Compression Fracture T11, T12, L1 16 months Post

[danielphysio]

Also, when she walks there is an audible clunk coming from the left hip or lower back which is quite worrisome for the client. Any ideas what could cause such an audible clunking noise?

[romygeorge]

Also, when she walks there is an audible clunk coming from the left hip or lower back which is quite worrisome for the client. Any ideas what could cause such an audible clunking noise?

I reckon the audible click could be from "hip snapping syndrome". Might be from slipping of iliopsoas over the lesser trochanter or tight IT band or gluteus maximus. It might be also due to acetabular tears or loose bodies in the joint. What movements bring on the clicking? Is it when hip is moving into flexion from extension? eg. climbing stairs? Or is it during pivoting movements?

Regarding the pain, one would expect she should have healed from her injuries considering the normal physiological healing time frame, but the pain resolution can take more time. I feel trying pool therapy and core stability exercises on a gymnastic ball would be useful as well.

Cheers

Romy

[KevinDeakins]

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[danielphysio]

Hi Romy,
Thanks for your reply, sorry it has taken me a while to reply, didn't realise someone had replied to my post.

The snapping occurs as you said, when the hip is moving from full range extension into the onset of hip flexion during the gait cycle.
Would you suggest stretching and manual therapy techniques for releasing iliopsoas and ITB? Plus strengthening of glute max/med?

Thank you
Daniel

[romygeorge]

Hi Daniel,

Thanks for your response. It appears that either the Gluteus maximus or IT band or both could be tight. You may need to single out the tight structures first and like you pointed out stretching would be a good option. However, I would also be interested to see if there are any biomechanical factors or foot wear factors contributing to the tightness. Also the client needs to be reassured especially if the clicking is painless/asymptomatic.