Recognizing and Managing Snapping Hip Syndrome in Dancers

2018 ◽  
Vol 33 (4) ◽  
pp. 286-291 ◽  
Author(s):  
Esther C Nolton ◽  
Jatin P Ambegaonkar
Keyword(s):  
External Rotation ◽  
Neutral Position ◽  
Initial Management ◽  
Snapping Hip ◽  
Bony Prominence ◽  
Hip Abduction ◽  
Dynamic Ultrasound ◽  
Hip Flexion ◽  
Snapping Hip Syndrome ◽  
Flexion And Extension

BACKGROUND: Snapping hip syndrome (SHS) is a common hip pathology in dancers. SHS can be either internal or external, resulting from muscle tendon tightness from repetitive hip flexion and extension, accompanied with hip abduction and/or external rotation. Muscular tightness may cause the tendon to become taut and snap over a bony prominence during hip movement, leading to muscular weakness and reduced range of motion from pain. Because SHS is poorly identified and can present similarly to other hip pathologies, many SHS incidences are underreported or misdiagnosed. Though SHS can begin as a harmless popping sensation, pain can become severe enough to limit dancers’ activities and potentially result in the development of concomitant issues. EVALUATION: Physical examination for snapping hip includes moving the hip from flexion, abduction, and external rotation (FABER) into extension, adduction, and rotated to a neutral position. Dynamic ultrasound can also be used to study SHS, as using this method allows clinicians to observe the snapping tendon in real-time. Radiographs and magnetic resonance imaging may serve to rule out other differential diagnoses. MANAGEMENT: Conservative management through rehabilitative therapy is the standard for initial management. In severe cases, arthroscopic intervention may be useful in releasing tension in the pathological tendon. Active rest with training modifications should be attempted to mitigate further injury. CONCLUSION: Early and comprehensive examination and management can help to reduce SHS risk and potentially decrease the ability of this debilitating condition to derail a dancer’s career.

VIDEO: Dynamic Ultrasound for Snapping Hip Syndrome

2020 ◽  
pp. 1-1
Author(s):  
Benjamin D. Levine ◽  
Steven Kwong ◽  
Kambiz Motamedi
Keyword(s):  
Snapping Hip ◽  
Dynamic Ultrasound ◽  
Snapping Hip Syndrome

scholarly journals Lower-Limb Flexibility Profile Analysis in Youth Competitive Inline Hockey Players

2020 ◽  
Vol 17 (12) ◽  
pp. 4338 ◽  
Author(s):  
Antonio Cejudo ◽  
Víctor Jesús Moreno-Alcaraz ◽  
Mark De Ste Croix ◽  
Fernando Santonja-Medina ◽  
Pilar Sainz de Baranda
Keyword(s):  
Injury Risk ◽  
Profile Analysis ◽  
External Rotation ◽  
Ankle Dorsiflexion ◽  
Injury Incidence ◽  
Hockey Players ◽  
Hip Abduction ◽  
The Individual ◽  
Hip Flexion ◽  
Low Prevalence

During puberty, the growth of the bones is faster than that of the muscles, which may result in muscular tightness. Muscular tightness and asymmetry have been associated with an increase in injury incidence. The assessment of a joint range of motion (ROM) could help to identify athletes classified as high injury risk. The objectives of the present study were to describe the lower-extremity flexibility profile (LEFP) of youth competitive inline hockey players using the ROM-SPORT battery (I) and to identify muscular tightness and asymmetry (II). Seventy-four young players were examined for maximum passive ankle, knee, and hip ROMs. Muscle asymmetry or tightness was classified according to cutoff scores previously described. The LEFP of the 74 players was 10.8° for hip extension, 26° for hip adduction, 33.6° for ankle dorsiflexion, 38.6° for ankle dorsiflexion with knee flexed, 36.7° for hip abduction, 46° for hip internal rotation, 60.6° for hip external rotation, 65.1° for hip abduction with the hip flexed, 66.3° for hip flexion with the knee extended, 119.7° for knee flexion, and 133.7° for hip flexion. The individual analysis of the flexibility values identified tightness in all players for one or more movement, except for hip abduction. A low prevalence of asymmetries was observed (range: 5.4% to 17.6% of players) depending on the ROM.

