Snapping or clicking hip syndrome can be divided into 2 types -internal and external.
External snapping hip is thought to involve the tendon of a tight muscle flicking over the greater trochanter which makes an audible clicking noise. Several groups of muscles cross the hip including the tensor fascia lata (TFL), gluteus maximus and the iliotibial band (ITB).
Internal ‘snapping hip’ is thought to involve the iliopsoas tendon flicking painfully over the iliopectineal eminence when the hip is flexed. Internal ‘snapping hip’ syndrome is found more commonly in dancers and is therefore also known as ‘dancers hip’.
Signs & Symptoms
· an audible snap or click with hip flexion
· pain when the snapping occurs (internal snapping hip).
· Location of the snapping/clicking may be lateral (external snapping hip) or anterior and deep in the groin (internal snapping hip).
· occasionally the sensation of the hip subluxing is described
· pain may subside with rest
· duration of symptoms is commonly months or years rather than days or weeks.
· Snapping/clicking may happen only occasionally or it may happen all the time.
What Causes It?
Tight gluteus maximus, TFL and ITB (external snapping hip)
Tight iliopsoas muscle (internal snapping hip)
Poor pelvic stability
Walking or running with an adducted gait
How to Self Manage
Rest from aggravating activity if the clicking is painful
Commence a stretching program targeting the glutes, hip flexors and ITB
Review of ballet dance technique by your teacher if applicable
Exercises will help stretch and strengthen the muscles around your hip that lead to the snapping and will reduce the amount of snapping and discomfort.
If conservative management is unsuccessful then surgical release may be indicated.
How Physio Helps
Your physiotherapist should be able to:
differentiate whether you have internal or external snapping hip syndrome;
assess your biomechanics for imbalances and muscle tightness;
assess your core/pelvic stability and address this if required;
provide manual therapy including soft tissue release and stretching; and
prescribe a self management program including stretches and stabilizing exercises.