Snapping Hip Syndrome
An audible clock or snapping sensation which may or may not be painful when the patients move the hip is known as snapping hip/coxa saltans or dancer’s hip. The snap is caused by the motion of muscles and tendons over the bony structures around the Hip joint.
The sound/sensation occurs during activities such as walking, getting up from a chair, swinging leg, or engaging in sports activities involving the hip. An estimated 5-10% of the population is affected but is more common among athletes and active young teenagers/adults. The annoying snap over time develops into inflammation of the bursae around the hip resulting in pain during activities of daily living.
Structures around the Hip joint
The hip joint is a large weight-bearing ball and socket joint. The ball is formed by the upper part of the thigh bone (femur), which fits into a socket formed by the pelvis (acetabulum). The socket is covered by tough tissue known as labrum, which seals the joint stabilizing it.
MRI of the hip joint showing various structures
The joint is also covered by ligaments that hold the joint in place. Tendons are tough tissues connecting muscles to the bones. Several tendons and muscles cross the Hip joint connecting the thigh bone to the pelvis. Bursae are fluid-filled bags that aid in smooth movement of the structures over the hip, providing a cushion.
Causes & Symptoms
Athletes such as runners, soccer players, and heavy weight lifters engaging in repetitive motion around the hip joint are usually affected.
Also, young adults and teenagers engaging in competitive or recreational activities such as ballet dancing or sports with repetitive motion often suffer from snapping hip.
Certain surgeries performed about the hip or intramuscular injections in the buttock muscle can lead to snapping hip syndrome. Some patients with anatomical variations and tight muscle tendons are predisposed to the condition.
Internal snapping
Snapping is caused by tendons passing in front of the Hip joint. The patients’ illicit audible snapping by bending and extending their affected hip, pointing at the area in front of the Hip with their finger. This type of snapping is due to the tendon of the iliopsoas and rectus femoris passing over the knobby head of the femur bone repeatedly.
External snapping
Patients usually report the visible movement of snapping of structures around the later side of the Hip joint. The iliotibial band (ITB) acts like a tight band moving from behind to front over the outer side of Hip while bending the hip.
The greater trochanter is a projection on the outer side of the Hip joint, the ITB when tight moves and accompanies a snapping sensation. Over time the bursae overlying the greater trochanter becomes inflamed and causes pain.
The hamstrings are a large group of muscles behind the Hip joint. The tendon can sometimes cause snapping sound when passing over the ischial tuberosity, also known as the sitting bone.
Intra-articular
Labrum tears and foreign bodies inside the joint capsule cause snapping of the Hip joint. Snapping is usually accompanied by a locking sensation. The labrum and lose bodies cause physical obstruction to the movement of the Hip joint in some positions of the hip.
Diagnosis
The doctor’s office visit involves a detailed history of the course of events and a physical examination. Diagnostic hip joint anesthesia injections may be used to differentiate and diagnose the cause of snapping.
Imaging modalities such as X-rays, USG scans, CT scans, or MRI arthrograms may be used to diagnose the cause of snapping.
Management
Depending upon the cause, treatment can be surgical or nonsurgical. Conservative or nonsurgical methods are usually the first line of treatment consisting of the following:
- Activities which precipitate the snapping are avoided or modified
- Painful bursitis is due to inflammation, which can be relieved with rest or user of over the counter medications such as Tylenol or Advil.
- Corticosteroid injections are usually helpful in relieving inflammation and pain.
- Physical therapy helps to strengthen the muscles around the hip, and stretching exercises relax the tight structures. Some of the exercises such as iliotibial stretch and piriformis stretch, can be performed at home.
Surgical procedures are used to correct the anatomical variations and relieve tight structures to treat snapping hip syndrome.
- Arthroscopic surgery is performed using a miniature camera, which is used to visualize the structures inside the hip which are projected on a big screen. The surgeon can guide miniature tools to relieve the structures or remove any loose bodies from the joint. The incisions are minute, and the procedure is daycare, patients walk home the same day.
- Open procedures are done where arthroscopic procedures cannot be performed. The incisions can be several inches long. The tight structures are released and repaired with prolonged recovery time.
Regardless of the treatment outcomes are good, and the majority of patients describe relief from symptoms. Schedule your visit with an orthopedic surgeon who specializes in arthroscopic procedures if you have any of the above symptoms.
Do you have more questions?
Can snapping hip syndrome lead to long-term damage or complications in the hip joint?
Snapping hip syndrome typically does not lead to long-term damage or complications in the hip joint, but persistent symptoms may affect quality of life and warrant further evaluation.
Are there different types of snapping hip syndrome, and how do they differ in presentation and treatment?
Yes, snapping hip syndrome can be classified into internal (intra-articular) and external (extra-articular) types, each with distinct causes, symptoms, and treatment approaches.
What diagnostic tests are used to confirm the diagnosis of snapping hip syndrome?
Diagnostic tests for snapping hip syndrome may include physical examination, imaging studies such as X-rays, MRI, or ultrasound, and occasionally diagnostic injections to localize the source of snapping.
Can snapping hip syndrome be treated without surgery, and what nonsurgical treatment options are available?
Yes, many cases of snapping hip syndrome can be successfully managed with nonsurgical treatments such as rest, activity modification, physical therapy, stretching exercises, anti-inflammatory medications, and corticosteroid injections.
Is surgery necessary for all cases of snapping hip syndrome, or are there specific criteria for considering surgical intervention?
Surgery for snapping hip syndrome is typically reserved for cases that do not respond to conservative treatments or when there is significant functional impairment or pain that affects daily activities.
