Snapping Hip Syndrome
Snapping hip syndrome is a condition where you feel a popping sound or snapping sensation in your hip joint. It often affects highly active people and is usually harmless.
What Is Snapping Hip Syndrome?
Snapping hip syndrome is a condition in which you may sense something catching or hear a popping sound or click in your hip when your hip joint moves. If you put your hand over the hip area, you might feel or even see the snap happen when walking, running, bending or getting up from a sitting position. This condition can occur in one or both hips. It does not always cause pain.
What Are the Different Types of Snapping Hip Syndrome?
There are different names for snapping hip syndrome based on where it occurs.
- External snapping hip happens on the side of the hip where the boney part the hip joint sticks out a little. It is caused when the iliotibial (IT) band slides over the greater trochanter area. The IT band is a tendon that runs down the side of the leg. The greater trochanter is where the hip muscles come together and attach to the hip. It covers the top part of the thigh bone (femoral head) and hip socket.
- The snap occurs when the leg moves back and forth.
- A tight IT band or weakness in one of the hip muscles, such as the gluteus maximus (butt) muscle, can cause external snapping hip.
- Internal extra-articular snapping hip happens in front and just inside the hip. One of the hip flexor muscles, either the psoas major muscle or the iliopsoas tendon, slides over the front of the hip bone and catches.
- The snap occurs when going from a bent to a straight position. The affected flexor muscle stretches, gets caught on the hip bone, then snaps when it releases or slides back into place.
- The space between the hip flexor muscles and bone (the bursa) can become irritated and inflamed, leading to pain. This is called bursitis.
- Internal extra-articular snapping hip is a common overuse injury caused by a tight or inflamed (irritated) hip flexor or when muscle strength in the hip muscles are unequal, (one side is stronger than the other).
- Internal intra-articular snapping hip happens inside the hip joint. It can be caused by a tear in the cartilage lining of the hip or by debris floating inside the hip joint. Floating debris can come from either a piece of the lining of the hip or a piece of cartilage or bone breaking off from the femoral head.
Risk Factors
Groups at higher risk for snapping hip syndrome are:
- people who do sports that use the same muscles over and over, such as in soccer, running, gymnastics and dance
- young adults who have had recent growth spurts
- females
How Is Snapping Hip Syndrome Diagnosed?
The exam is the best way to diagnose snapping hip syndrome. The health care provider will:
- ask questions about when the snapping or pain happens.
- press on the hip area in different places while your child stays still and when they move their legs and knees.
- if needed, get an x-ray to make sure there are no other problems with the bones or hip.
How Is Snapping Hip Syndrome Treated?
- Rest - Usually the best treatment for snapping hip syndrome is rest. Your child should avoid motions that cause pain.
- Physical therapy (PT) - PT can help stretch and strengthen the muscles around the hip. The therapists may use massage and ultrasound (high frequency sound waves) to loosen tight muscles and tendons. Ultrasound can help muscles relax and is painless.
- Over-the-counter (OTC) medicines - OTC’s such as ibuprofen (Advil®) or naproxen (Aleve®) can help treat pain and reduce inflammation (swelling). Do not give aspirin.
- It is important to read the bottle and give the right dose for the age of your child.
- Give the medicine with food or water to help prevent stomach upset.
- Do not combine or double up on doses of pain medicines.
- Corticosteroids – To treat bursitis, sometimes the health care provider will use a syringe (needle) to inject anti-inflammatory medicine, a corticosteroid, directly into the area of pain. The needle is guided by ultrasound to know the exact place to give the medicine. This procedure is done in the doctor’s office or in the radiology department.
- Surgery - If none of the above treatments work, the doctor may suggest surgery. The options are:
- Make small cuts in the affected tendon to lengthen it. This gives more room for it to stretch over the hip bones.
- Go into the hip joint (arthroscopic hip debridement) to remove floating debris.
What to Do at Home
Snapping hip syndrome usually can be cured over time. To speed healing and prevent it from coming back, your child should:
- Do stretches before starting any physical activity. Stretch the muscles on the front, side and back of the hip. Repeat those stretches after you finish a sport.
- Develop a daily exercise routine to improve muscle strength and flexibility.
- Increase the intensity of a sport slowly. Do not push too hard, too fast or too soon. They should back off on the intensity if they feel pain again.
- Do different types of sports so that the same muscles are not used over and over again.
- Wear well-fitted shoes that give good support.
Helping Hands Patient Education Materials
Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.
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