Snapping Hip syndrome Rehab

[Keilani Gutierrez]

okay, this has kind of been(not ironically) popping up now that i've foam rolled my quads and close to the hip. 

 

is there anything from F1 or extra i can implement beside frog presses? 

 

I was just finishing my warm up and literally, every step I took in lizard walk, my right hip kept clicking and clacking and yesterday while doing RC/PE1>iM I was getting a deep bothersome discomfort in my right hip socket. 

 

this is annoying. really annoying. 

 

edit: it was also occuring on the prone leg lifts. 

[Jon Douglas]

I've recently got some popping from hips doing straddle-ups (a lot of them) an have been refining the compression by lying on my back (with PPT-- lower back into floor) and doing that half of the lift. This is even gentler than the hanging version, and over the course of a couple of days has cleared the sound. YMMV

[Keilani Gutierrez]

I don't have it in the illiotibial band, it's happening internally where the illiopsoas tendon inserts into the femur. 

 

it's driving me nuts at this point (used to click every once in a while before rolling, now it happens every other extension)

[Jon Douglas]

Oh I see. Different problem

[Keilani Gutierrez]

something entirely new started happening on todays workout. 

 

mn/pe1 felt challenging, i couldn't get my legs all the way to the floor and PPT felt harder to hold.

 

SL/pe1 engaged my glutes harder but on every leg lift, i had a pop on the right side of my pelvis. 

 

on SLS/pe1, there was zero hip popping, even when focusing on hip extension and recruiting my glutes the best i could.

 

then when i started doing dumb bell swings as my cool down, i couldn't do a rep where i didn't create a pop. so after 5 reps, i discontinued the cool down and just went straight to do wall extensions instead.

 

this is extremely annoying and im dumbfounded. up until a few weeks ago, i was blowing through mn/pe1 week 5-6-7 progressions and now week 5 was hard? unbelievable. could this be due to opening up an entirely new range of motion? i dont know or have the slighest idea. 

 

I'm gonna visit my quiro to see what he recommends for the snapping hip. hopefully it isn't anything serious. 

[Michael Böhme]

sounds like coxa saltans interna ( i´m PT )

coservative rherapy :

- hard to alleviate

- maybe  ultrasound therapy will help

- manual release technique for iliopsoas  and related fascial structures

 

http://www.mcworthopaedics.com/pdf/hoch-anne/internal-snapping-hip-syndrome.pdf

 

 

 

http://www.msdlatinamerica.com/ebooks/PracticalOrthopaedicSportsMedicineArthrocopy/sid422645.html

[Keilani Gutierrez]

I love you. thank you for the resources!

last night i was doing frog presses and something fell in place when I was getting in bed and today i've felt pretty good.

i'll read up on this later today after work

again, thank you and the gesture is greatly appreciated^_^

[Joshua Naterman]

something entirely new started happening on todays workout. 

 

mn/pe1 felt challenging, i couldn't get my legs all the way to the floor and PPT felt harder to hold.

 

SL/pe1 engaged my glutes harder but on every leg lift, i had a pop on the right side of my pelvis. 

 

on SLS/pe1, there was zero hip popping, even when focusing on hip extension and recruiting my glutes the best i could.

 

then when i started doing dumb bell swings as my cool down, i couldn't do a rep where i didn't create a pop. so after 5 reps, i discontinued the cool down and just went straight to do wall extensions instead.

 

this is extremely annoying and im dumbfounded. up until a few weeks ago, i was blowing through mn/pe1 week 5-6-7 progressions and now week 5 was hard? unbelievable. could this be due to opening up an entirely new range of motion? i dont know or have the slighest idea. 

 

I'm gonna visit my quiro to see what he recommends for the snapping hip. hopefully it isn't anything serious. 

I think I'm going to need to explain some stuff in a video to help you, which I don't have time for right now, but here's my opinion in text:

 

Your body is not properly stabilizing the hip with all of the deep "rotators," and as a result the psoas complex is being called upon for too much work. Without the other muscles doing their job as they should, the bones are in a slightly different position and this causes the bone and tendon to line up and... pop.

 

Some positional isometrics can make a HUGE difference, but that's a completely different thing from stretching. The entire idea is to re-condition your recruitment thresholds for these muscles so that your body will actively use them again. That is what Muscle Activation Technique is all about, and it works really well. Positional isometrics are one half of the technique, and you basically put the desired muscle into a shortened position and use just enough force, in the correct orientation and direction, to cause just that one muscle to fire. Believe it or not, this will actually happen. As you can imagine, it is a very light contraction, but over time you learn to feed more force into that muscle without activating others.

 

I believe, but do not know for sure, that this is representative of a lower activation threshold being established for the motor units you are using, largely as a result of re-educating the afferent structures and inter-neurons.

 

What I do know is that this works. I have seen it work on my girlfriend, and I have been through it personally as well. I have been using these principles to rapidly re-educate my body, and it is a really handy tool. 

 

 

 

The REAL magic happens when you combine cyclically stretching (which deactivates the muscles) and using the MAT work to re-activate them. It seems to take about 30-60 minutes to get a specific muscle group to where it basically can't be completely inhibited. I don't mean that it's tight all the time, I basically mean that your body cannot easily lose the ability to call the muscle group into action when appropriate.

 

It is fascinating, and is completely based on the most current neuroscience. They are even very good about adjusting the application of the technique as neuroscience develops in this area.

[Michael Böhme]

hi Josh , Basically your explanation of etiology of those symptoms sounds good .

