Diagnostics
The diagnosis of snapping hip or coxa saltans can be made by a clinical examination of the patient. The hip is moved by the examiner until the symptoms appear. A palpation of the hip region is also necessary in order not to overlook an accompanying bursitis at the hip (Bursitis subcutanea trochanterica).
In this case, the area at the side of the hip is swollen and painful under pressure. In addition, the mobility of the hip is restricted by the pain. In addition, an X-ray of the hip should be taken to see bony changes.
An ultrasound examination or other imaging procedures can also be added to better visualize the tendons, bursae, etc. In particularly pronounced and unclear cases, the MRI examination of the hip is particularly valuable. MRI of the hip shows the soft tissues of the hip particularly well, i.e. it can show the tendons, the bursa and, with restrictions, the hip.
Therapy
First of all, an attempt should be made to alleviate the patient’s complaints (especially pain) using conservative therapy methods. If this does not lead to a lasting improvement, surgical treatment can be considered. These therapeutic concepts all aim to relieve the symptoms, but the cause is not eliminated.
Physiotherapeutic measures, the use of painkillers or the intake of preparations containing cortisone are applied. It is also possible to infiltrate the affected hip region with painkillers or similar to provide relief.Usually, the non-surgical therapy consists of the local or oral application of so-called NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or diclofenac or the injection of glucocorticoids into the bursa trochanterica, a bursa between the femur and the muscles that attach to it. Surgical therapy procedures for coxa saltans In principle, both forms of the snapping hip can be treated surgically.
The operation can be performed open or by arthroscopy of the hip. In internal coxa saltans, the psoas tendon is usually severed (tenotomy). In the external form, the tractus iliotibialis is often sutured to the greater trochanter.
After the operation, there is usually a reduction in strength in the area of the operated hip. With targeted physiotherapy, however, the function can quickly be taken over by other muscles. Of course, there are some risks associated with the operation, such as bleeding, infection, injury to nerves and lymphatic or blood vessels, as well as tendons with subsequent reduced mobility.
However, every patient is informed in detail about these risks before the operation.
- These therapeutic concepts all aim to relieve the symptoms, but the cause is not eliminated. Physiotherapeutic measures, the use of painkillers or the use of preparations containing cortisone are used.
It is also possible to infiltrate the affected hip region with painkillers or similar to provide relief. Usually, the non-surgical therapy consists of the local or oral application of so-called NSAIDs (non-steroidal anti-rheumatic drugs) such as ibuprofen or diclofenac or the injection of glucocorticoids into the bursa trochanterica, a bursa between the femur and the muscles that attach to it.
- Surgical therapy procedures for coxa saltans In principle, both forms of the snapping hip can be treated surgically. The operation can be performed open or by arthroscopy of the hip.
In internal coxa saltans, the psoas tendon is usually severed (tenotomy). In the external form, the tractus iliotibialis is often sutured to the greater trochanter. After the operation, there is usually a reduction in strength in the area of the operated hip.
With targeted physiotherapy, however, the function can quickly be taken over by other muscles. Of course, there are some risks associated with the operation, such as bleeding, infection, injury to nerves and lymphatic or blood vessels, as well as tendons with subsequent reduced mobility. However, every patient will be informed in detail before the operation.
Exercises can help to reduce the discomfort and pain.
However, it must be noted that the cause of the disease cannot be eliminated with exercises. It is generally recommended that the exercises be supervised by a physiotherapist in order to learn the technique of the exercise and to achieve the optimal effect of the exercise. Any exercise that trains stability in the groin, as well as the lower back and especially the thighs, is suitable for use with a Cox saltans.
Stretching exercises of the lateral thigh muscles can also help to reduce the complaints in the long term. Strengthening the lateral thigh muscles can be achieved, for example, by using so-called Thera bands. By moving the legs apart laterally against traction, either lying down or walking sideways, the crucial muscle groups are trained.
Likewise, when lying on the side in the forearm support, the critical muscle groups on the thigh and the important torso stability can be trained by repeatedly lifting the affected leg in a stretched position. You can read more information on this topic here: Leg muscle training – exercisesTaping is the application of a tape bandage, which should lead to a stabilization of individual muscle groups, but there are currently no meaningful studies on the use of a tape bandage for snapping hips. It is nevertheless to be assumed that the taping of the hip with a Cox saltans can lower the complaints within a certain framework.
Thus concerning, by the plant of the federation, the movement in the hip joint more strongly notice and a movement beyond the snapping point is possibly avoided. Side effects of the tape bandage can occur and should therefore be taken into account when considering the application of such a bandage. Skin irritations and sensations, as well as increased pain and itching, are more likely to occur than the benefits of the tape bandage.Whether a tape bandage is appropriate in an individual case can best be clarified in a personal conversation with an experienced doctor or physiotherapist. You can read more information on this topic here: Kinesiotape
