Video presented by Ana Bracilovic, MD
This video accompanies: Treatment for Snapping Hip Syndrome Video
With a snapping hip syndrome, a patient typically will come in complaining of, just that, a snapping hip. The snapping hip can be painless or it can be painful. It can vary in the degree of time it has been going on for. Quite often, the patient knows that their hip has been snapping, and if it’s painless, the patient has not thought anything about it. Typically people come in if the pain is starting to bother them, or they’re curious as to what’s going on and where is it coming from.
What Causes a Snapping Hip?
When a patient presents with snapping hip, typically they can voluntarily elicit the snapping hip. Usually this is when they flex the hip and externally rotate it. Normally, this type of snapping hip is not painful and you don’t have to do anything about it. When we are diagnosing the cause of snapping hip, there are usually three main sources.
The first, and usually the most common when a patient comes in with a painless snapping hip, is that the pain arises from one of the tendons on the outside of the leg that is snapping over the greater trochanter, or the small bone on the side of the femur. This is normal and not associated with any kind of underlying irritation of that tendon. If the patient can do it voluntarily and elicits the snapping without pain, that’s usually not anything we do something about.
The second cause of snapping hip is also outside of the joint, but from the inside of the leg. This is called extraarticular medial snapping hip. So here, the muscle tendon is also rubbing against the inside of the leg and it’s a different tendon that is causing friction. Normally this is the iliopsoas tendon and it’s rubbing against the small part of the less trochanter, which is the small bone on the inside of the thigh bone (femur).
The third cause of snapping hip syndrome is when there is actual pathology inside the hip joint. That is called intraarticular snapping hip. When snapping hip syndrome is coming from inside the joint the most common cause of that type of pain is a hip labral tear. A labral tear is a tear within the cartilage that is lining the socket part of the hip joint.
Typically, snapping hip syndrome occurs in dancers, gymnasts, and athletes who really use the hip flexor muscles repetitively. Most commonly, it occurs as an overuse syndrome, so dancers and gymnasts, they are often overusing their hip flexor muscles, which then secondarily tends to irritate the main flexor tendons of the joint and cause irritation.