The gait pattern is not impaired in subjects with external snapping hip: a comparative cross-sectional study

Background: Symptomatic external snapping hip is a painful condition, where pain in the trochantor region and limitations of daily activity dominate clinical findings. The aetiology of symptomatic external snapping hip is elusive, but previous studies have suggested that weakness of the hip abductors and an altered walking pattern may play a role in the development of symptomatic external snapping hip. The aim of this study was to compare the walking pattern and muscular activity of the hip muscles between subjects with symptomatic external snapping hip and healthy subjects. Methods: Thirteen subjects with diagnosed symptomatic external snapping hip (age: 25.5 years) were matched with 13 healthy subjects (age: 25.6 years). Joint kinematics and kinetics of the lower extremity were quantified by the peak hip adduction angle; the average knee rotation range of motion (ROM) and the peak valgus knee angle after data recording using a Vicon 612 motion capture system. Muscle activity was recorded bilaterally using surface electromyography (sEMG) on five muscles: gluteus maximus, gluteus medius, tensor fascia latae, rectus femoris and biceps femoris. A paired t-test was used to evaluate differences between the two groups. Results: No significant differences were found between the groups concerning the peak hip adduction angle, the average knee rotation ROM, and the static valgus knee angle. No significant between-group differences were found concerning all other kinematics, kinetics or muscle activity. In subjects with symptomatic external snapping hip activity of the gluteus medius muscle during the acceptance phase of walking was 0.58 +/- 0.19 whereas the activity was 0.68 +/- 0.07 in the asymptomatic group (p=0.115). Conclusions: No significant differences in the walking pattern were found between subjects with symptomatic external snapping hip and healthy subjects. This suggest that subjects with symptomatic external snapping hip does not have an impaired gait pattern.