Snapping Hip Syndrome
Information about the causes of a snapping hip
What is snapping hip syndrome?
Snapping hip syndrome is a condition that is characterized by a snapping sensation, and often an audible 'popping' noise, when the hip is flexed and extended. There are several causes for snapping hip syndrome, most commonly due to tendons catching on bony prominences and "snapping" when the hip is moved.
What causes snapping hip syndrome?
There are three primary causes for snapping hip syndrome:
- Iliotibial Band Snap
The iliotibial band is a thick, wide tendon over the outside of the hip joint. The most common cause of snapping hip syndrome is when the Iliotibial band (or "IT band") snaps over the greater trochanter (the bony prominence over the outside of the hip joint). If this is the cause of snapping hip syndrome, patients may develop trochanteric bursitis from the irritation of the bursa in this region.
- Iliopsoas Tendon Snap
The iliopsoas tendon is the primary hip flexor muscle, and the tendon of this muscle passes just in front of the hip joint. The iliopsoas tendon can catch on a bony prominence of the pelvis and cause a snap when the hip is flexed. Usually when the iliopsoas tendon is the cause of snapping hip syndrome, patients have no problems, but may find the snapping annoying.
- Hip Labral Tear
The least common cause of snapping hip syndrome is a tear of the cartilage within the hip joint. If there is a loose flap of cartilage catching within the joint, this may cause a snapping sensation when the hip is moved. This cause of snapping hip syndrome typically causes a snapping sensation, but rarely an audible "pop." This cause of snapping hip syndrome may also cause an unsteady feeling, and patients may grab for support when the hip snaps.
Are any tests necessary to diagnose snapping hip syndrome?
An X-Ray is usually taken to confirm that there is no bony problem around the hip joint, but X-Rays are almost always normal with snapping hip syndrome. If the cause of snapping hip syndrome is thought to be due to a tear of the cartilage within the hip joint, an MRI may be obtained to look for evidence of this difficult to diagnose problem.
Is any treatment needed for snapping hip syndrome?
This condition is usually curable with appropriate treatment, or sometimes it heals spontaneously. If it is painless, there is little cause for concern.
Correcting any contributing biomechanical abnormalities and stretching tightened muscles, such as the iliopsoas muscle or iliotibial band, is the goal of treatment to prevent recurrence.
Referral to an appropriate professional for an accurate diagnosis is necessary if self treatment is not successful or the injury is interfering with normal activities. Medical treatment of the condition requires determination of the underlying pathology and tailoring therapy to the cause. The examiner may check muscle-tendon length and strength, perform joint mobility testing, and palpate the affected hip over the greater trochanter for lateral symptoms during an activity such as walking.
Surgical Treatment
If the patient does not respond well to medicine or physical therapy, or abnormal structures are found, surgery may be recommended.
Surgical treatment is rarely necessary unless intra-articular pathology is present. In patients with persistently painful iliopsoas symptoms surgical release of the contracted iliopsoas tendon has been used since 1984.
Physical Therapy
Both active and passive stretching exercises that include hip and knee extension should be the focus of the program. Stretching the hip into extension and limiting excessive knee flexion avoids placing the rectus femoris in a position of passive insufficiency, thereby maximizing the stretch to the iliopsoas tendon. Strengthening exercises for the hip flexors may also be an appropriate component of the program. Education, a non-steroidal ant-iinflammatory drug regiment, as well as activity modification or activity progression (or both) may be used. Once symptoms have decreased a maintenance program of stretching and strengthening can be initiated. Light aerobic activity (warmup) followed by stretching and strengthening of the proper hamstring, hip flexors, and iliotibial band length is important for reducing recurrences.
Conservative measures generally resolve the problem in 6 to 8 weeks.
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