💥Snapping Hip Flexors💥
Internal snapping hips are very common, especially in young adolescents.
Some are quite innocuous. Some are debilitating.
Understanding it’s mechanism is fascinating.
⬇️ Here is how it occurs, and why conditioning it can work
What’s the snap? 💥
US, surgical and computational studies have suggested it is the Psoas tendon rolling/snapping over the anterior femoral head/hip capsule occurring when the hip is moved from a combined hip flexion, abduction and external rotation (FABER) back to neutral.
US studies suggests when the medial fascicle of iliacus muscle interdisposes itself with psoas tendon & the anterior femoral head and suddenly releases the psoas tendon back toward the bone once the iliacus muscle “squirts” (Lee et als word - not mine) back to its normal position
Check out this awesome video demonstrating the roll of the psoas tendon by @GSERRANOB_MSK
Size & shape matters. Several anatomical variations & pathologies can ⬆️ likelihood of snapping.
Excessive anteversion and underlying torsional femoral dysplasia appear to predispose it.
Microinstability, labral pathology, psoas tendon disruption, ligament tears are common.
REHAB: First the hip microinstability must be well controlled. Surgical
Issues resolved. Femoral head control is a must.
Then load, load, load.
Focussing on psoas and iliacus loading - especially the last 25% of of returning FABER to neutral - Audenaert et al 2020.
ISOMETRIC LOAD: Early.
Develop load tolerance through varying ranges of iliacus and psoas contractions
ISOMETRIC LOAD: End range hip extension.
Femoral head control and happy anterior hip labrum/capsule is a must prior to loading end range.
DYNAMIC LOAD: FABERS to neutral.
Varying the degree of external rotation can assist a confident return to the psoas tendon rolling.
Think of this like a graded exposure. 📊
Confidence in the hip is a must!
Overall, confidence in the last 25% of the return to neutral is a must.
Build strength, load tolerance and endurance into the psoas tendon and surrounding musculature.
And isn’t it’s mechanism fascinating🤓 👊🏻
Share this Scrolly Tale with your friends.
A Scrolly Tale is a new way to read Twitter threads with a more visually immersive experience.
Discover more beautiful Scrolly Tales like this.