Case Study: a successful treatment of the Snapping Hip Syndrome

This article will demonstrates the successful treatment of a case of extra-articular Snapping Hip.

First let's see the symptoms: the patient was a runner used to running long distances.

The person changed the type of training from medium-long distances to short distances and very fast interval training. After some weeks of this new workout routine, the person started experiencing as he ran a "click" or snap at the level of the left Greater Trochanter. In a short time, hip pain developed as well.

At first it was necessary to exclude joint conditions. Placing the fingers on the Trochanter with the patient on the right side while bending the left leg, one could detect the snap was apparently caused by the tendon of Gluteus Medius / Gluteus Minimus. Since these tendons are separated by a Bursa from the Greater Trochanter, the constant friction had inflamed such a structure causing pain and bursitis.

The Tensor Fasciae Latae was a candidate. However, the structure appeared more posterior than the Tensor. But for completeness, it was decided to treat the three musclesGluteus Medius, Gluteus Minimus, Tensor Fasciae Latae.

Logically, what was needed was stretching the structures pulling the Femur into the Acetabulum.

In this case it is interesting to note that the main problem was not the referred pain from Trigger Points, but the contracture that caused motor dysfunction from completely mechanical causes, and bursitis due to friction of the tendon on the Greater Trochanter.

In general, the Trigger Points of the Gluteus Medius and Minimus are among the most common causes of pain in the Sacrum, buttocks and leg (sciatica, lumbago). But in this case the problem was also due to mechanical dysfunction caused by the extreme tension generated.

Gluteus Medius

The main Trigger Points of the Gluteus Medius are located in three areas of the muscle.

Trigger Point no. 1 is located medially in the muscle, ie toward the Sacrum. The referred pain extend along the side of the Sacrum in an area immediately above and below this bone.

Trigger Point no. 2 is located in the superior area the muscle. The pain extends primarily to the hip.

Trigger Point no. 3 is located in the lateral section of the muscle near the insertion to the Trochanter. The pain in this case paradoxically extends to the central portion of the Sacrum.

Gluteus Minimum

The main Trigger Points of the Gluteus Minimus are two.

Trigger Point no. 1 is located at the top of the muscle and refers pain along the posterior area of the thigh and outercalf.

Trigger Point no. 2 is located at the bottom of the muscle and refers pain to the hip and the lateral thigh and leg.

Tensor Fasciae Latae

The Trigger Pints of the Tensor Fasciae Latae are located towards the center of the muscle and refer pain to the Greater Trochanter, but the pain, in more severe cases, can extend to the outer knee.

Stretching

In addition releasing the Trigger Points, the therapy is also based on daily stretching of hip flexors and Gluteus muscles, since as we have seen, the problem is essentially mechanical in nature.