Snapping Hip Syndrome: Systematic Review of Surgical Treatment

2017 ◽  
Vol 27 (2) ◽  
pp. 111-121 ◽  
Author(s):  
Gabriele Potalivo ◽  
Walter Bugiantella
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
General Population ◽  
Conservative Treatment ◽  
Invasive Procedure ◽  
Daily Activities ◽  
Peak Performance ◽  
Snapping Hip ◽  
Snapping Hip Syndrome ◽  
Flexion And Extension

The snapping hip (SH) syndrome is characterised by an audible snapping, often accompanied by pain, which usually occurs with the flexion and extension of the hip during exercise or ordinary daily activities. The causes of SH can be classified as external, internal and intraarticular. The prevalence of asymptomatic SH in the population is unknown and the incidence of symptomatic cases is not well-defined. The painless snapping in the hip is common in the general population; the symptomatic SH with debilitating pain and weakness is often seen in those who take part in activities such as ballet and running hurdles. The clinician's goal is to determine the cause and treat patients who have symptomatic SH so that they may return to their activities or to athletic peak performance. Most patients with SH can be treated conservatively. However, surgery may be indicated if the condition becomes chronically symptomatic. Arthroscopy may prove useful in the treatment of intraarticular lesions that are causing discomfort. Various techniques have been described with different grades of success. The aim is to achieve the least invasive procedure with the lowest potential complications that corrects the painful snapping, according to the patient's characteristics. The purpose of this systematic review is to clarify the results of the surgical treatment of SH, after the failure of the conservative treatment.

scholarly journals Assessment of Functional End Ranges of Lower Limb Joints in Positions Commonly Used for ADLs in India

2021 ◽  
pp. 64-71
Author(s):  
Niketa Patel ◽  
Lavina Rajesh Khatri ◽  
Lata Parmar
Keyword(s):  
External Rotation ◽  
Plantar Flexion ◽  
Cultural Practice ◽  
Lower Limbs ◽  
Rural And Urban ◽  
Ankle Joints ◽  
Hip Abduction ◽  
Hip Flexion ◽  
Age Range ◽  
Ankle Plantar Flexion

Background: In many countries of Asian continent, floor sitting is preferred instead of chair supported sitting. Indian population differs noticeably in its cultural practice and daily tasks which involves squatting and cross-legged sitting on the ground. Aim: The purpose of the study was to assess the functional end-ranges of the hip, knee and ankle joints in healthy Indian subjects in positions commonly used for ADLs in India which includes squatting and cross-legged sitting. Methods: 66 healthy subjects were recruited from rural and urban populations with age range 30-50 years. Joint ROM of the lower extremities was measured using Universal Goniometer. All the subjects were asked to acquire squat and cross legged positions which were graded. Results: Our results finding showed that the subjects in cross leg sitting grade 2 (independent CLS) had hip flexion ranges ≥1150, hip abduction ≥ 410, hip external rotation ≥ 420, ankle plantar flexion ≥ 460, p<0.005.  For squatting, grade 2 (independent squat) had hip flexion ranges ≥ 1130,p>0.005, Knee flexion ≥1200, p>0.005 and ankle dorsiflexion ≥150, p<0.005. Conclusion: From the results, it is suggested that squatting and cross-leg sitting multiple times a day can prevent the early closer of end ranges of the lower limbs.

scholarly journals Diagnostic value of ultrasonography in acute lateral and syndesmotic ligamentous ankle injuries

2020 ◽  
Author(s):  
Thomas P. A. Baltes ◽  
Javier Arnáiz ◽  
Liesel Geertsema ◽  
Celeste Geertsema ◽  
Pieter D’Hooghe ◽  
...  
Keyword(s):  
External Rotation ◽  
Diagnostic Value ◽  
Ankle Injuries ◽  
Anterior Talofibular Ligament ◽  
Neutral Position ◽  
Post Injury ◽  
Calcaneofibular Ligament ◽  
Tibiofibular Ligament ◽  
Anterior Inferior Tibiofibular Ligament ◽  
Dynamic Ultrasound

