Snapping Hip Syndrome is a condition in which a muscle, tendon or ligament rolls over a bony prominence in the hip resulting in a snapping or popping sound or sensation. This sensation is most commonly heard or felt when forcefully lifting, lowering or swinging the leg, which can make activities such as walking, running or even standing from a seated position difficult.
Snapping hip can occur in different areas of the hip, the most common include:
- Front:
Iliopsoas tendon – The iliopsoas muscle is a primary hip flexor, and the tendon of this muscle passes over the iliopectineal eminence on the anterior of the pelvis. This bony prominence can be a cause of snapping hip, when the iliopsoas tendon catches as the hip is flexed.
Rectus femoris tendon – The rectus femoris is one of the four muscles that make up the quadriceps muscle group. Its action is to extend the knee and assist with hip flexion. As the hip is flexed (bent up) the tendon of the rectus femoris shifts across the head of the femur. It is this back and forth motion that can contribute to the “snapping” sensation felt with snapping hip.
- Side:
Iliotibial Band (ITB) – The IT band is a wide tendon that runs down the outside of the hip joint to the knee. This tendon or band is the most common cause of snapping hip syndrome. The snapping sensation is felt or heard when the ITB snaps over a bony prominence on the outside of the hip known as the greater trochanter. Occasionally, people who have snapping hip syndrome caused by the ITB will also develop trochanteric bursitis due to irritation of the bursa.
Gluteus maximus – Similarly to the ITB, gluteus maximus is situated over the greater trochanter. Due to this orientation, the glut maximus may also be a source of snapping hip as the muscle contracts and causes friction over the bony prominence.
- Back:
Hamstrings – If the snapping sensation is felt in the back of the hip, the cause is most likely to involve the hamstring tendon. This tendon attaches to the ischial tuberosity, or the “sitting bone.” As the hamstrings are contracted and the tendon moves across the ischial tuberosity, the tendon may catch, which causes the snapping sensation.
- Torn Cartilage:
Labral Tear – The acetabular labrum is a ring of cartilage that lines the hip joint. In rare instances, this cartilage ring can become torn, which can be a cause of snapping hip syndrome. In some cases, this cartilage can become loosened and float in the joint causing catching or locking of the hip with movement that can be painful and even disabling.
Cause:
Snapping hip is most often a result of muscular or tendinous tightness of the muscles & tendons surrounding the hip. Individuals who participate in activities that involve repeated bending of the hip are more prone to acquire snapping hip syndrome. While the condition most commonly affects dancers and athletes, it can occur in anyone who participates in activities that require vigorous movement of the legs. Snapping hip is most commonly seen in youth, due to tightness of musculature around the hip during adolescent growth spurts.
Prevention:
Warming up before physical activity is especially important in the prevention of snapping hip syndrome. The warm up should include stretches for the muscles surrounding the hips that are most commonly involved with snapping hip, which can be prescribed and instructed by a physical therapist. Following a warm up, it is important to gradually increase the intensity of activity. Progressing too quickly or too soon may cause increased susceptibility to developing an injury. Also, following a consistent exercise program that includes strength and flexibility can help to maintain physical conditioning to prevent injury.
Physical Therapy’s Role in Snapping Hip Syndrome:
A physical therapist will perform a thorough evaluation that includes your history and special tests that will determine a diagnosis of snapping hip. Once a diagnosis is made, a treatment program will be designed to return the patient to normal activity and reach patient and therapist determined goals. Treatment may include: pain reduction through modalities such as ice, heat, electrical stimulation, taping, exercises and manual therapy techniques; stretching and strengthening to restore motion, strength and agility. As progress is made with treatment, the physical therapist will advise on gradual return to work, physical activity or sport in a way that is safe and effective.
References:
1. Move Forward by the American Physical Therapy Association
https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=ce73393a-f583-4960-9eed-a6fcae984ea2
2. American Academy of Orthopedic Surgeons
https://orthoinfo.aaos.org/topic.cfm?topic=A00363
We treat patients with snapping hip syndrome in the 34711 area!
