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Overview of Snapping Hip Syndrome

by Jaydee Vykoukal, PT, DPT June 20, 2018 0 Comments

Snapping hip pain

Snapping hip syndrome (SHS), also known as dancer’s hip, is a hip condition that causes a snapping noise or snapping sensation in the hip joint. People with SHS may notice this “snapping” with everyday activities, such as when they get up from an armchair, climb steps, or walk around the block. Read on to learn more about identifying and treating snapping hip syndrome.

What is Snapping Hip Syndrome?

The medical name for snapping hip syndrome is coxa saltans. In addition to a snapping noise, SHS can sometimes cause pain, inflammation, and reduced flexibility in the hip.

The hip joint is one of the body's largest weight-bearing joints. It is a ball-and-socket joint that consists of two parts—the rounded end of the thigh bone (femur) and a cup-shaped socket in the pelvis (acetabulum). Various muscles, tendons, and ligaments surround the hip, while a thin membrane called synovium helps encapsulate the joint for adequate support and lubrication.

Inflamed or damaged muscles, tendons, or other connective tissue can have an impact on the hip’s function and lead to snapping hip syndrome. Similarly, damage inside the joint can cause hip problems.

What Causes Snapping Hip Syndrome

Snapping hip occurs due to two reasons: 

  • tendons or muscles sliding over bone
  • actual damage to the hip joint

The underlying cause depends on the type of snapping hip you have and where it’s located.

External Snapping Hip

External SHS occurs when the gluteus maximus muscle or the iliotibial band (IT band) slips over the bone (the greater trochanter) at the top outer edge of the thigh bone (femoral bone). This slipping action causes tension, followed by a snapping release over the bony prominence. External snapping hip often suggests that the IT band or gluteus maximus is too tight or the hip mechanics are off. If you have external SHS, you will notice symptoms at the outside of your hip. Due to its location, it can also cause irritation of the hip bursa, pockets of fluid that lubricate the tendons, known as bursitis.

Internal Snapping Hip

Internal SHS occurs when the iliopsoas tendon or the quadriceps muscles slide over bones at the front (anterior) of the hip joint, including the joint itself or the pelvis. Again, this action causes tension that leads to a snapping release. Both the iliopsoas tendon and quadriceps muscle are referred to as hip flexors. People with internal SHS primarily experience symptoms around the hip flexors, which are located at the front of the hip.

Intra-articular

Unlike internal and external SHS, intra-articular snapping does not involve slipping tendons or muscles. Instead, it results from an injury or problem in the hip joint. Intra-articular SHS may be caused by a tear in the cartilage that lines the hip socket (known as a labral tear) or debris within the socket.

What are the Symptoms?

The term “snapping hip syndrome” comes from the so-called snapping or clicking sound that occurs when flexing the hip. People with snapping hip syndrome may also experience:

  • Sharp pain around the hip joint or pelvis
  • Swelling at the joint or affected tendons
  • Difficulty running, climbing stairs, or carrying heavy loads
  • The feeling that the hip may pop out of place or get “stuck” due to instability
  • Weakness in the leg muscles

For people with snapping hip syndrome, groin pain is a common complaint, especially when the injury is classified as internal or intra-articular. There may also be a connection between snapping hip syndrome and lower back pain as the iliopsoas muscle is linked to both lower back and hip injuries.

Sometimes the only symptoms will be snapping with no progression. However, other symptoms can come on gradually over several weeks or months. The pain and inflammation may get more intense after long periods of activity.

Proper Diagnosis

Your doctor will diagnose snapping hip syndrome based on your medical history and a physical examination. They may ask you questions like:

  • What part of the hip hurts?
  • What activities worsen the pain and inflammation?
  • Do you have a history of hip injuries?

To confirm a diagnosis of snapping hip syndrome, your doctor may also carry out one or both of the following:

“Snapping Hip Syndrome Test”

This test allows a doctor to hear the popping sound when they move your leg into various positions. Your doctor will place your injured hip into the flexion, abduction, and external rotation (FABER) position before moving it into an extended, adducted, and internally rotated one. If SHS is present, your hip will make the snapping sound. If this test is positive it usually points to an intraarticular issue in the hip itself, such as the cartilage of the hip or labrum.

MRI Scan or X-Ray

If necessary, an MRI scan or X-ray, or both, may be ordered to more accurately diagnose snapping hip. X-ray images allow the doctor to see the bones and joints, while an MRI scan shows soft tissues. These imaging tests can be used to rule out other hip conditions including arthritis, synovitis, or tumors.

Approximate Recovery Time

Many people wonder “will snapping hip syndrome go away?” In truth, the outlook depends on the severity of the condition and the underlying cause.

Most cases are harmless and many are asymptomatic, but they can increase the risk of future damage to the joint. Those who experience pain and inflammation can recover quicker if they see a sports medicine doctor and follow a treatment program, most often with a physical therapist.

For people who undergo snapping hip syndrome orthopedic surgery, recovery time varies and requires several weeks of physical therapy. This is a very rare treatment option and is only relevant to true internal hip issues.  With proper treatment, most people will experience complete relief from pain after three to six months.

Steps Towards Relief

Snapping hip syndrome is a potentially painful and annoying condition. Left untreated, it can cause joint damage in the long term with overuse of the affected hip. If you experience the symptoms of snapping hip syndrome, see a doctor for a proper diagnosis. Then learn ways to manage mild symptoms with conservative treatments. More severe cases may require anti-inflammatory medication, a corticosteroid injection, or arthroscopic surgery in conjunction with home remedies.

Sources:

https://www.webmd.com/a-to-z-guides/snapping-hip-syndrome-causes-symptoms-treatments#1

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT



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