Abstract Objectives To determine the diagnostic value of ultrasonography for complete discontinuity of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL) and the anterior inferior tibiofibular ligament (AITFL). Methods All acute ankle injuries in adult athletes (> 18 years old) presenting to the outpatient department of a specialised Orthopaedic and Sports Medicine Hospital within 7 days post-injury were assessed for eligibility. Using ultrasonography, one musculoskeletal radiologist assessed the ATFL, CFL and AITFL for complete discontinuity. Dynamic ultrasound measurements of the tibiofibular distance (mm) in both ankles (injured and contralateral) were acquired in the neutral position (N), during maximal external rotation (Max ER), and maximal internal rotation (Max IR). MR imaging was used as a reference standard. Results Between October 2017 and July 2019, 92 acute ankle injuries were included. Ultrasound diagnosed complete discontinuity of the ATFL with 87% (CI 74–95%) sensitivity and 69% (CI 53–82%) specificity. Discontinuity of the CFL was diagnosed with 29% (CI 10–56%) sensitivity and 92% (CI 83–97%) specificity. Ultrasound diagnosed discontinuity of the AITFL with 100% (CI 74–100%) sensitivity and 100% (CI 95–100%) specificity. Of the dynamic measurements, the side-to-side difference in external rotation had the highest diagnostic value for complete discontinuity of the AITFL (sensitivity 82%, specificity 86%; cut-off 0.93 mm). Conclusions Ultrasound has a good to excellent diagnostic value for complete discontinuity of the ATFL and AITFL. Therefore, ultrasound can be used to screen for injury of the ATFL and AITFL. Compared with ultrasound, dynamic ultrasound has inferior diagnostic value for complete discontinuity of the AITFL. Key Points • Ultrasound has a good to excellent diagnostic value for complete discontinuity of the anterior talofibular ligament (ATFL) and anterior inferior tibiofibular ligament (AITFL). • Ultrasound can be used to screen for injury of the ATFL and AITFL. • Compared with ultrasound, dynamic ultrasound has inferior diagnostic value for complete discontinuity of the AITFL.

scholarly journals A CT study of the femoral and sciatic nerve periacetabular moving in different hip positions

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yagmur Isin ◽  
Onur Hapa ◽  
Yavuz Selim Kara ◽  
Ali Ihsan Kilic ◽  
Ali Balcı
Keyword(s):  
Sciatic Nerve ◽  
External Rotation ◽  
Periacetabular Osteotomy ◽  
Femoral Nerve ◽  
Neutral Position ◽  
Bony Landmarks ◽  
Level 3 ◽  
Hip Flexion ◽  
Level 2 ◽  
Different Levels

Abstract Background Femoral and sciatic nerves could be damaged during various stages of the periacetabular osteotomy. Changing the position of the hip could be the most effective way of preventing nerve injuries. The purpose of the present study was to investigate the distances of the nerves to various bony landmarks with different hip positions in computerized pelvic scanograms of healthy adults. Materials and methods Fifteen healthy male adults (30 hips) (age 30 ± 6) were included. Scans were performed at three different hip positions measured by goniometer (neutral “N,” flexion (30–45°) + abduction (30–45°) + external rotation (20°) “F” and neutral+ abduction (30–45°) + external rotation (20°) (Nabext) at three different levels (sourcil “1,” the middle of the femoral head “2,” and lower border of triradiate cartilage “3.” Results At the sourcil level, the femoral nerve was found to be the furthest distance from the anterior acetabulum in the neutral position compared to flexion or neutral plus abduction, external rotation (p < 0.001). For the sciatic nerve, at level 2, hip flexion resulted in a greater distance than in the neutral position (p = 0.001). For level 3, hip flexion caused a decrease in the distance of the sciatic nerve to the acetabulum compared to both neutral positions (N or Nabex) (p = 0.001). Conclusions During a pubic cut of the osteotomy, the femoral nerve moves closer to the anterior acetabulum wall with hip flexion or abduction plus external rotation. During an ischial cut, the sciatic nerve gets closer to the ischium with hip flexion while it moves away from the bone during retroacetabular cut. Level-III Study

