HOW TO TREAT SNAPPING HIP SYNDROME SYMPTOMS : A SPORTS PHYSICAL THERAPY APPROACH TO TREATMENT & REHABILITATION
03 May 2021
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HOW TO TREAT SNAPPING HIP SYNDROME SYMPTOMS WITH SPORTS PHYSICAL THERAPIES

This snapping hip syndrome is an uncommon hip disorder; it is also called coxa saltans and dancer’s hip amongst physicians and sports therapy practitioners. Healthline specifies that the snapping hip syndrome may impact any person of all ages or genders but women are actually more prone to be harmed by SHS. Predominantly, this disorder is innocuous nevertheless it can inflict joint damage as its main risk. In more severe cases it may bring out a lot of pain which can decrease sports performance in athletes and execution in dancers. ChoosePT informs that the statistics of patients with SHS worldwide can reach around 5% up to 10% being the elite athletes such as runners, weight lifters, and footballers along with dancers the patients with higher prevalence.

So How can physical therapy help me to treat Snapping Hip Syndrome?

Sports physiotherapy is widely known as the means to achieve a full recovery from a sports injury, treat certain pathologies, and most importantly, prevent them. If you consider that you are suffering from this condition, you should go to the nearest sports physiotherapy clinic, remember that something that is not treated in time can go from mild to severe and harm you, even more, affecting your lifestyle’s quality considerably. At our MY Sports Injury Manchester Rehabilitation Centre we have highly trained staff such as our sports therapy Manchester practitioners, Acupuncturists, and deep-tissue therapists who will assess you and pinpoint which is the most appropriate treatment for your condition and in this case if you are going to require snapping hip syndrome exercises, always ensuring the physical and mental well-being of our patients.

How does Snapping Hip Syndrome sound like? Individuals who have been impaired by snapping hip syndrome usually can perceive a particular snapping sensation or sound coming from the front/ groin area, side, or back of their hips when walking, dancing, running, standing up, and weightlifting. It is like one or both hips are snapping or popping. This audible click is produced in the joint around the hip.

What is snapping hip syndrome? Anatomical point of view

 This snapping hip syndrome can occur in different areas of the hip where tendons and muscles slide over the hip bones. The most common site where it occurs is where the iliotibial band passes over the greater trochanter, which is a protrusion of the proximal femur.

Why does Snapping Hip Syndrome occur?  A publication of US National Library of Medicine National Institutes of Health - Understanding and Treating the Snapping Hip, a reliable journal, says when the hip flexes, the IT band moves or "jumps" over the trochanter. This movement of the iliotibial band over the greater trochanter produces the clicking sound and the “giving way” sensation typical of the pathology.

This pathology can eventually irritate the trochanteric bursa, causing bursitis, which is the inflammation of the bursa. Other tendons that can cause a dancer’s hip are the rectus femoris tendon, the hamstring muscles, or the iliopsoas tendon. A labrum injury can also cause symptoms of a snapping hip.

In the medical reference article, Snapping Hip Syndrome, it is mentioned that there are manifold causes of dancer’s hip and its classification is established by body structure that is the source of clicking sensation and soreness in acute cases. Two prime denominations of SHS have been classified:

·       Extra-articular SHS (either internal or external). A literature review Extra-Articular Snapping Hip reports a figure of 90% elite ballet dancers with SHS and 80% of these cases are bilateral. The incidence in women with SHS is quite remarkable from the teenage years. Being higher in comparison to adolescent men, where 12 young female individuals were diagnosed and just three boys were detected with SHS.

·       Intra-articular SHS.

What causes Snapping Hip Syndrome? WebMD explains that the SHS is the result of repetitive tension in the muscles and tendons that surround the hip.

·       People who participate in sports and activities that require repetition of hip flexion are more likely to experience snapping hip. Dancers are especially vulnerable.

·       Young athletes are also more likely to have SHS due to the additional stress on the muscles due to accelerated bone growth.

·       Acetabulum labrum injury.

How can Snapping Hip Syndrome be diagnosed? The diagnosis of Snapping Hip will be fundamentally clinical, trying to reproduce the click with various tests or specific manual techniques, examining whether the click comes from the hip joint itself or from the tissues that surround it, such as muscles or tendons.

What is the treatment for Snapping Hip Syndrome?

Sierra R. Musick et la (2020) most of the patients respond to conservative treatment, which consists of:

·       Rest; a period of rest and modification of activities helps control symptoms.

·       Physical therapy; exercises to stretch and strengthen the muscles around the hip, especially the iliotibial band. It may require the help of a physical therapist/ sports massage Manchester therapist. Physiotherapy and osteopathy treatment involves a global assessment of the subject. We will assess the mobility of the hip, both by excess and by default, of the musculature and all the structures that surround it. It can be very useful to achieve a good release of the adhesions of the tensor fascia lata / iliotibial tract concerning the vastus lateralis, up to the knee.

