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. 2007 Mar;51(1):23-9.

External coxa saltans (snapping hip) treated with Active Release Techniques: a case report

Andreo A Spina  1
Affiliations

External coxa saltans (snapping hip) treated with Active Release Techniques: a case report

Andreo A Spina. J Can Chiropr Assoc. 2007 Mar.

Abstract
in English, French

Background: The presence of painful coxa saltans (snapping hip) can be a debilitating injury for a competitive athlete, hindering both training, and performance. Considering the various potential etiologies, it often poses a diagnostic and management dilemma for health care practitioners and the success of treatment is often dependent on the practitioner's precise understanding of the cause. Although it is suggested by various authors that conservative therapy should be attempted before considering surgical management, little is known in terms of the most effective modes of manual therapy that should be attempted.

Case presentation: A case of chronic, external coxa saltans in a 16 year old competitive dancer treated with Active Release Techniques(R) is presented. The clinical presentation, differential diagnosis, management and rehabilitation of the case are discussed.

Conclusion: Active Release Techniques, or ART, is a soft tissue treatment method that focuses on relieving tissue tension via the removal of fibrosis/adhesion that develops in tissue that is overloaded with repetitive use. In this case of external coxa saltans, the underlying cause of the condition was increased tissue tension leading to increased friction of the proximal Iliotibial band (ITB) complex over the greater trochanter. Utilizing ART resulted in a complete resolution of this athlete's symptoms and may be a good treatment option for external coxa saltans.

Historique: Avoir des hanches à ressort (coxa saltans) peut s’avérer une expérience douloureuse et une lésion débilitante pour un athlète de compétition, nuisant tant à son entraînement qu’à sa performance. Tenant compte des diverses étiologies possibles, cette condition souvent pose un problème de diagnostic et un dilemme de gestion pour les professionnels de la santé et la réussite d’un traitement dépend souvent de la connaissance précise du médecin traitant cette affection. Bien que plusieurs auteurs suggèrent qu’on procède en premier lieu à une thérapie conventionnelle avant d’envisager une chirurgie, on en sait très peu sur les traitements manuels les plus efficaces qui pourraient être expérimentés.

Présentation du cas: On présente le cas d’une jeune danseuse de compétition, âgée de 16 ans, souffrant d’un problème chronique de hanches à ressort externes, traitée avec la méthode Active Release Technique®. On discute de la présentation clinique, d’un diagnostic différentiel, de la gestion du cas et du rétablissement.

Conclusion: Active Release Technique® ou ART est une méthode de traitement des tissus mous qui est axée sur le soulagement de la tension exercée sur les tissus en procédant à l’élimination de la fibrose/adhésion qui se développe dans les tissus en raison de l’accumulation de mouvements répétitifs. Dans le cas des hanches à ressort externes, la cause sous-jacente de la condition était l’accroissement de la tension des tissus menant à l’augmentation de la friction du système de la bandelette de Maissiat proximal sur le grand trochanter. Le recours à l’ART a permis de résoudre complètement les symptômes de l’athlète et pourrait s’avérer un bon traitement pour les hanches à ressort externes.(JACC 2007; 51(1):23–29)

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Figures

Figure 1a
Figure 1a
Starting position for the side lying test for external coxa saltans. Lying with the unaffected side down, the affected hip is passively adducted, then moved from full extension, to 90 degrees of flexion.
Figure 1b
Figure 1b
Ending position. As the ITB complex travels over the greater trochanter, the practitioner palpates for a click/snapping.
Figure 2a
Figure 2a
Start position for hip hiking exercise.
Figure 2b
Figure 2b
Ending position for hip hiking exercise.
Figure 3
Figure 3
ITB complex – published with permission – Primal Pictures © www.primalpictures.com
See this image and copyright information in PMC

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