who I can trust to help get me back going again CORRECTLY - you have no idea how much I would appreciate it. I've worked with a few trainers who seemed to be it (one was a powerlifter with many national records - yes, I tried powerlifting - won't get into the injuries I got from that) but they were not it. Not aware enough of the physical states of those they were working with - and did not approach training from the right perspective. Like one of the guys who trains Lance Armstrong. He understood Lance's capabilities and potential with his larger heart but knew it would take years of the correct approach to build up to a certain point. ANd to do it correctly without injury.

That's what would be great to develop - a list of trainers who really are competent. And who have the background and knowledge of physiology, body type and injuries and who know how to approach sports from a full-body perspective - develop core strength before pushing too much. I need that but the trainers I've seen - most of them- really don't know but they think they do. ANd I just trust them much to my chagrin. Even my martial arts Sensei - who I highly respected - blew it. I was young, eager and did not know when to stop. ANd neither did he. Language barrier also. Now I know more than when I was younger but I really don't know how to properly train myself particularly with my injury background. I still have a strong body - just don't know how to make the most of it. ANd looking for trainers in the phone book or at the gym is like sitting on reailroad tracks looking the other way.

[sydunisportsmed]

hhh, you need to translate Barry Crockers into American if you are going to post a reply to Septic Tank (and you might also need to explain what rhyming slang and sarcasm are, as I don't think the seppos know about these either).

Freidricksen is also a guru and will do a good job on the work-up and I would have money on the labral tear diagnosis as well.

[Thihan]

As a physio with a keen interest in chronic hip and groin pain (years of martial arts have led to two battered hips), the description of your symptoms definitly points to some sort of intra-articualar hip pathology. Probably acetabular labrum with a greater to lesser extent cartilage damage. My practice in Melbourne, Aus has a big hip bias and currently standard treatment usually goes: hip anaesthetic injection, which depending on resolution of symptoms is followed by a hip scope then a very specific lumbo-pelvic retraining program to correct all the biomechanical compensations which have occured due to a buggered hip. This area is greatly under researched and we have a hip study group at Melbourne University which is investigation the incidence, assessment and management of these difficult conditions.

Also that superior knee pain is a common hip joint pain refferal pattern. In fact some of my clients have presented with only knee pain and no hip or back signs at all. On investigation they are found to have nothing wrong with their knee and a stuffed hip joint.

Hope that helps.

[South Sydney Sports Med]

Agree that hip labral tears are very underdiagnosed. Jury still out on whether surgery gives long term relief (or short term only). Hip scope is in the list of operations that is much more common in Melbourne than Sydney.

[Thihan]

On the note of long term relief, I suppose as with any surgery the clinical reasoning has to be very clear. Hip arthroscopes are generally used for the relief of symptoms which have been differentially directed to intra-articular hip pathology. There will always be arguments on the long term effects and whether (if any) there is a risk of accelerated degeneration. At the end of the day if the hip is buggered, its buggered and its a very difficult to prove whether hip scopes will in any way effect future damage. The problem of course is with false positives especially with imaging and in chronic or more complex problems. However if we go back to the clear picture of underlying patho-physiologically and biomechanics especially regarding area of pain, aggravating fators as well as objective measures of hip function(particularly following intra-articular injection) we can make a clear case for surgery.

Of course as a physio I have to state the other side of the coin. Do all people with positive hip injections for their pain need arthroscopes? I have a growing group of clients (myself included) with mild to moderate hip pathology who can, with the right rehab reach up to 99% of the ADL functional requirements of their hips. Not quite sure how to pick these ones yet though. However I suppose that it does suggest that long term relief is possible following surgery as well. Probably a good research topic hey? Sorry about the long post, at least it got one person's brain ticking over.

[sydunisportsmed]

Pathology that is minimally symptomatic is very common. One pro rugby league player of mine had a labral tear diagnosed on MRI 3 seasons ago and had advice from the surgeon he saw to let it go as he was able to keep playing on it (in season this is standard advice, but many surgeons would have said to go ahead with a scope in the off-season). The player still has a very tight hip and gets some pain but still hasn't missed a game with the problem 3 seasons later and is playing well.

If anyone starts doing total body MRIs of the musculoskeletal system, we are all going to get very worried about the amount of pathology we are all sitting on.

