A double-blind randomised controlled trial comparing two physiotherapy interventions to treat hip impingement.

The physiotherapy intervention will be delivered to participants in two consecutive 12 week phases. Phase I physiotherapy treatment (week 0-12), will consist of 6x 30 minute face to face physiotherapy sessions delivered fortnightly. Participants will also attend one 45 minute supervised gym session per week. Gym sessions will be semi-standardised and reflect the same program tailored to suit the individual within the face to face physiotherapy session and will be supervised by physiotherapists. Physiotherapy face to face treatment and gym sessions will consists of: i) manual hip mobilisation and stretching based on the persons clinical presentation addressing any assessed range of movement deficits in hip, knee and spinal joints; ii) hip muscle retraining tailored according to any assessed strength deficits with progression based on achievement of repetition and resistance goals in a semi-standardised strength program iii) trunk muscle retraining in same semi-standardised program iv) functional, proprioceptive and sports- or activity-specific retraining tailored to assessed sport or occupational loads within same semi-standardised program v) enhancing physical activity via a semi-standardised, 12 phase cardiovascular fitness program with progression based on achievement of training goal within set parameters for perceived effort and pain vi) education will be individualised and could include topics including exercise, weight loss if appropriate and appropriate stretching. The physiotherapist will supervise exercises during each face to face session for 15 minutes. The same exercise program will be performed independently at home two times per week for 30 minutes per session. An information and exercise manual will be provided to each participant as well as access to a mobile phone app which contains the home exercise program. Participants will be asked to record both the number of exercises completed and any associated symptoms for each exercise. They may record this in the app or in a paper, self-report diary if they prefer. Compliance with the home program will be reviewed at each visit, as well as use of medications and additional activity undertaken. Phase II physiotherapy treatment (week 13-24) consists of three 30min face to face treatment sessions (monthly) and continuation of the exercise program by attendance at a community gym three times per week., Face to face physiotherapy sessions will address any participant concerns regarding symptoms or their program and advise strength, functional and cardiovascular exercise progressions for the unsupervised gym sessions.