Snapping Hip Syndrome
Hip Syndrome is a clinical entity that causes pain and snapping in
joint. There are several known causes, the most common being the iliotibial
band snapping over the greater trochanter. It can also be caused by
snapping of the iliopsoas tendon over the iliopectineal line, the iliofemoral ligaments
over the femoral head, the long head of the biceps femoris tendon over
tuberosity, as well as by certain intra-articular pathology.
The most common cause of snapping hip is when the iliotibial
band slides over the greater trochanter. This is common in ballet dancers
and runners. The gluteal muscles can also make a snapping sound as they go over
the greater trochanter. The psoas tendon
also causes snapping
hip as it passes over the hip joint,
producing pain with hip flexion. The question to ask is why is this happening?
The psoas tendon
is in the front of the hip
joint, the gluteal muscles are over the hip joint, and the iliotibial band
(tensor fascia lata) is on the side of the hip joint, yet all of these
structures are considered part of the problem? We don't think so! The typical
approach to Snapping Hip Syndrome is to blame it on overtraining and tight
muscles. So anti-inflammatories
shots are given and the athlete must immediately stop training. Some people
get better, some do not. The ones who avoid surgery get better. During surgery
the tendons that are "tight" are lengthened. Most do not do well
after this surgery. There must be a better way.
Hip joint ligament
weakness causes excessive movement of the hip
joint. Athletic events put tremendous strains
on the hip joint, especially those sports that involve collisions. Even sports
such as running
put 4.5 to 5 times the body weight through the joint with each step. It would
make sense that a long distance runner would eventually develop laxity in the
hip joint over the years. This ligament weakness in the hip would cause
excessive movement of the hip and thus the greater trochanter, since they are
connected. This excessive movement of the greater trochanter would then
encroach on the iliotibial band or gluteal muscles, causing a snapping sound.
If the hip joint laxity caused the hip to move forward it would encroach on the
psoas muscle, causing hip snapping with movement of this muscle (hip flexion).
It is easier to explain Snapping Hip Syndrome as one hip problem versus three
separate muscle problems. This also explains the dramatic results seen with
treating Snapping Hip Syndrome with Prolotherapy.
is our treatment of choice for Snapping Hip Syndrome because it gets at the root
cause of the problem, which is hip ligament laxity. Prolotherapy
to the posterior hip capsule and ischiofemoral ligaments generally resolves the
problem if the condition involves snapping of the iliotibial band or gluteal
muscles, because posterior hip laxity is involved in these conditions. In
psoas-muscle-related Snapping Hip Syndrome, the hip joint is moving anteriorly,
encroaching on the muscle. Prolotherapy to the anterior hip ligaments, namely
the iliofemoral ligament (Y ligament of Bigelow), will tighten the joint and
stop the anterior protrusion of the hip. Prolotherapy
is extremely effective at permanently resolving Snapping Hip Syndrome because
it repairs the underlying etiology of the problem, hip ligament laxity.
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