What are the potential risks and complications of surgical treatment for snapping hip syndrome?
Risks and complications of surgical treatment for snapping hip syndrome may include infection, nerve injury, scar tissue formation, persistent pain, and failure to resolve symptoms.
How long does it take to recover from surgery for snapping hip syndrome, and what is the rehabilitation process like?
Recovery from surgery for snapping hip syndrome varies depending on the specific procedure performed and individual patient factors but may involve a period of immobilization followed by gradual rehabilitation to restore strength and mobility.
Can snapping hip syndrome occur in both hips simultaneously, or is it typically unilateral?
Snapping hip syndrome can occur unilaterally or bilaterally, with symptoms manifesting in one or both hips depending on the underlying cause and contributing factors.
Are there any specific exercises or stretches that can help alleviate symptoms of snapping hip syndrome?
Yes, targeted exercises and stretches aimed at improving flexibility, strengthening muscles around the hip joint, and correcting biomechanical imbalances can help alleviate symptoms of snapping hip syndrome.
What lifestyle modifications can individuals with snapping hip syndrome make to reduce symptoms and prevent recurrence?
Lifestyle modifications such as maintaining a healthy weight, avoiding repetitive movements that exacerbate symptoms, and incorporating proper warm-up and cool-down routines into physical activities can help reduce symptoms and prevent recurrence of snapping hip syndrome.
Can snapping hip syndrome be aggravated by certain activities or movements, and if so, which ones should be avoided?
Yes, snapping hip syndrome can be aggravated by activities or movements that involve repetitive hip flexion or extension, such as running, cycling, or certain dance movements. Avoiding or modifying these activities may help alleviate symptoms.
Are there any specific risk factors that predispose individuals to developing snapping hip syndrome?
Yes, risk factors for snapping hip syndrome may include participation in sports or activities that involve repetitive hip movements, tight hip muscles or tendons, structural abnormalities in the hip joint, and previous hip injuries.
Can snapping hip syndrome be a sign of a more serious underlying hip condition, such as hip impingement or labral tear?
Yes, in some cases, snapping hip syndrome may be associated with underlying hip conditions such as femoroacetabular impingement (FAI) or labral tears, which may require further evaluation and treatment.
How does the age of the individual impact the likelihood of developing snapping hip syndrome?
Snapping hip syndrome can occur in individuals of any age but may be more common in younger individuals, particularly athletes or dancers, due to increased hip mobility and participation in activities that stress the hip joint.
Can snapping hip syndrome affect athletic performance, and if so, are there strategies athletes can use to manage symptoms while continuing to participate in sports?
Yes, snapping hip syndrome can affect athletic performance by causing pain, discomfort, or limitations in movement. Athletes can work with sports medicine professionals to develop strategies for managing symptoms while optimizing performance, such as modifying training techniques or using supportive braces.
How does the severity of snapping hip syndrome influence treatment decisions, and are there different treatment approaches for mild versus severe cases?
Treatment decisions for snapping hip syndrome are influenced by the severity of symptoms and functional impairment. Mild cases may respond well to conservative treatments, while severe or refractory cases may require surgical intervention.
Can snapping hip syndrome cause referred pain or symptoms in other areas of the body, such as the lower back or knee?
Yes, snapping hip syndrome may cause referred pain or symptoms in other areas of the body, such as the lower back or knee, due to compensatory movements or altered biomechanics. Addressing the underlying hip dysfunction can help alleviate these secondary symptoms.
Are there any specific precautions individuals with snapping hip syndrome should take to prevent exacerbating symptoms during daily activities or exercise?
Yes, individuals with snapping hip syndrome may benefit from avoiding activities or movements that exacerbate symptoms, using proper body mechanics and posture, and incorporating regular stretching and strengthening exercises into their routine to maintain hip joint health.
Can snapping hip syndrome spontaneously resolve without treatment, or does it typically require intervention to improve symptoms?
Snapping hip syndrome may spontaneously resolve without treatment in some cases, particularly if it is caused by temporary muscle tightness or overuse. However, persistent or recurrent symptoms may require intervention to address underlying biomechanical issues.
How does the location of the snapping sensation (front, side, or back of the hip) influence the diagnostic approach and treatment plan?
The location of the snapping sensation in the hip (front, side, or back) can provide clues to the underlying cause of snapping hip syndrome and may influence the diagnostic approach and treatment plan. For example, anterior snapping may be related to iliopsoas tendon impingement, while lateral snapping may involve the iliotibial band or greater trochanter.
Can snapping hip syndrome be exacerbated by specific movements or positions, such as sitting for prolonged periods or climbing stairs?
Yes, snapping hip syndrome may be exacerbated by specific movements or positions that place stress on the hip joint, such as sitting for prolonged periods with the hip flexed or climbing stairs, which can increase friction or tension on the affected structures.
Are there any dietary or nutritional supplements that may help alleviate symptoms of snapping hip syndrome or support hip joint health?
While dietary or nutritional supplements alone may not directly treat snapping hip syndrome, maintaining a balanced diet rich in essential nutrients such as calcium, vitamin D, and omega-3 fatty acids may support overall musculoskeletal health and potentially reduce inflammation in the hip joint.
My name is Dr. Suhirad Khokhar, and am an orthopaedic surgeon. I completed my MBBS (Bachelor of Medicine & Bachelor of Surgery) at Govt. Medical College, Patiala, India.
I specialize in musculoskeletal disorders and their management, and have personally approved of and written this content.
My profile page has all of my educational information, work experience, and all the pages on this site that I've contributed to.
