About Snapping Hip Syndrome

Overview
Snapping hip syndrome, also known as dancers hip or coxa saltans, is a condition where a person feels a snapping sensation or popping sound as the hip joint moves. It is more common among people who participate in sports and dancers. The snapping sound or sensation can occur when walking, running, sitting, or bending down. There are different types of snapping hip syndrome depending on the part of the hip affected: external snapping hip (outside of the hip), internal extra-articular snapping hip (front and just inside the hip), and internal intra-articular snapping hip (inside the hip joint). Most people with this condition do not experience pain and do not require treatment. However, in rare severe cases, surgery may be necessary. Overuse of the hip joint is usually the cause of snapping hip syndrome.
Causes and Risk Factors

The causes of snapping hip syndrome can vary depending on the type of SHS:

  • Internal SHS: This occurs when the hip muscle or tendons slide over the front of the hip joint. It is commonly caused by the hip tendon (iliopsoas) moving over the pelvic bone or the thigh muscles (quadriceps) moving over the ball part of the hip joint.
  • External SHS: This type happens when the thick band of connective tissue that runs along the outside of your thigh, from your hip bone down to just below your knee (iliotibial band) slides over the top of the thigh bone. It is the most common form of SHS.
  • Intra-articular SHS: This type can be triggered by the reasons above, as well as a hip joint injury or issue, such as articular cartilage injury, acetabular labral tear, or broken bone fragments.

Non-modifiable risk factors for SHS, which are factors that cannot be controlled to reduce the risk of developing the condition, include:

  • Growth spurts: Young adults who have experienced a recent growth spurt
  • Gender: Females are more likely to experience SHS.
  • Body structure: Some people born with abnormal body structures, like uneven hips and different leg lengths, may be more at risk.
  • History of previous hip injuries

Modifiable risk factors for SHS, which are factors that can be controlled to reduce the risk of developing the condition, include:

  • Activities: Participation in sports that require repetitive use of the same muscles, such as soccer, running, and gymnastics. Dancers are at particularly high risk.
  • Overuse: Constant overuse stress on the hip joint can increase the risk of developing SHS.

Consult with your healthcare professional for more information and to discuss your personal risk factor for developing this condition.

Symptoms

The most common symptoms of snapping hip syndrome include:

  • Snapping or popping sensation: Many people with this condition initially notice a snapping or popping sensation in their hip joint during certain movements, such as walking, running, or climbing stairs.
  • Pain or discomfort: As the condition progresses, some individuals may start experiencing pain or discomfort in the hip area. This pain can range from mild to severe and may be felt on the outside or inside of the hip joint.
  • Tenderness: The affected area may become tender to touch, particularly around the outer or inner hip region.
  • Limited range of motion: As the snapping hip worsens, individuals may notice a decrease in their hip's range of motion. This can make it difficult to perform certain activities that require full hip movement.
  • Swelling: In some cases, swelling may occur around the hip joint due to inflammation caused by the repetitive snapping or popping motion.
  • Difficulty sleeping on the affected side: As the condition progresses, it may become uncomfortable to lie on the affected side while sleeping.

Remember that these symptoms can vary from person to person and not everyone with Snapping Hip Syndrome will experience all of them. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment options.

Diagnosis

To diagnose snapping hip syndrome, doctors commonly perform the following examinations, tests, and procedures:

  • Physical examination: Doctors will ask about your symptoms and may perform a physical examination to assess the snapping hip.
  • X-rays: X-rays are often ordered to check for any bone or hip problems that may be contributing to the snapping hip.
  • Magnetic resonance imaging (MRI): MRIs may be used to evaluate the soft tissues around the hip joint and rule out other hip disorders.
  • Ober test: This test is used to assess tightness in the iliotibial band (part of the inner muscles of the hip) by having you lie down while the doctor cycles your knee and hip through flexion and extension.
  • Palpation: The doctor may palpate the trochanteric region (the side of your hip) to identify the snapping sensation.

Additional examinations, tests, and procedures to determine the severity of snapping hip syndrome may include:

  • Dynamic ultrasonography: This test can check for snapping of the iliotibial band over the greater trochanter and any associated tendonitis or bursitis.
  • Iliopsoas bursography: This procedure involves filling the bursa (a fluid-filled sac) with a contrast dye to visualize the movement of the iliopsoas muscle over the iliacus muscle on a monitor.
  • Magnetic resonance arthrography: This test can identify intra-articular hip problems that may be present with internal snapping hip syndrome.

It's important to note that specific examinations and tests may vary depending on whether it is external or internal snapping hip syndrome. Your doctor will determine which tests are necessary based on your individual situation.

Treatment Options

The goals of treatment for snapping hip syndrome are as follows:

  • Reduce pain: The primary goal of treatment is to alleviate pain associated with snapping hip syndrome. This can be achieved through various approaches, including rest, avoiding movements that provoke the snapping, and applying ice to the affected area. Anti-inflammatory medications, such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), may also be recommended to reduce inflammation and pain. However, it's important to consult with your doctor before taking any medication.
  • Improve flexibility: A stretching program specific to the hip muscles (iliotibial band (ITB) and iliopsoas muscles) is often recommended to improve flexibility and reduce snapping. Physical therapy may also be beneficial in restoring range of motion and improving muscle strength.
  • Equalize limb length difference: In some cases, Snapping Hip Syndrome may be associated with a difference in leg length. If this is the case, treatment may involve measures to equalize the length of the legs, which can help improve symptoms.
  • Surgical intervention: If non-surgical treatment fails to provide relief, surgery may be considered. The goal of surgical treatment is to release the contracted ITB and resolve the snapping.

It's important to note that specific therapeutic procedures and health behavior changes may vary depending on individual circumstances. It's best to consult with a healthcare professional for personalized recommendations and guidance.

Medication dosing may be affected by many factors. Check with your healthcare professional about dosing for your individual situation. Side effects can occur. Check with your healthcare professional or read the information provided with your medication for side effect information.

What are the treatment options for Snapping Hip Syndrome?

Are there any exercises or stretches that can help improve flexibility and reduce snapping?

Is surgery necessary for Snapping Hip Syndrome, or can it be managed with conservative treatment?