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  • Writer's pictureSuyi the physio

Do you have a noisy hip? Part 3: Intra-Articular "Snapping Hip"

In our final instalment of the noisy hip series - we’re going through intra-articular snapping hip syndrome (SHS). It is typically associated with structural abnormalities or injuries within the hip joint, such as a torn labrum, loose bodies, or hip joint instability.



The symptoms of intra-articular SHS may include:

  • Snapping or popping sensation within the hip joint during certain movements, such as hip flexion or rotation.

  • Pain or discomfort in the hip joint, which may be intermittent or persistent.

  • Catching or locking sensation in the hip joint.

  • Limited range of motion or stiffness in the hip.



Treatment for intra-articular SHS typically involves a combination of conservative measures and, in some cases, surgical intervention. The specific treatment approach depends on the underlying cause and severity of symptoms.


Conservative treatments may include:

  1. Rest and activity modification: Avoiding activities that aggravate the symptoms can help reduce inflammation and allow for healing.

  2. Physiotherapy: Working with a physiotherapist can help strengthen the muscles around the hip joint, improve joint stability, and address any muscle imbalances. Manual therapy techniques may also be used to improve joint mobility and reduce pain.

  3. Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) or pain medications may be prescribed to manage pain and reduce inflammation.


The efficacy of physiotherapy for intra-articular snapping hip syndrome can vary depending on the underlying cause, severity of symptoms, individual factors, and the specific treatment approach used.





Physiotherapy plays a crucial role in the management and treatment of intra-articular SHS, aiming to reduce pain, improve joint function, and address any contributing factors with the following strategies:


  1. Pain management: Manual therapy techniques such as joint mobilisation, soft tissue mobilisation, and myofascial release to reduce muscle tension and promote tissue healing.

  2. Range of motion exercises: These may include gentle stretching exercises for the hip flexors, hip rotators, and other relevant muscles to promote flexibility and reduce stiffness.

  3. Strengthening exercises: Strengthening the muscles around the hip joint is crucial for promoting stability and reducing stress on the joint. Physiotherapists can design targeted strengthening exercises to address muscle imbalances, improve biomechanics, and support optimal hip function. This may involve exercises for the hip abductors, adductors, extensors, and other hip muscles.

  4. Proprioception and balance training: Enhancing proprioception and improving balance can contribute to better joint control and stability. Specific exercises and activities to enhance proprioception and improve balance, can reduce the risk of further injury or joint instability.

  5. Functional training: Working on activities that replicate the demands of their daily life, work, or sports is crucial for rehabilitation. This helps ensure a smooth transition from rehabilitation to normal activities while addressing any specific functional deficits or movement patterns that contribute to intra-articular SHS.

  6. Education and activity modification: Education on proper body mechanics, posture, and ergonomics to minimise stress on the hip joint. Guidance on activity modification, teaching how to modify certain movements or activities that exacerbate symptoms.

If conservative measures are ineffective or if there are significant structural issues causing the SHS, surgical intervention may be considered. The specific surgical procedures vary based on the underlying cause and may involve arthroscopic procedures to repair labral tears, remove loose bodies, or address hip joint instability.


It is recommended to consult with a qualified physiotherapist who is experienced in hip conditions to receive a comprehensive evaluation and individualised treatment plan. They can assess your specific condition, provide targeted interventions, and monitor your progress over time to optimise the outcomes of physiotherapy for intra-articular SHS.


References


  • Cheatham, Scott W. PT, DPT, OCS, CSCS, NSCA-CPT; Cain, Matt MS, CSCS; Ernst, Michael P. PhD. Snapping Hip Syndrome: A Review for the Strength and Conditioning Professional. Strength and Conditioning Journal 37(5):p 97-104, October 2015. | DOI: 10.1519/SSC.0000000000000161


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