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Internal Snapping Hip Resulting from Minor Stress Fracture of L-4


#1

Currently I am 19 years old suffering with internal snapping hip syndrome.

I can pretty much always 100 percent count on my hip snapping when i bring it into flexion and externally rotate my leg outwards. I've been dealing with this since i was 16, when I went through a minor stress fracture in my L-4. Just 2 weeks later I started experiencing symptoms of internal snapping hip, and I've been trying relentlessly to fix it ever since. Treatment for my fracture was being put in a boston overlap brace about 2 months after the injury (had to get MRIs and catscans) and my orthopedist says the fracture healed completely.

I've been to numerous physios and chiropractors, tried egoscue online, and even tried a posture corrective exercise enthusiast who diagnoses me with "Anterior Pelvic Tilt', I decided to make this forum post because that seems to be a hot topic on here whenever I google it. It makes sense, I believe my internal snapping in my hip is being caused by my psoas, which is tight in people with anterior pelvic tilt. However I've been working on my tilt for 4 months, strengthening my core with planks, deadbugs, and strengthening glutes and hamstrings while stretching my hip flexors with no luck.

I cant find any research on stress fractures in the L spine and how that can affect surrounding musculature, but I want to know if I should continue to treat my dysfunctions as "Anterior Pelvic Tilt" or is there a bigger picture I should be looking at. No matter what I always find my psoas very tight, even though I am a very flexible person. Thanks in advance


#2

This is a 3-d situation bro.

People know about anterior pelvic tilt, which is a "front to back" problem.

Fewer people understand side to side pelvic tilt. You have a Psoas on BOTH sides. So if your "right Psoas?" (I'm not sure if this is the correct term) is tight, or tighter than the left, your hips will be tilted sideways, as well as front to back.

When the hips tilt sideways, one leg can start sticking out to the side, the knee can start to move in a different path, and the foot can turn out, or start to roll over, to the outside. Once your your body starts these faulty patterns, you can do all the deadbugs you want. But as soon as you stand up and start moving "wrong", you pull yourself right back into tightness.

Core/glutes/hamstrings/obliques are all good stuff to train.

But you may also need to Train your feet and ankles( if you have flat feet, or 1 flat foot, or 1 foot turned out.) Or your quads/vmo, step-up pattern if your knee is not moving right. Or maybe your adductors and abductors if they are not working together properly.

There is an ART guy named John Quint. Check him out on Instagram/ Youtube. He seems to have a good handle on these issues.


#3

Check out the videos from post 8 in this thread:

Listen to "The Westside Barbell Podcast, Episode 15: 50 most frequently asked questions."
-Question 1: How do I lengthen the Psoas?

Also check out episode 2 of the podcast on injury prevention. They talk hips in there somewhere.


#4

This is an old thread, and I haven’t posted here in years, but I am very interested in this.

For what it’s worth, I’m an orthopedic physical therapist.

I’d love to know some more information about this case. Where on the L4 vertebra was your fracture? Anterior aspect of the body? Transverse process?
Which hip is the one that’s causing you trouble?

Clinically, I tend to find more internal snapping hip/coxa saltans on the right side, so I suspect this to be the case. Due to normal patterns of human asymmetry, the sacrum and spine typically become oriented in a position of right rotation, causing a right hip internally rotated position, leading to a variety of pathologies that may be related to impingement of soft tissues, especially around the iliopectineal region.