Snap, Crackle & Pop

Is that Snapping Hips Syndrome? 

1. Internal Snapping Hip

When a tendon slides over a bit of bone, the result is a snap. This is by far the most common and usually caused by Iliopsoas slipping over a protrusion of the pelvis called the iliopectineal prominence or Rectus Femoris, your main quadriceps muscle moving over the head of the femur (your thigh bone).

Symptoms?

  • Popping when running, or when the hip is flexed more than 90degrees or rotates away from the body.
  • Popping with a sharp sudden pain at the front deep in the groin.
  • Pain worsens with activity
  • The original onset is vague and may have begun as a mild annoyance.

Treatment Required? Not always. If pain is present then yes as it is important to offload the irritated tendon and make sure the iliopsoas bursa isn’t involved but usually just lots of stretching and flexibility work should resolve the issue in a couple of weeks.

2. External Snapping HipThis is also when a tendon slides over a bit of bone but this time between the bone and the skin rather than deeper in the pelvis. This is still very common and usually caused by the ITB (iliotibial band) or Gluteus Maximus slipping over part of the top of the femur called the greater trochanter.

Symptoms?

  • Popping when the hip is flexing and extending e.g. when climbing stairs. Carrying heavy bags or playing golf or tennis makes this more prominent.
  • Popping with a sharp sudden pain on the outside of the hip. Sometimes this can be seen too.
  • The hip feels like it may pop out of its socket (it’s not, don’t worry!)
  • The original onset is vague and may have begun as a mild annoyance.

Treatment Required? More often than not, treatment is needed to nudge a patient in the right direction for rehabilitation. If pain is present then this is a must as your gait is likely to have been affected, which can lead to further problems down the line.

3. Intra-Articular Snapping Hip

This is a problem with the hip itself. Less common but not unheard and should always be treated professionally.Causes?

  • Acetabular Labral Tear – When the tough cartilage that rings the hip joint tears. Symptoms include snapping and pain in the groin area. The most common cause of intra-articular snapping hip.
  • Injury to articular cartilage – the surface of the joint is damaged causing aching deep in the hip, not always snapping.
  • Loose bodies in the hip – When a fragment of bone or soft tissue breaks away and gets trapped between the hip joint causing snapping or a vague locking sensation in the hip.
  • The original onset is usually traumatic and pain starts immediately.

Treatment Required? Yes, identifying what is going on with this form of snapping hip is important as the longer it goes on the longer term the effect on the function of your body.

These are the musculoskeletal causes of a snapping hip. There are other things that may cause a change in the biomechanics of the hip which may mimic this, from arthritis to infection to tumours. It is really important that these more serious causes of any pain you are experiencing is ruled out.

So if you are struggling, then our team is always here to help, whether that is on email, phone or in person.

HoHo..Oh. Back Pain Season, Part 3 – Driving Home For Christmas

Cars are often cited as a cause for aggravation of back pain. Rather than buying every contraption possible on the internet we have some simpler tips to help you get comfortable for your Christmas getaway…

1. Pick Your Car

All people are different shapes and sizes so if you are in the market for a new car try and take this into consideration too as some cars provide better care for your back than others. This might not help this Christmas but equally if you have the choice between your friend’s amazing Lamborghini to drive the length of the country vs. your own sturdy VW Golf then pick the one that will let you stand up straight without crying in pain at the end (I mean the Golf….definitely the Golf).

2. Prepare Your Space

Unless you are just popping to the next suburb for your Christmas lunch, the likelihood is you will be driving over an hour. So spend 90 seconds getting the seat you will be confined to more suited to you. Raise the back of the seat relative to the front, implement the lumbar support if there is one and raise the head rest so you can actually rest your head onto it.The problem is that the human body isn’t designed to spend long periods of time sitting down. Sitting down for long periods of time, combined with using your feet means you can’t support or stabilise our lower body, as we might when sitting in a chair. This leads to problems and lots of muscle fatigue, particularly in the lower back and hip flexors.

3. Take a Break

Taking a break to stretch your legs and your back (and your shoulders and your neck!) is as important as taking a break when you are tired. It adds a couple of minutes to your journey and will mean you don’t spend the first day of your trip fighting off the remnants of the ache.If you have found yourself reading this after you have arrive home from Christmas, come and see our team and we will help straighten you out!

We will be offline next week so we would like to wish all of our patients a very healthy Christmas and New Year. Thank you for being part of our clinic and we hope you have an injury free 2017!

Forward Head Posture

HoHo..Oh. Back Pain Season, Part 2

The head is heavy and balanced on top of the rather thin spinal column. The average head weighs somewhere between 8 and 12 pounds if it is balanced happily atop the spine. But if the head moves forward to any degree, the weight the spine has to cope with increases.

That extra weight can be a problem, because it adds the tension to connective tissues such as muscles, tendons, ligaments and fascia.

Forward head posture

Forward head posture, which is exactly what it sounds like, is one of the most common problems for the upright skeleton, especially with these days of walking and texting – AKA Text Neck

But if your head is forward trying to pull it back into a better position is not really the answer. You have to realign the rest of your posture to enable the head to move backwards. A simple three-step way to look at it is:

1. Chest Up
2. Shoulders Down
3. Chin Tucked In

If this doesn’t work in the medium term, we need to look further afield which is where Clinical Pilates comes in. This form of Pilates is a way to teach you how to recognise where your body is in space – a surprisingly difficult task – and enables the muscles to work appropriately and to take the tension away from the wrong muscles, ligaments and connective tissue and improve blood flow around the spine and neck and help you feel all round better.

If you would like to see Lucy or Claire at our London Bridge Clinic location for 1-2-1 clinical Pilates, please see the link here

Forward Head Posture Third Space Sports Medicine