- first of all the internal snapping hip (synonym is psoas impingement) occurs only , when you move  the leg as free leg , it doesn´t happen , when you move it as supporting leg ( closed chain )

-  this could show that  the activation of the hip stabilising muscles ( Ab-and Adducturs plus deep rotators) in closed chain prevents the   psoas  from gliding over the emininentia iliopubica .

 

---> maybe consequent strengthening of these muscles could help

- dunno about MAT , but i have several ideas , how to activate those muscles also in open chain movements  ..... ( for example using theraband  isometrically resisting abb/adduction and  internal/external rotation during concentric/excentric ASLR)

[Keilani Gutierrez]

there is no hurry for this, a side effect of these types of things happening are propelling my self education in a direction that i want to develop( if i feel something, i need to fix it in a way that is helpful and not some flight of fancy short term fix illusion of progress) 

 

from what i have to report since the last post i made, i've been learning to walk around with my pelvis engaged in the right orientation. it feels wierd, my body still wants to revert back to the APT, on the other hand, holding the neutral/PPT is now becoming simpler and simpler. 

 

I had a good rolling session with a golfball on my glutes and actively moved the tissues, while i held the trigger point and golfball stationary.

 

I felt good yesterday and today, i haven't been working out because i've been working in the office and on my car(8hrs+ standing up each day) and yesterday, i felt a little bit of tenderness/soreness on my right hip. 

 

despite this, i tried on several occasions to do a straight knee flexion to 90degrees and then glide it to my side as a side kick and then back behind me. i felt a whole new host of feelings, 1) there was smoothness upon moving my hip along that ROM whereas before i felt an "emergency brake" holding my leg movement back and then the pop once i started extending it behind me. there was no pop the 2-3 times i did this. 2) i have more ROM in extension now. I've been doing prone leg lifts in my warm up(3 sets of 5 in giant sets with no rest in between)

 

my hip is a little tender today, it doesn't hurt to walk around or feels as tender. I'm not feeling too well today but not sick, so i'll do some mobility and perhaps even my warmup and go take a dip in the ocean. I really need the connection with nature this week. 

[Joshua Naterman]

hi Josh , Basically your explanation of etiology of those symptoms sounds good .

- first of all the internal snapping hip (synonym is psoas impingement) occurs only , when you move  the leg as free leg , it doesn´t happen , when you move it as supporting leg ( closed chain )

-  this could show that  the activation of the hip stabilising muscles ( Ab-and Adducturs plus deep rotators) in closed chain prevents the   psoas  from gliding over the emininentia iliopubica .

 

---> maybe consequent strengthening of these muscles could help

- dunno about MAT , but i have several ideas , how to activate those muscles also in open chain movements  ..... ( for example using theraband  isometrically resisting abb/adduction and  internal/external rotation during concentric/excentric ASLR)

Thanks!

 

The crux of the other, more clinical half of MAT is palpation of the origin and insertion of each muscle you are trying to activate. You are typically only going to palpate one muscle at a time, particularly with something like the hip, and use an isometric exercise that is specifically targeting that muscle. The palpation is a simple ~0.25 second cross-fiber palpation on the origin and insertion. You'll want fingertip pressure, and you will want to actually reach in and get near the true insertion where possible. You don't want to use TOO much pressure, because that seems to inhibit the muscles. Done properly the sensation ranges from pain-free pressure to mild discomfort in most cases, though if a muscle is really inactive (or if the body has learned to be overly sensitive to the area) they can sometimes be quite painful, but not because you're using a ton of pressure.

 

After you palpate, which only takes a few seconds for something like quadratus femoris or pectineus, and maybe 10-15 seconds to properly hit something like gluteus medius and minimus, you will do a few sets of the isometrics. These are truly easy isometrics, in the sense that you are not trying to cause movement... just activation of the muscle you palpated.

 

I use this quite frequently for upper traps and serratus anterior.

[Keilani Gutierrez]

Thanks!

 

The crux of the other, more clinical half of MAT is palpation of the origin and insertion of each muscle you are trying to activate. You are typically only going to palpate one muscle at a time, particularly with something like the hip, and use an isometric exercise that is specifically targeting that muscle. The palpation is a simple ~0.25 second cross-fiber palpation on the origin and insertion. You'll want fingertip pressure, and you will want to actually reach in and get near the true insertion where possible. You don't want to use TOO much pressure, because that seems to inhibit the muscles. Done properly the sensation ranges from pain-free pressure to mild discomfort in most cases, though if a muscle is really inactive (or if the body has learned to be overly sensitive to the area) they can sometimes be quite painful, but not because you're using a ton of pressure.

 

After you palpate, which only takes a few seconds for something like quadratus femoris or pectineus, and maybe 10-15 seconds to properly hit something like gluteus medius and minimus, you will do a few sets of the isometrics. These are truly easy isometrics, in the sense that you are not trying to cause movement... just activation of the muscle you palpated.

 

I use this quite frequently for upper traps and serratus anterior.

let me know when you put up something like this in your channel and what you explained earlier with the MAT and Cyclical stretching. I get times where my ABH is solid and it will progressively go back to the ROM where it previously was and start over again. 

[Michael Böhme]

Here https://www.youtube.com/watch?v=HrH_Rqzu1KU is a late reply  .

Useful for anybody with snapping hip syndrome 

[Roman Jakob]

I just found an interesting article about the biomechanics of the "Snapping Hip syndrome".

 

http://www.katysays.com/snapping-psoas-hidden-tiger/