Snapping Hip Syndrome

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photo credit: Dr. Nabil Ebraheim

by Janine Bryant for The Dance Journal

Hello, Readers!

After a 6-month hiatus whilst organizing a move to the UK for a new teaching post, Bryant’s Dance Medicine and Science continues with a ‘taster’ article regarding Snapping Hip Syndrome.

This information is presented as an abridged piece that will be published in its entirety for the IADMS Education Committee Blog in September. (International Association for Dance Medicine and Science) http://www.iadms.org/blogpost/1177934/General

I touched a bit on this syndrome back in September 2013, with a post entitled, ‘Plies, Popping and Power’, but would like to elaborate and provide more helpful information as well as encourage readers to refer to the full article at the above IADMS blog address this coming September.

Does this statement sound familiar to you? ‘My hip snaps or pops when I do grand battement or developpe´ devant or a´ la seconde. The snap sometimes presents with pain but sometimes not, and happens either on the up phase or down phase of the movement’. Dancers might also notice decreased range of motion through the sagittal or frontal planes.

Usually painless and harmless, a snapping hip is the result of a tendon or muscle passing over a bony structure. It occurs frequently in dancers in three ways:

1.) Lateral Snapping Hip (Iliotibial band syndrome), which is more common, involves movement of the IT (Iliotibial) band moving over the greater trochanter (large bony structure on the head of the femur) and also referred to as external snapping hip syndrome. A clue to diagnosis of this condition is the inability to adduct past anatomic neutral.

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Photo credit: sportsandspinalphysio.com.au

2.) Anterior Snapping Hip presents as a more internal kind of clicking or snapping, as the iliopsoas tendon passes over the iliopectineal eminence on the front of the pelvis or pelvic brim. This can be caused by inflammation of the bursa that lies between the front of the hip joint and the iliopsoas muscle.

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Photo credit: sportsandspinalphysio.com.au

3.) Intra-Articular Snapping Hip (intra-articular meaning inside the joint) results from a labral tear or capsular instability caused by muscular imbalance, skeletal inconsistencies, or previous injury to the hip joint. Dancers with this condition may experience decreased range of motion in the hip and a painful click directly inside the joint.

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Photo credit: spineandsportsmed.com

Treatment: If there is no pain with the snapping or clicking, there is no need for treatment, although I recommend keeping the hip joint stretched via some non-weight bearing flexibility exercises to develop smoother biomechanics.

Please refer to the examples below, however, all conditions, especially painful ones, should ALWAYS be assessed by a physician or clinician for restrictions in the joint and the soft tissue. Strength and/or flexibility deficits should also be checked by a qualified physician or athletic trainer. In the Philadelphia area, I highly recommend Dr. Marc Harwood at Rothman Institute, consultant to the Pennsylvania Ballet, University of the Arts School of Dance, Eastern University Dance Department, to name a few, and fellow IADMS member.

Dancers may need to temporarily reduce rehearsal/class regimen as part of recovery/management of the syndrome. NSAIDs (non-steroidal inflammatory drugs) could assist with pain and decreasing inflammation and edema (swelling).

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Photo: reaperes.tistory.com

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Photo: reaperes.tistory.com

Snapping or clicking hip is common in dancers and athletes who regularly move through range of motion extremes, experience some degree of tendinitis, and repeat abduction of the legs above waist level. {1} With proper diagnosis and care, the condition can be addressed in a timely way so as to minimize loss of rehearsal and class time.

 

Until next time, dance healthy and strong!

Janine Bryant, BFA, PhD (ABD)
Senior Lecturer, School of Dance
The University of Wolverhampton, UK
J.Bryant@wlv.ac.uk
http://www.wlv.ac.uk/

Registered Safe In Dance International Certificate Provider
http://www.safeindance.com/

 

Resources:

  1. Keene S, Coxa Saltans: Iliopsoas Snapping and Tendinitis, Hip Arthroscopy and Hip Joint Preservation Surgery, 64(1), 2014.

International Association for Dance Medicine and Science: www.iadms.org

Rudolph Nureyev Medical Foundation website: http://www.noureev-medical.org/

Harkness Center for Dance Injuries: http://www.med.nyu.edu/hjd/harkness/

 

 

 

 

About Janine Bryant

Janine Bryant, Senior Lecturer in Dance, Faculty of Performing Arts at University of Wolverhampton in The United Kingdom. She originally hails from Pennsylvania, USA and was the former Chair of Dance and Director of the Dance Program at Eastern University in St. Davids, Pa. There she taught courses for Dance, Biokinetics/Kinesiology at the Loeb School of Education, as well as at the Campolo College of Graduate and Professional Studies. She has been teaching technique and choreographing classical and contemporary ballets for more than twenty years.

Janine received her B.F.A. in Modern Dance from the University of the Arts in 1986. Janine is an active member of the International Association for Dance Medicine and Science and was recently added to their Peer Review Board, Poster Judging Committee and Education Committee. Janine also is a member of PAMA (Performing Arts Medicine Association) and is currently earning her PhD in Dance Medicine and Science from The University of Wolverhampton in the United Kingdom.

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