Snapping hip

Three types of snapping hip

Internal - occurs when tendons slide over bony structures on the anterior surface of the hip joint. People with this type of snapping hip may experience pain in the groin area and hear a snapping sound when running. Symptoms felt in the hip joint are mild at first, and may tend to worsen significantly over time.

• External - occurs when the iliopsoas band moves on the outside of the upper part of the femur, an area called the greater vertebral body. People with this type of snapping hip experience pain in the hip area and tenderness on the outside of the hip. They may experience snapping while running or climbing stairs. Also, while sleeping, lying on this hip can give pain, which can worsen over time.
• Intra-articular - occurs most often as a result of an injury to the hip joint, and is not caused by a tendon or muscle. Common causes include: damage to the articular cartilage, a tear of the acetabular rim of the joint, or a fractured section of the femur.

Snapping hip - causes

A snapping hip is most often the result of tension in the tendons and muscles surrounding the hip. The group most susceptible to a snapping hip are athletes who practice sports that place a heavy load on the hip joint and require rotational movements of the joint, such as dancing or ballet. The problem can also affect young athletes, due to the compression of the hip's muscular structures during rapid growth.

The most common causes of a snapping hip:

• dysfunctions of the knee, e.g., its valgus,
• postural defects - anterior tilt of the pelvis,
• abnormalities in the structure of the hip joint,
• flexion contracture of the hip,
• history of trauma in the area of the hip joint,
• frequent intramuscular injections in the hip area.

Snapping hip - symptoms

As the name suggests, we may have to deal with an audible popping sound (hence the term "snapping hip") or a clicking sound within the hip (hence the term "jumping hip"). The characteristic sound occurs in certain situations, especially when flexing the hip. It is an extra-articular symptom, having nothing to do with the displacement of the femoral head in the joint. Instead, it is the result of soft tissue conflict with bony protrusions. Painful symptoms accompany about one in three patients. Other symptoms that may occur include swelling, leg muscle weakness, difficulty with regular physical activity or the onset of inflammation.

How is a snapping hip diagnosed?

The hip is a complex joint, which is why it is so important to make a detailed diagnosis before starting treatment. The doctor first tries to determine the exact cause of the condition by discussing the patient's history and conducting a physical examination. He or she may also ask what activities cause the snapping, or ask you to demonstrate in what situation it occurs. The orthopedist may also order an X-ray to see the bones or an MRI scan to see the hip joint even more closely and rule out other diseases of the joint like inflammation or degeneration, which can cause pain and limit movement.

Snapping hip - treatment

Typically, a snapping hip does not give pain and does not require surgical treatment. People facing this problem are most often treated conservatively. People with snapping hip syndrome are advised to limit physical activity and, above all, avoid movements that cause a snapping, or jumping, sensation. Resting allows the affected tendons, muscles or bursae to heal. If you are experiencing pain in your hip joint, your doctor may recommend the use of cold compresses and pain medication. Taking non-steroidal anti-inflammatory drugs for a limited period of time can also relieve inflammation.

Rehabilitation to stretch and make contracted structures more flexible, restore proper posture and correct pelvic alignment is extremely important. A physiotherapist can also prepare a set of exercises to perform at home. If the pain caused by snapping hip syndrome significantly impedes daily life, the doctor may recommend a steroid injection. The injection is performed using ultrasound imaging.

A snapping hip is rarely treated with surgery. Surgery may be recommended to relieve symptoms. This method of treatment is used only in patients with severe complaints resulting in impaired gait function, as well as in cases where conservative treatment has not been successful. At the Rehasport clinic, arthroscopic hip snapping surgery is performed using a minimally invasive arthroscopic technique, which guarantees the fastest recovery.

We have three procedures for snapping hip syndrome:

• hip-band lengthening - recommended for those experiencing pain due to external SHS,
• release of the patellofemoral muscle tendon - recommended for those with internal SHS symptoms,
• arthroscopic hip revision - the most suitable technique for people with intrinsic SHS.

Related articles:

Learn about other possible causes of hip pain.

Bibliography:

• "Zespół trzaskającego biodra w dynamicznym badaniu ultrasonograficznym" - Małgorzata Piechota, Jarosław Maczuch, Jarosław Skupiński, Karolina Kukawska-Sysio, Wojciech Wawrzynek - Journal of Ultrasonography 2016
• "Snapping Hip Syndrome" - William Morrison, Kiara Anthony - Healthline 2018
• "3 Types of Snapping Hip Syndrome" - Kwame Ennin - Sports-health 2018