·       Corticosteroid injection.

It should be noted that conservative treatment with physical therapy in cases of SHS with mild to moderate pain is highly effective.

Is it necessary surgical treatment for Snapping Hip?

If sports physiotherapy management does not cure your Snapping Hip completely,your healthcare provider may recommend surgery which is known to be efficient in grave scenarios for this type of disorder. The type of surgery will depend on the cause of your SHS.The operation can be performed either with arthroscopy or open. The primary aim of the surgery is to eradicate the strain of the tendon to remove the snapping. Yi-Meng Yen, MD, PhD et la (2016).

At MY Sports Injury Rehabilitation Centre of Manchester City we will carry out a team and coordinated work between all the professionals of My Sports Injury Clinic (Sports physiotherapists, Personal trainers, Sports Therapist practitioners, Osteopaths amongst TCM Acupuncturists), and thus be able to achieve a complete functional and sports re-education

What are Snapping Hip Syndrome Exercises? Sports Physiotherapy Manchester

·      Stretch for quadratus lumbar fibers.

This has its variants to stretch the muscle fibers according to their orientation.Quadratus lumbar fibers stretching| Sports Physiotherapy Exercises | MY SPOTS INJURY CLINIC

·      Pyramidal stretch.

With these stretches, you work on the pyramidal and all the buttocks (major, middle, and minor), including the tensor fascia lata. However, the stretches below are best suited for the pyramidal muscle. Pyramidal stretch | Sports Physiotherapy Exercises | MY SPORTS INJURY CLINIC

·      Tensor fascia lata muscle stretch.

Standing next to a wall, with the injured side closer to the wall, lean on the hand on the same side, cross the good leg over the other leg keeping the affected foot flat on the floor and tilt the pelvis (hips) towards the Wall. Tensor fascia lata muscle stretch | Sports Physiotherapy Exercises | MYO

 

·      Long adductor muscle stretch.                              


Lying on your back, with your legs raised against a wall, we slowly spread our legs until we feel the adductor muscles begin to stretch. Long adductor muscle stretch | Sports Physiotherapy Exercises | MYO




 

·      Iliopsoas muscle stretch. 

The muscle is stretched on the side of the leg that is behind. Iliopsoas muscle stretch | Sports Physiotherapy Exercises | MYO



·      Sartorius muscle stretch.

The lower leg muscle is stretched. In this way, the leg that is above and that hooks the knee below must pull downwards (in the direction of internal hip rotation, with the knee previously flexed at least 90º). Sartorius muscle stretch | Sports Physiotherapy Exercises | MYO

Key points about Snapping Hip Syndrome, conclusions:

·      The snapping hip is the clicking sound produced in the joint or around the hip associated with added bursitis or the presence of muscle spasms.

·      A dancer’s hip can occur due to various factors: lower limb dysmetria, activities that require extreme and repetitive ranges of movements of joint range, the strain produced in the psoas muscle, and /or presence of bone alterations.

·      It is more common amidst women between 15-40 years, although there are also cases in men.

·      Only 30% of people with it present pain.

·      Symptoms: audible pop in the hip when performing movements of said joint, superficial lateral or deep anterior pain in the groin area, palpation of the femoral trochanter is painful, there is no pain unless exercise is performed.

·      Treatment: rest, cold, analgesics, and exercise program (warm-up, stretching, and eccentric exercises, especially in athletes).


Written by Rafael Peña for mysportsinjury.co.uk

 

 

 

REFERENCES

·       Nolton EC,Ambegaonkar JP, Recognizing and Managing Snapping Hip Syndrome in Dancers. Medical problems of performing artists. 2018 Dec;     [PubMed PMID: 30508831].

·       Yen YM, Lewis CL, Kim YJ. Understanding and Treating the Snapping Hip. Sports Med Arthrosc Rev. 2015;23(4):194-199. doi:10.1097/JSA.0000000000000095.

·       Nunziata A, Blumenfeld I. Snapping hip; note on a variety. Prensa Med Argent. 1951 Aug 10;38(32):1997–2001.

·       Lewis CL. Extra-articular Snapping Hip: A Literature Review. Sports Health. 2010 May;2(3):186-90. doi: 10.1177/1941738109357298. PMID: 23015936; PMCID: PMC3445103.

·       Musick SR, Varacallo M. Snapping Hip Syndrome. [Updated 2020 Aug 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.

·       Nolton EC, Ambegaonkar JP. Recognizing and Managing Snapping Hip Syndrome in Dancers. Med Probl Perform Art. 2018 Dec;33(4):286-291.

·       Potalivo G, Bugiantella W. Snapping hip syndrome: systematic review of surgical treatment. Hip Int. 2017 Mar 31;27(2):111-121.

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