T Nation

Snapping Hip Syndrome

Well, I’ve been having problems with this for years, but only today have I had it diagnosed. Thursday, I begin Physical Therapy.

I was wondering if any in the medical community had any knowledge about this, or if anyone in general had some tips, tricks, or ideas on how to get me back into the gym as soon as possible whilst avoiding any type of injury.

Thanks.

[quote]Vash wrote:
Well, I’ve been having problems with this for years, but only today have I had it diagnosed. Thursday, I begin Physical Therapy.

I was wondering if any in the medical community had any knowledge about this, or if anyone in general had some tips, tricks, or ideas on how to get me back into the gym as soon as possible whilst avoiding any type of injury.

Thanks.[/quote]

I made this post a while back; luckily, I was able to dig it up from the archives.

Snapping hip syndrome is somewhat of a garbage term, really.

Basically, it can be caused by a number of things, most commonly the ITB catching on the greater trochanter of the femur. In most cases, it’s associated with bursitis at any number of locations. There are both intra- and extra-articular causes. Here’s a list from “Sports Injury Management:”

Intra-articular causes:
-osteocartilaginous nodules in the joint’s synovial membrane (synovial chondromatosis)
-loose bodies
-osteocartilaginous exostosis
-hip subluxation
-negative joint capsule pressure

Extra-articular (more applicable to the problems noted in the article) causes:
-ITB friction syndrome
-catching of the iliopsoas over iliopectineal eminence on the medial aspect of the inferior ilium
-catching of the iliofemoral ligaments over the femoral head
-catching of the long head of the biceps femoris over the ischial tuberosity

Basically, you can count on a ton of stretching. Hopefully, they’ll recommend some myofascial work and/or ART as well.

[quote]Eric Cressey wrote:

most commonly the ITB catching on the greater trochanter of the femur.[/quote]

Thanks for the response. After the exam, this is almost word for word what he told me was probably wrong. He said that my overly-tight right ass cheek (his words, not mine) was contributing to the problem. He figures that therapy, ROLFing, and a lot of ibuprofen should minimize the symtpoms, but because of the build of my hips, and the tilt of my sacrum, I’m probably always going to have some problems in that area.

[quote]Vash wrote:
Eric Cressey wrote:

most commonly the ITB catching on the greater trochanter of the femur.

Thanks for the response. After the exam, this is almost word for word what he told me was probably wrong. He said that my overly-tight right ass cheek (his words, not mine) was contributing to the problem. He figures that therapy, ROLFing, and a lot of ibuprofen should minimize the symtpoms, but because of the build of my hips, and the tilt of my sacrum, I’m probably always going to have some problems in that area.[/quote]

Funny how he didn’t tell you to stretch on your own! Be careful with the ibuprofen, though (see recent forum discussion thread on DOMS for more info).

So who is this physical therapist that is going to losen up your ass cheeks?

I’m not a big fan of ibuprofen - I hate taking pain pills for any reason.

With regards to the flexibility, I thought I was flexible. I can do the splits then stand up and kick over my head (going forward and sideways), but my ass is too tight? Argh.

And the PT is, I understand, a short, pretty woman from Vietnam. Last time I saw her, she put me through hell.

Hey Vash, i dunno if this is relevant to you, but I also am pretty flexible, and it was in the process of getting there that gave me a lot of injuries.

I used to only stretch hamstrings and adductors. The result? Extremely tight hip flexors which gave me intense pain. When I introduced hip flexor stretches to my routine, all my symptoms disappeared and I could go back to training.

But I still wasn’t stretching my abductors. The result? Illiotibial band syndrome. Basically the outside of my leg was tighter than my inside, causing a poor fit for the tendons on the outside of my knee. So now I do lots of stretching there too.

If I had never stretched, I never would’ve run into these problems, but because I increased flexibility in certain ranges, and ignored others, it gave me imbalances which eventually, caused pretty yucky symptoms.

So these days, I try to stretch in 360 degrees, but i still have some problems because of my years of ill intentioned stretching.

Maybe you’ve done the same thing at some point. Something for you to think about. And 'luck, with both the therapy and the vietnamese mistress - i mean PT.