Dynamic Ultrasound Imaging for the Iliotibial Band/Snapping Hip Syndrome

2015 ◽  
Vol 94 (6) ◽  
pp. e55-e56 ◽  
Author(s):  
Kai-Shiang Chang ◽  
Yu-Hsuan Cheng ◽  
Chueh-Hung Wu ◽  
Levent Özçakar
Keyword(s):  
Ultrasound Imaging ◽  
Iliotibial Band ◽  
Snapping Hip ◽  
Dynamic Ultrasound ◽  
Snapping Hip Syndrome

scholarly journals Are isokinetic leg torques and kick velocity reliable predictors for competitive success in taekwondo athletes?

2020 ◽  
Author(s):  
Pedro Vieira Sarmet Moreira ◽  
Coral Falco ◽  
Luciano Luporini Menegaldo ◽  
Márcio Fagundes Goethel ◽  
Leandro Vinhas de Paula ◽  
...  
Keyword(s):  
Peak Torque ◽  
Knee Extension ◽  
Group Differences ◽  
Hip Abduction ◽  
Competitive Success ◽  
Expertise Level ◽  
Hip Flexion ◽  
The Relationship ◽  
Hip Extension ◽  
Flexion And Extension

AbstractThe aim of the study was to analyzed the relationship between isokinetic knee and hip peak torques and Roundhouse-kick velocities and expertise level (Elite vs. Subelite) of Taekwondo athletes. Seven elite and seven sub-elite athletes were tested for kick kinematic, power of impact and for isokinetic peak torque (PT) at slow (60°/s) and high (240°/s) concentric mode. PTs were compared between groups and correlated with the data of kick performance. It was found inter-group differences in hip flexors and extensors PT at the isokinetic fast speed. The hip flexion PT at 60°/s and 240°/s were negatively correlated with the kick time (R = −0.46, and R = −0.62, respectively). Hip flexion torque at 60°/s was also positively correlated (R = 0.52) with the peak of linear velocity of the foot (LVF) and the power of impact (R = 0.51). Peak torque of hip extension at 60°/s and hip abduction at 240°/s were correlated with the LVF (R= 0.56 and R = 0.46). Discriminant analysis presented an accuracy of 85.7% in predicting expertise level based on fast torques of hip flexion and extension and on the knee extension velocity during the kick. This study demonstrated that hip muscles strength is probably the dominant muscular factor for determining kick performance. Knee angular velocity combined with hip torques are the best discriminators for the competitive level in taekwondo athletes.

scholarly journals Neuromuscular Training Improves Self-Reported Function and Single-Leg Landing Hip Biomechanics in Athletes After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095934
Author(s):  
Christopher Nagelli ◽  
Stephanie Di Stasi ◽  
Rachel Tatarski ◽  
Albert Chen ◽  
Samuel Wordeman ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Neuromuscular Training ◽  
Abduction Angle ◽  
Hip Biomechanics ◽  
Hip Abduction ◽  
Anterior Cruciate ◽  
Hip Flexion ◽  
Main Effects

