What is snapping hip syndrome?
Snapping hip syndrome occurs when a snap or click can be heard and felt around the hip joint as it moves.
This problem can be caused by structures inside the joint or structures outside the joint. The snapping sensation can be caused by tendons or muscles flicking over a boney prominence. It can also be caused by a small piece of bone or cartilage getting stuck inside the joint.
People who suffer snapping hips are typically young and athletic, with dancers being particularly affected.
Snapping hip syndrome may be painful or painless. If pain is felt it may be present in the outer aspect of the hip or the groin depending on what structure is causing the snapping.
Symptoms
People with this problem usually have a snap or click in the hip which may be loud enough to be heard by an observer. The snapping sensation may be either painless or painful.
The location of the pain may be in the outer aspect of the hip, the groin or in rare cases the pain may refer to the knee.
Occasionally, the sensation of the hip ‘popping out’ is described and is associated with the tough band of tissue that runs down the outer side of the leg (iliotibial band) flicking over the hip bone.
The pain and snapping will usually subside with rest.
Causes
This problem can be caused by structures inside the joint (internal causes) or structures outside the joint (external causes).
External causes
- The most common cause of snapping hip syndrome is excessive movement of the tough band of tissue that runs down the outer side of the leg (iliotibial band) over the boney point of the hip joint (greater trochanter of the femur). If this is the tendon causing the problem, then the pain will be felt on the outer aspect of the hip.
- The hip flexor (psoas muscle): this muscle runs down the front of the hip and helps to lift or flex the hip bone. If this is the muscle causing the problem, then the pain will often be felt in the groin.
- The tough ligaments that surround the hip joint (the iliofemoral ligaments) can also be a cause of snapping hip syndrome but this is a rarer cause.
Internal causes
Internal causes of this syndrome include mechanical catching from cartilage tears (labral tears) or loose bodies.
Risk Factors
Snapping hip syndrome due to external causes is most commonly seen in young athletes and dancers. The large range of movement required of athletes and especially dancers, may lead to a tendon near the hip moving excessively.
Risk factors for snapping hip syndrome caused by internal structures include osteoarthritis, femoroacetabular impingement and loose bodies.
Investigations
Clinical examination
Investigation of a snapping hip begins with a thorough medical history and examination. Your doctor will want to know how often the snapping sensation occurs and whether there is pain associated with the problem. If there is pain, they will want to know where the pain is.
The physical examination will involve moving the hip to see if the sensation can be reproduced and observed clinically.
Imaging
X-rays are not necessary if the diagnosis based on history and clinical examination findings is clear.
X-rays, may be helpful if the diagnosis is unclear or a bony cause is being considered.
Ultrasound
Ultrasound is a useful, noninvasive diagnostic tool because it may demonstrate changes in the muscles and tendons around the hip.
An MRI scan is usually not needed in this condition but may be reserved for cases that remain undiagnosed following the above investigations
Complications
Snapping hip syndrome can cause irritation to the structure causing the snapping, or irritation to the structure over which the snapping occurs. It can lead to:
- hip bursitis
- hip muscle strains
- hip muscle tendonitis
Treatment
Conservative management
People with this condition may benefit from a course of manual therapy and rehabilitation with a physiotherapist.
Occasionally, patients may require medications such as NSAIDs or simple pain medication. A corticosteroid injection may be beneficial for those who have persistent pain despite an adequate therapy program or those that have developed bursitis.
Surgical Intervention
Several surgical procedures are available for patients with persistent pain associated with a snapping hip that has not responded to conservative treatment. However, surgical intervention is rarely necessary in the management of this condition.
If surgery is necessary, it involves making small incisions in the tendon that is causing the snapping and reattaching it so that the tendon no longer causes the problem.
Seeking Advice
Your Family Doctor (GP)
Your Family Doctor will be able to diagnose and help treat your problem. He or she will be able to
- tell you about your problem
- advise you of the best treatment methods
- prescribe you medications
- and if necessary, refer you to Specialists (Consultants) for further treatment
Prevention
The primary method for prevention of snapping hip syndrome is maintenance of good flexibility and strength in the hip and pelvis.
This can be carried out under the guidance of a physiotherapist that specialises in exercise therapy.