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Hi all

Does anyone have any experience of using lateral posting to treat a ‘clicking hip’(i.e. the iliotibial band catching on the greater trochanter)?

Regards

Tammy

 

Tammy:

If you are absolutely certain that it is the iliotibial band that is causing this clicking, and if the patient is experiencing pain in this area of the hip, then a more appropriate method of treatment would include 20 minutes of icing to the greater trochanter area twice daily, adduction stretching exercises of the hip to help lengthen the iliotibial band and also avoiding activities that could be causing irritation to this area of the lateral hip. Without further information regarding the history and physical characteristics of the patient, I wouldn't advise "lateral posting".....whatever that means!.

Please read http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=22144

 

Hi Kevin

Thank you for your feed back.

The idea behind a lateral wedge in this instance is to aid in internally rotating an externally rotated hip, this is not something I do or even intend to do, however a senior member of the bio-mechanics team I work with is a big fan of this technique, as this gentleman knows a lot more about the subject than I do, I really just wondered if anyone else had any opinions or experience of this technique?

Regards

Tammy.

 

Hi Tammy,

Can this senior member of your biomechanics team provide any evidence or research that a lateral foot wedge will internally rotate a hip?

Ian

 

Hi Ian

There is no research to prove this as far as I know, when I questioned the gentleman I work with I was told “it’s about having a box of knowledge which includes physics and anatomy and using all the resources at your disposal”, you know how some people just have a skill for making you feel 3cm tall he used it on me that day. I just wanted to be sure it wasn’t my lack of knowledge which sent alarm bells ringing over this issue.

Regards

Tammy.

 

Tammy


Give us some more details on your patient, When does the clicking occur, is it painful, what type of pain, onset. Does he/she supinate at the STJ during weight bearing? How is the hip externally rotated is there a compensated internal tibial torsion (antetorsion) or an external hip rotation (anteversion) due to tight soft tissues? Do they toe in or toe out, is there any torsional compensation at the malleoli? Any other diagnostic tests?

Usually ITB trauma are caused by tightness and movement that increases friction at local sites, such as ITB syndrome and GT bursitis and are reduced by physical therapy as described by Kevin and where appropriate orthoses that tend to invert the foot and externally rotate the knee and hip.

Cheers Dave

 

Hi Tammy!

I can't give you research on this, but in my 15 years of experience teaching Pilates, when a client experiences "clicking" or popping in the hip with movement, strengthening the pelvic floor muscles and increased lower core support, as well as focused exercises to improve hip mechanics will assist with this issue.

Contracting the pelvic floor for support during exercise helps to take the pressure off the hip joint, frees up the ball in the socket, and allows movement without the noise or aggravation.

With poor gait mechanics, a shortened stride, slightly posteriorly tilted pelvis, and overuse of the rec fem, the thigh bone is held to far to the front of the socket. Try to move the leg in a free range and it's not going to happen easily until the pelvis and hip muscles have a different relationship.

In my experience - this postural and mechanical use of the body is apparent in many if not most of the people who have walked through my door. And can quickly improve with an understanding of how to find and use the pelvic floor as well as exercises to get a better understanding of posterior/inferior ball & socket placement, how to more the ball in the socket, and how to move the socket around the ball. If the leg is working mechanically well from the hip, the foot and lower leg have a better shot at good mechanics too!

Thanks for letting me share my thoughts!

Aliesa George