Background: Neuromuscular training (NMT) has been shown to attenuate high-risk biomechanics in uninjured athletes. At the time that athletes return to sport after anterior cruciate ligament (ACL) reconstruction (ACLR), they demonstrate hip biomechanical deficits associated with injury to the reconstructed knee versus the uninjured contralateral knee. Purpose: The primary purpose of the study was to examine whether an NMT program can improve single-leg drop (SLD) landing hip biomechanics for athletes after ACLR. Secondarily, we compared the posttraining SLD hip biomechanics of athletes after ACLR with a control group of athletes who also completed the NMT program. Study Design: Controlled laboratory study. Methods: A total of 18 ACLR and 10 uninjured athletes were recruited and completed a 12-session NMT program. A knee-specific questionnaire and biomechanics of an SLD task was evaluated for each athlete before and after NMT. Paired t tests were used to compare pre- and posttraining International Knee Documentation Committee (IKDC) scores. Repeated-measures analysis of variance (ANOVA) was performed to assess the main effects and interactions of testing session × limb for the ACLR athletes. A 2-way ANOVA was conducted to quantify the interactions and main effects of group × limb. Results: There was a significant increase ( P = .03) in IKDC scores from pre- to posttraining. For the ACLR athletes, there was a significant session × limb interaction for hip external rotation moment ( P = .02) and hip abduction angle ( P = .013). Despite increases in hip external rotation moment, no significant changes from pre- to posttraining were observed for the involved limbs. No significant changes were observed for hip abduction angle of the involved limbs between training sessions. Significant main effects of session ( P < .05) revealed that athletes landed with greater hip excursion, lower hip flexion moment, and lower ground-reaction force after training. The posttraining comparison between the ACLR and control groups found no significant group × limb interactions for any of the hip kinematic or kinetic variables. A significant main effect of group ( P < .05) revealed that the ACLR athletes landed with greater hip flexion angle and hip external rotation moment. Conclusion: ACLR athletes demonstrated an improvement in SLD hip biomechanics and neuromuscular control after participating in an NMT program. Clinical Relevance: This evidence indicates a potential role for NMT to improve hip biomechanics during an SLD task so as to reduce ACL injury risk.

scholarly journals Comprehensive Lower Extremities Joints Range of Motion Profile in Futsal Players

2021 ◽  
Vol 12 ◽  
Author(s):  
Antonio Cejudo ◽  
Iñaki Ruiz-Pérez ◽  
Sergio Hernández-Sánchez ◽  
Mark De Ste Croix ◽  
Pilar Sainz de Baranda ◽  
...  
Keyword(s):  
Correlation Analysis ◽  
Range Of Motion ◽  
Knee Flexion ◽  
Injury Risk ◽  
External Rotation ◽  
Lower Extremities ◽  
Future Research ◽  
Bayesian Inferences ◽  
Hip Abduction ◽  
Hip Flexion

The purposes of this study were to describe the lower extremities joints range of motion (ROM) profile using a comprehensive approach in futsal players and to examine potential player position (goalkeepers vs. outfield players), competitive level (first [top] division vs. second division), number of playing years, sex (males vs. females), and bilateral (dominant limb vs. non-dominant limb) differences. A total of 72 male and 67 female elite futsal players from 11 clubs were measured of passive hip (flexion with knee flexed [HFKF] and extended [HFKE], extension [HE], abduction [HA], external [HER], and internal [HIR] rotation), knee (flexion [KF]) and ankle (dorsiflexion with knee flexed [ADFKF] and extended [ADFKE]) ROMs. Bayesian inferences exploring differences between player position, competitive level, sex and limb were made. A Bayesian correlation analysis was conducted to explore the influence of playing years on joints ROMs. The results showed no significant player position or competitive level related differences in any average ROM score. However, statistically significant sex-related differences were documented whereby female players reported higher hip and knee joints ROM average values than their male counterparts. Especially relevant were the proportions of males (72%) and players from teams engaged in the second division (61%) displaying limited HFKE ROMs. Likewise, around 35% of all players showed restricted ADFKF ROMs. In addition, approximately 21, 18, 22, and 25% of the futsal players were identified as having bilateral asymmetries (≥8°) for HA, HIR, HER, and KF ROMs, respectively. Finally, Bayesian correlation analysis did not report any significant association between years of playing futsal and ROM measures (all r values &lt; 0.34). The implications that these restricted HFKE and ADFKF ROMs and bilateral asymmetries in hip (abduction, internal and external rotation) and knee (flexion) ROMs caused by the practice of futsal may have on physical performance and injury risk warrant future research.

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