[Snuffy]

Spoke with a colleague this week, Martin Richardson. He says of all the hip surgeons in Melnourne there are only 3 that should be perofrming hip arthroscopes for labrum injuries and he's not one of them. Read a study in BJSM that found that 4/18 patients presenting with groin pain to a sports clinic had a labral tear detected by MRa. Whether the tear is subclinical or not remains to be seen. Can probably add labral injury to the DD list for things like adductor tendinopathy, OP, conjoint tear, inguinal hernia etc etc. Similar to the other injuries in that success for conservative management and surgical management is equivocal.

[Slowman]

I'd like to add Lawrence Kohan to the list of hip specialists. He practices out of Bondi Junction and Leichhardt. He does BHRs and THRs. I just had a high femoral revision osteotomy of my right hip. I had an osteotomy done in 1994 and I wanted it reversed so I could regain full range of movement before probably going on for a BHR.

[Unregistered]

hi

I have had worsening hip instability and pain since a car accident over a year ago. I have had cortisone injections x2 to the bursa which
relieved the pain for 5 weeks each time. I have had both an MRI and
a MR Athrogram which both showed up a torn gluteus minimus which apparently should have healed by now and a trochanteric bursitis. I have done stretching and strengthening exercises daily for 5 months which made no difference to the pain and instability. Then I have been on crutches for 4 weeks with hydrotherapy and had no pain. Now I am back to walking short distances and continue hydrotherapy. My hip now feels more unstable than it has been. I am a nurse and currently on workers comp. This greatly affects my ability to do my job and am considering I might have to find another job to do. After all of this I still do not have a definite diagnosis and can't understand why this hasn't healed or at least begun to improve a little.

Can anyone recommend any hip specialists in Brisbane specialising in tendons, bursitis??

Thanks
Jo

[Nicholas]

I'd definatly reccomend Neil Haplin. He one of the best groin and hip specialists. He does work with quite a lot of football players.

[windsor]

Re The posting on Groin and Hip Specialists.

You asked us to add others we knew about and I saw a web site for Dr John Garvey (Surgeon) at www.groinpainclinic.com.au.
I noticed he is now in Macquarie Street.

Also Dr John Orchard is an excellent Sport's Physician at Kensington in Sydney.

Hope this helps,
W

[Sportsfan]

[QUOTE=injuryupdate]Hip surgeons:
Michael O’Sullivan, 02 8920 3399*
Bill Walter, 445 Victoria Ave Chatswood, 99691989
Warwick Bruce, 160 Belmore Rd Randwick, 93995333
James Sullivan, 116 Macquarie St Parramatta, 98938778
Bernard Zicat, 3/100 Bay Rd Waverton, 89201200
Michael Neil, St Vincent’s Clinic, 93326912


Hi,

Has anyone on this site had experience with the doctors above? (+ve or -ve) or any other Sydney Ortho hip specialist?

Thanks

[garvey]

Yes, Michael Neil is brilliant.

[Jean M]

I went through a MELBOURNE ortho called John O'Donnell -excellent! He later referred me to a sports physician called John Orchard (Sydney Uni Sports Medicine Centre). He was quite on the ball, and could point you in the right direction.

[Sportsfan]

I went through a MELBOURNE ortho called John O'Donnell -excellent! He later referred me to a sports physician called John Orchard (Sydney Uni Sports Medicine Centre). He was quite on the ball, and could point you in the right direction.


Yeah ive heard O'Donnell one of the best in Oz, just wondering if Sydney had any really experienced hip orthos as well....

[Jean M]

I've heard (through a work colleague) that Michael O'Sullivan is good. But I don't think he's had John O'Donnell's degree of experience.

[fuge19]

Dose Neil Halpin do any work down in melbourne. And dose any one know of any one who knows anything about osteitis pubis around melbourne?

[GuitarCrazyo]

could be inflammation at the pubis symphasis. thats the cartiledge where your hips meet about an inch above your genitals. radiates pain and can get very serious. radiated pain into my left testicle for almost a year. i didnt train legs for 5 years because it was reoccurring after months off. keep your hamstrings, groin, and hip flexors flexible.

i wouldnt be stretching before you do legs or any other body part. your taking away all of the stretch reflex in the muscle which isnt good. take a rubber band and stretch the shit out of it and see how stable it is after. stretch when your done training.

[ben_1301]

Dose Neil Halpin do any work down in melbourne. And dose any one know of any one who knows anything about osteitis pubis around melbourne?

gday Fuge19 there r a few good Sports physicians who have a good understanding of o.p in Melbourne I see a Dr Michael Makdissi at olympic park sports medicine, http://www.opsmc.com.au/

What area of Melbourne are you in?