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Case Study: Anterior Hip Pain During Pregnancy

Background
Patient is a 29 year-old female (34 weeks pregnant) complaining of bilateral hip and pubic pain, both of which were more pronounced on the left side.  Pain was present during activities of daily living and while sleeping.  Patient reported being unable to sleep throughout the night for several weeks secondary to the discomfort.  Patient is a devout Crossfit athlete and, with certain modifications, has remained extremely active throughout the pregnancy, her first.  Patient’s medical history is otherwise unremarkable.

Key Findings

  • Hip extension within normal limits bilaterally
  • Limited hip adduction: positive Ober’s test bilaterally, soft end feel, resistance from posterolateral hip
  • 20 degrees hip internal rotation (left), 40 degrees hip internal rotation (right)

Interventions
Pt instructed to perform sequence 2-3x throughout the day, including before bed.
1. Wall Squat w/FA IR and Left Hip Shift: 3×5 breaths

2. Left Sidelying Adduction/IR with Right Abduction: 3×5 breaths

Results

  • Within session
    • Negative Ober’s test bilaterally
    • 40 degrees of hip internal rotation bilaterally
  • 24 hours later
    • No hip pain, decreased pubic pain
    • Able to “walk around and do errands all day for first time in a while”
    • Slept through the night without waking secondary to discomfort