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Snapping
Hip Syndrome
Ross Hauser, M.D.
This is the injury that has
plagued Joan Benoit Samuelson, the famous track star. Snapping Hip Syndrome is
a clinical entity that causes pain and snapping in the hip joint. There are
several known causes, the most common being the
iliotibial band snapping over
the greater trochanter (at the top of your thigh bone). It can also be caused
by snapping of the iliopsoas tendon over the iliopectineal line (in general
the pubic area of the hip bone), the iliofemoral
ligaments over the
femoral head (where the thigh bone connects to the hip bone), as well as other places
on the hip bone.
The gluteal muscles can also make
a snapping sound as they go over the greater trochanter. The psoas tendon can
also cause 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.
Hip joint ligament weakness
causes excessive movement of the hip joint 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.
In my opinion,
Prolotherapy is the 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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