Hey Vash, i dunno if this is relevant to you, but I also am pretty flexible, and it was in the process of getting there that gave me a few injuries.

I used to only stretch hamstrings and adductors. This resulted in extremely tight hip flexors which gave me intense pain. When I introduced hip flexor stretches to my routine, all my symptoms disappeared and I could go back to training.

But I still wasn’t stretching my abductors. The result? Illiotibial band syndrome. Basically the outside of my leg became tighter than the inside, causing a poor fit for the tendons on the outside of my knee. It hasn’t caused pain exactly, but it’s not a good feeling at all. Especially under load. So now I do lots of stretching there too.

If I had never stretched, I never would’ve run into these problems, but because I increased flexibility in certain ranges, and ignored others, it gave me imbalances which eventually, caused pretty yucky symptoms.

So these days, I try to stretch in 360 degrees, but i still have some problems because of my years of ill intentioned stretching.

Maybe you’ve done the same thing at some point. Something for you to think about. It could be as simple as stretching in a range that you’ve ignored until now. 'luck with the therapy, and with the vietnamese mistress - i mean PT.

Thanks for the reply.

I think inflexibility at certain points is certainly a contributing factor. The funny thing is, I started stretching to correct certain imbalances (I was doing the same as you), but that’s about the time the symptoms really started to show.

I dunno. I got PT at 8 in the morning. This better hurt, or I’ll feel jipped.

Eric has an excellent reply as usual. I need to start saving some of those answers, as it would save me some typing .

Definitely stretch ITB/TFL frequently. The therapy should help to work out any trigger points or adhesions in the tissue. Obviously make sure they show you a good home stretching program. Check out Eric’s Feel Better for 10 bucks article, on how to use a foam roll to do some myofascial work at home.

Stop being such a tight ass :slight_smile:

Take care,

Ryan

Everybody has been giving some great advice and I’m sure the PT will give you some great stretching programs. I just recently did a short paper on ITB/TFL in my sports med. class and here are two websites that I had found for some resources.

http://www.runningtimes.com/04may/itb.htm

http://www.physsportsmed.com/issues/2000/02_00/fredericson.htm

Hope it helps. Best of luck.

[quote]Dr. Ryan wrote:
Eric has an excellent reply as usual. I need to start saving some of those answers, as it would save me some typing .

Definitely stretch ITB/TFL frequently. The therapy should help to work out any trigger points or adhesions in the tissue. Obviously make sure they show you a good home stretching program. Check out Eric’s Feel Better for 10 bucks article, on how to use a foam roll to do some myofascial work at home.

Stop being such a tight ass :slight_smile:

Take care,

Ryan[/quote]

Thanks for the reference - I’ll definetly check that out.

As for the tightness of my ass, it will NEVER change! I pinch pennies for a reason.

[quote]LevelHeaded wrote:
Everybody has been giving some great advice and I’m sure the PT will give you some great stretching programs. I just recently did a short paper on ITB/TFL in my sports med. class and here are two websites that I had found for some resources.

http://www.runningtimes.com/04may/itb.htm

http://www.physsportsmed.com/issues/2000/02_00/fredericson.htm

Hope it helps. Best of luck.[/quote]

Thanks for the links. Funny thing, the second link’s second exercise - that is one of the aggraviting motions in my lifting. Hellofathing.

Oh, doing this therapy won’t make me poverty-stricken-skinny like that guy in article #2, will it? I busted my ass (which makes me wonder why it’s so tight) to get from 105 to 205.

I should probably sleep now. First PT session at 8 in the morning.

Again, thanks to all, and please keep it coming - this thread might prove useful to more than just my tight ass.

Finished my first session today. Though, it wasn’t the therapist I saw last time. This one is about 5’9", blonde, tanned, willowy, and has a great smile.

And a rock on her finger bigger than my tight ass.

But, I digress. I now must do approximately 45 minutes of stretching and specific strengthening exercises for about the next three weeks. Also, it is advised I not lift weights, and no karate.

Hell, three weeks ain’t nothin’, to borrow a southern turn-of-phrase. I was out of commision for 15 months and eight days before - three weeks is my bitch.

Good to hear! Hope all goes well with your rehab. and in no time you will be ready to hit the gym again.