2013 – Snapping hip syndrome

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By Erika Kruger Snapping hip syndrome (SHS) (coxa saltans, iliopsoas tendinitis or dancer’s hip) is characterized by an audible snap or click that occurs in or around the hip while walking, getting up from a chair, or swinging the leg around. It is a condition which affects mostly young athletes whose sport involves repetitive twisting such as dancing, gymnastics, horse riding and soccer. 1, 2) The condition is also known to occur with heavy weightlifting and excessive running where the cause is usually attributed to extreme thickening of the tendons in the hip region. 1) SIGNS & SYMPTOMS Patients typically present with reports of an audible snap or click in the hip, which may be either painless or painful. The location may be described as lateral (indicating the iliotibial band or gluteus maximus) or anterior and deep in the groin (indicating the iliopsoas tendon). Occasionally, the sensation of the hip subluxing or dislocating is described and is associated with the iliotibial band. Patients reporting anterior groin pain usually note that the pain is dull or aching in nature and is exacerbated by extension of the flexed, abducted, and externally rotated hip. The pain and snapping may subside with decreased activity and rest.  The duration of symptoms at presentation more commonly is several months or years rather than days or weeks.  The syndrome occurs most often in individuals aged 15-40 years and affects females slightly more often than males. 2,3) DIFFERENT TYPES OF SHS According to Dr Joseph P Garry, MD of the East Carolina University Brody School of Medicine, different biomechanical mechanisms are responsible for different types of SHS – the first involves the iliotibial band and/or the gluteus maximus and the second involves the iliopsoas musculotendinous unit. The condition is usually described according to the location of the mechanism namely external, internal, or posterior SHS. 2) Even more specific, clinicians also distinguish between lateral and medial external SHS. 1) Lateral external SHS Lateral external SHS is primarily caused by 1) subluxation of the iliotibial band over the greater trochanter of the femur or 2) the snapping of the outer border of the gluteus maximus over the greater trochanter. This normal action leads to SHS when one of these connective tissue bands thickens and catches with motion. 1) Popping occurs when the thickened posterior aspect of the ITB or the anterior gluteus maximus rubs over the iliopectineal eminence or the femoral head as the hip is extended. Lateral external SHS may result from an acute injury leading to subsequent bursitis, tendinitis, or biomechanical changes resulting in pain and discomfort. More commonly, SHS is the result of repetitive overuse. 2) It may also be associated with increased varus of the...

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2013 – Home care rehabilitation exercises for snapping hip syndrome

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Quadriceps stretch: Stand an arm’s length away from the wall, facing straight ahead. Brace yourself by keeping the hand on the uninjured side against the wall. With your other hand, grasp the ankle of the injured leg and pull your heel toward your buttocks. Don’t arch or twist your back and keep your knees together. Hold this stretch for 15 to 30 seconds. Repeat 3 times. Hamstring stretch on wall: Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you along the floor. Raise the injured leg and rest it against the wall next to the door frame. Your other leg should extend through the doorway. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat 3 times. Piriformis stretch: Lying on your back with both knees bent, rest the ankle of your injured leg over the knee of your uninjured leg. Grasp the thigh of your uninjured leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the injured side. Hold this for 15 to 30 seconds. Repeat 3 times. Iliotibial band stretch (standing): Cross your uninjured leg in front of your injured leg and bend down and touch your toes. You can move your hands across the floor toward the uninjured side and you will feel more stretch on the outside of your thigh on the injured side. Hold this position for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Iliotibial band stretch (side-leaning): Stand sideways near a wall, your injured leg toward the inside. Place the hand of your injured side on the wall for support. Cross your uninjured leg over the injured leg, keeping the foot of the injured leg stable. Lean into the wall. Hold the stretch for 15 seconds and repeat 3 times. Prone hip extension: Lie on your stomach with your legs straight out behind you. Tighten up your buttocks muscles and lift one leg off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10. Side-lying leg lift: Lying on your uninjured side, tighten the front thigh muscles on your injured leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight. Do 3 sets of 10. Source: Tammy White McKesson Provider Technologies...

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