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.

Human Carpentry

Yesterday I went to watch a particularly interesting surgery – Sacroiliac Fusion using the Si-Bone implant system.  Essentially what happens is three triangular shaped titanium rods are chiselled through the joint to hold the back of the pelvis in place.

These patients are disabled with their pain before their surgery – manual therapy like osteopathy and physiotherapy had been done to exhaustion and wasn’t giving any lasting relief. However, after the surgery, these patients often “bound out of bed” (in the words of Mr Khai Lam, the surgeon performing the days surgery). A great result all round. Remarkable but the good news for the vast majority of patients is that surgery isn’t usually needed and a few visits to the good old osteopath or physiotherapist should get you the strength and movement back into your joints.

Have a look at the video for exactly how it is done (don’t worry, all animated not real life gore) and the picture for highly technical, yet remarkable carpenter-like equipment used during the procedure.

 

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

 

Don’t Shoulder The Pain

Shoulder and upper back pain are so endemic that our patients often report that it is so common to feel it that it has become ‘normal’. Just to be clear, shoulder aches and pains in everyday life should never be ‘normal’.

The postural muscles around the scapular and thoracic spine are prone to getting chronically tight in response to postural behaviours like sitting at a desk or slouching as they try to keep the upper back and rib cage stable. This tension is then felt in those low grade but sometimes agonising pesky aches and pains.

This video shows an easy release for these muscles that can be done anywhere so try it today and get friends and family who get bogged down by headaches to try as well – you’ll be amazed at the immediate results you can have if these muscles are tight!

For other stretches please see our YouTube Channel here.

STOP Foam Rolling Your ITB!

Foam rolling is painful at the best of times, but if you have been rolling your ITB you are a glutton for punishment with no benefit to you! The ITB is not a muscle so won’t respond to deep massage, what you need is to loosen the muscles that influence it, namely the TFL, Quads and Hamstrings.

This single stretch for your TFL is easy for anyone to do and takes half the time of foam rolling which I call a double win. For other stretches for your quads or hamstrings please see our YouTube Channel here.

Back to Basics

Your lower rib cage and middle back can take a lot of load which over time can lead to aches and pains which are hard to shift.

Here is a single stretch which can be done seated, standing or even on the move  so really no excuse not to be able to try it. Who knows, your back might even thank you for it!

Open Up & Stretch

Sitting is a sad reality of modern life. So if we can’t reduce the amount we sit for whatever reason, we can try and do somethings to counteract the effects.

This single hip stretch can open out the hips, stretch the quadriceps muscles and  prevent that joint restriction and muscle tension from causing more problems above in your back or below in your knees.

Bag Yourself NO Injuries

Bags are functional, beautiful, essential, but also sometimes painful? 

Carried incorrectly a bag of any size or shape can cause you pain – in your neck, shoulders and back mainly. Your muscles have to work too hard and your joints start to ache.

However, it is possible to follow just three simple guidelines when carrying a bag to prevent this pain and allow you to carry the bag of your choice whenever you like! Hurrah!

Running Hot & Cold

Ice packs and heat packs are very useful tools in the management of acute and chronic injuries. However the advice about which pack to use when is often conflicting and inaccurate. 

This week our video explains why you use each, when and how to use them safely so you can get some first aid onto those injuries while you call our team for some specific treatment…

 

 

Eccentric Muscles?

Bad desk posture, and even moderately good desk posture can leave lasting effects, notably hunched shoulders, flexed neck and tight hips. This can often cause pain in the shoulders, back and neck as well as tight hamstrings and weak gluteal muscles. 

This week, the video consists of ONE single stretch-type exercise to help combat the pain of tendinitis and tendinopathies. It can be applied to almost any tendon in the body and can be done anywhere so there is no excuse not to at least try it!