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Written by Meagan Robichaud, PT, DPT
What is Snapping Hip Syndrome?
Have you ever noticed an audible “clicking” or “snapping” in the front or side of your hip? You may have a very common injury called snapping hip syndrome. Snapping hip stems from either your iliotibial band rubbing across the bone on the side of your hip or from your iliopsoas (hip flexor muscle) rubbing across the bone on the front of your hip, creating the snapping sound that can be so common for dancers to hear. Iliopsoas snapping hip syndrome is the more common of the two for ballet dancers and can effectively be treated with physical therapy and dance modification.
Causes:
Overuse: The iliopsoas muscle is a common muscle used in developpes, grand battements, and passes (think about how many of these you do in just one ballet class).
Iliopsoas tightness: this can stem from a pelvis that is more anteriorly tilted or from inadequate stretching of the hip flexor muscle.
How can it be related to low back pain?
Excessive iliopsoas tightness can place the pelvis in an anterior tilt which in turn will cause increased lumbar lordosis in the spine, or in other words will place your lower back in excessive extension. This motion can place stress on the bones of the lumbar spine and cause instability with dance. Many times, to account for this instability, a dancer will tense the muscles surrounding the lumbar spine and therefore cause tightness and low back pain on top of the anterior hip pain and snapping. If you are experiencing some low back pain especially with arabesque, it may be beneficial to consult with a physical therapist to examine your hips as the source of the pain.
Treatment:
A physical therapist will guide a dancer through a series of exercises that can help reduce tension and improve pain symptoms with dance such as:
Strengthening the hip musculature, focusing on the glutes in order to more effectively use the proper muscles during movements in dance
Strengthening the abdominal and core muscles as low back pain and excessive lumbar extension can stretch the abdominal muscles causing weakness and therefore requiring the lower back muscles to work harder, increasing tension and pain in this area.
Hip stretching program including psoas lengthening stretches
Dance modification to limit number of grand battements and developpes during ballet class to reduce repetitive stress on the psoas.
Deep Psoas Release:
A deep psoas release is performed by a physical therapist with the patient laying on their back. The psoas muscle can be palpated through the abdominal cavity and the PT will look for any trigger points or areas of tension. Then, through a series of active release techniques, such as marching in this position, tension and trigger points in this muscle can be effectively released. This technique has demonstrated immediate increases in psoas length following the treatment and has good potential to show long term results for a dancer. The image below demonstrates the immediate improvement following 1 session.
Prevention:
Perform a regular daily stretching program to maintain the mobility of your hips required for dance movements. Your physical therapist can help you create a program geared towards your needs.
Modify your dance repertoire when you begin to feel hip pain or tightness in order to reduce repetitive stress on the psoas muscle and decrease the risk of injury.
Establish a good dynamic warm up before dance that includes more than just stretching in order to activate your muscles and avoid dancing “cold”.
If you feel as though you have dealt with similar symptoms described in this post with no luck to improve them, please reach out to our dance medicine staff at Magna Physical Therapy! We are ready to help you maximize your function and mobility in dance!