Limits...
Iliopsoas Syndrome in Dancers.

Laible C, Swanson D, Garofolo G, Rose DJ - Orthop J Sports Med (2013)

Bottom Line: Within this injured population of 653 patients, the incidence in female dancers was 9.2%, significantly higher than that in male dancers (3.2%).The mean age at the time of injury was 24.6 years.All patients responded to conservative treatment, and no patients required corticosteroid injections or surgical intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, New York, USA.

ABSTRACT

Background: Coxa saltans refers to a constellation of diagnoses that cause snapping of the hip and is a major cause of anterior hip pain in dancers. When the internal type is accompanied by weakness or pain, it is referred to as iliopsoas syndrome. Iliopsoas syndrome is the result of repetitive active hip flexion in abduction and can be confused with other hip pathology, most commonly of labral etiology.

Purpose: To report the incidence, clinical findings, treatment protocol, and results of treatment for iliopsoas syndrome in a population of dancers.

Study design: Retrospective case series; Level of evidence, 4.

Methods: A retrospective database review of 653 consecutive patients evaluated for musculoskeletal complaints over a 3-year period was completed. The diagnosis of iliopsoas syndrome was made based on anterior hip or groin pain, weakness with resisted hip flexion in abduction, or symptomatic clicking or snapping with a positive iliopsoas test. Patients identified with iliopsoas syndrome were further stratified according to age at time of onset, insidious versus acute onset, duration of symptoms, side of injury, presence of rest pain, pain with activities of daily living, and associated lower back pain. All patients diagnosed with iliopsoas syndrome underwent physical therapy, including hip flexor stretching and strengthening, pelvic mobilization, and modification of dance technique or exposure as required.

Results: A total of 49 dancers were diagnosed and treated for iliopsoas syndrome. Within this injured population of 653 patients, the incidence in female dancers was 9.2%, significantly higher than that in male dancers (3.2%). The mean age at the time of injury was 24.6 years. The incidence of iliopsoas syndrome in dancers younger than 18 years was 12.8%, compared with 7% in dancers older than 18 years. Student dancers had the highest incidence (14%), followed by amateur dancers (7.5%), while professional dancers had the lowest incidence (4.6%). All patients responded to conservative treatment, and no patients required corticosteroid injections or surgical intervention.

Conclusion: This is the largest series reported to date of iliopsoas syndrome in the dance population, treated noninvasively. This study supports that conservative treatment with nonsteroidal anti-inflammatory medication, activity modification, and a physical therapy regimen specific to the iliopsoas should be the primary treatment for patients with iliopsoas syndrome.

Clinical relevance: This study supports current literature and conservative treatment of iliopsoas syndrome diagnosis. Furthermore, this study gives specific information regarding incidence of iliopsoas syndrome in dance populations and provides a test for diagnosis and an algorithm for treatment.

No MeSH data available.


Related in: MedlinePlus

Treatment algorithm.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4555490&req=5

fig3-2325967113500638: Treatment algorithm.

Mentions: The FADIR test, consisting of hip flexion, adduction, and internal rotation, is typically used to diagnose labral pathology. In our patient population, this test was also found to be positive in approximately 50% of patients initially diagnosed with iliopsoas syndrome. With resolution of the iliopsoas syndrome, defined as a negative iliopsoas test, many of these patients also resolved the FADIR test, therefore avoiding the need for advanced imaging and possibly unnecessary surgical intervention. Patients who continued to have symptoms and a positive FADIR test after 12 weeks of conservative intervention for presumed iliopsoas syndrome received further workup, including radiographs and an MRI to evaluate for labral pathology, femoroacetabular impingement, or other causes of hip pain (Figure 3).


Iliopsoas Syndrome in Dancers.

Laible C, Swanson D, Garofolo G, Rose DJ - Orthop J Sports Med (2013)

Treatment algorithm.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4555490&req=5

fig3-2325967113500638: Treatment algorithm.
Mentions: The FADIR test, consisting of hip flexion, adduction, and internal rotation, is typically used to diagnose labral pathology. In our patient population, this test was also found to be positive in approximately 50% of patients initially diagnosed with iliopsoas syndrome. With resolution of the iliopsoas syndrome, defined as a negative iliopsoas test, many of these patients also resolved the FADIR test, therefore avoiding the need for advanced imaging and possibly unnecessary surgical intervention. Patients who continued to have symptoms and a positive FADIR test after 12 weeks of conservative intervention for presumed iliopsoas syndrome received further workup, including radiographs and an MRI to evaluate for labral pathology, femoroacetabular impingement, or other causes of hip pain (Figure 3).

Bottom Line: Within this injured population of 653 patients, the incidence in female dancers was 9.2%, significantly higher than that in male dancers (3.2%).The mean age at the time of injury was 24.6 years.All patients responded to conservative treatment, and no patients required corticosteroid injections or surgical intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, New York, USA.

ABSTRACT

Background: Coxa saltans refers to a constellation of diagnoses that cause snapping of the hip and is a major cause of anterior hip pain in dancers. When the internal type is accompanied by weakness or pain, it is referred to as iliopsoas syndrome. Iliopsoas syndrome is the result of repetitive active hip flexion in abduction and can be confused with other hip pathology, most commonly of labral etiology.

Purpose: To report the incidence, clinical findings, treatment protocol, and results of treatment for iliopsoas syndrome in a population of dancers.

Study design: Retrospective case series; Level of evidence, 4.

Methods: A retrospective database review of 653 consecutive patients evaluated for musculoskeletal complaints over a 3-year period was completed. The diagnosis of iliopsoas syndrome was made based on anterior hip or groin pain, weakness with resisted hip flexion in abduction, or symptomatic clicking or snapping with a positive iliopsoas test. Patients identified with iliopsoas syndrome were further stratified according to age at time of onset, insidious versus acute onset, duration of symptoms, side of injury, presence of rest pain, pain with activities of daily living, and associated lower back pain. All patients diagnosed with iliopsoas syndrome underwent physical therapy, including hip flexor stretching and strengthening, pelvic mobilization, and modification of dance technique or exposure as required.

Results: A total of 49 dancers were diagnosed and treated for iliopsoas syndrome. Within this injured population of 653 patients, the incidence in female dancers was 9.2%, significantly higher than that in male dancers (3.2%). The mean age at the time of injury was 24.6 years. The incidence of iliopsoas syndrome in dancers younger than 18 years was 12.8%, compared with 7% in dancers older than 18 years. Student dancers had the highest incidence (14%), followed by amateur dancers (7.5%), while professional dancers had the lowest incidence (4.6%). All patients responded to conservative treatment, and no patients required corticosteroid injections or surgical intervention.

Conclusion: This is the largest series reported to date of iliopsoas syndrome in the dance population, treated noninvasively. This study supports that conservative treatment with nonsteroidal anti-inflammatory medication, activity modification, and a physical therapy regimen specific to the iliopsoas should be the primary treatment for patients with iliopsoas syndrome.

Clinical relevance: This study supports current literature and conservative treatment of iliopsoas syndrome diagnosis. Furthermore, this study gives specific information regarding incidence of iliopsoas syndrome in dance populations and provides a test for diagnosis and an algorithm for treatment.

No MeSH data available.


Related in: MedlinePlus