This article will review the symptoms, causes, and management of snapping hip syndrome. Symptoms of this condition include a snapping or locking sensation as well as pain, swelling, or weakness of the hip. Several home remedies may be helpful.
What Is Snapping Hip Syndrome?
Snapping hip syndrome is caused by the movement of tendons or ligaments passing over one of the large, bony knobs or cups of the hip. It occurs most frequently in people that flex and extend their legs regularly (e.g. dancers, bikers, soccer players, gymnasts, runners). There are specific causes depending on the location of the snap or discomfort, but generally, all snapping hips are caused by tightness in the muscles and tendons around the hip.
Treatment is mainly supportive to address associated pain and may include activity modification or physical therapy, pain medication, and possible steroid injections or surgery.
You can treat this at home by avoiding aggravating exercises, stretching, and NSAIDs. If things keep bothering you, a doctor can offer an anesthetic or corticosteroid injection to calm things down.
Snapping Hip Syndrome Symptoms
- Snapping sensation: A snapping sensation can occur on the front, back, or side of the thigh. In many cases, it gradually worsens over time and becomes louder, and it is usually audible to those near you by the time you seek medical care. The noise is often elicited by a particular action and can be reliably reproduced by repeating the action.
- Locking sensation: If snapping syndrome is caused by intra-articular damage (e.g. damage within the hip joint), then it can disrupt the ability of the hip bone to move smoothly can cause a “catching” or “locking” sensation as the particles, debris, or damage to the labrum cause friction. That friction interrupts the smooth movement of the hip joint.
- Pain and swelling: As the tendon or ligament runs across the bony knobs of the pelvis repeatedly, it can cause compression of inflammation of some of the suck absorbing portions of the pelvis. These small packets are usually full of fat and are called bursa. If a bursa is exposed to repeated trauma, it can become inflamed and cause bursitis. Additionally, the tendon can also become inflamed from the repeated friction it experiences as it “strums” across the larger knobs of the femur.
- Weakness: Weakness may both aggravate snapping hip syndrome and, conversely, be aggravated by snapping hip syndrome. Specifically, the weakness of gluteus medius is commonly associated with snapping hip syndrome. The gluteus medius is one of the deeper muscles of the bottom.
Causes of Snapping Hip Syndrome
Snapping hip syndrome is , affecting 5-10% of the population. It is most common in individuals between the ages of 15 and 40 and occurs more commonly in females. The following sections will detail some anatomy and functionality of the hip that may be causing your
Tightness of the iliotibial band
The iliotibial band is a band of connective tissue that sits along the outside side of the thigh and runs from the hip to the knee. The band usually flexes and holds the muscles of the thigh together when standing and stabilizes the muscles in the front and back of the thigh when running. Because of this, the iliotibial band can become tight for individuals who are on their feet regularly and engage in jumping or running regularly and continually. Snapping occurs because the iliotibial band runs across one of the bony knobs of the thigh, the greater trochanter. As it runs across this prominence, the knob strums the iliotibial band, similar to a rubber band, causing a snapping sensation. This type of snapping hip syndrome usually begins with a gradually worsening snapping sensation or pain and can be aggravated by knee instability.
Tightness of the rectus femoris tendon
The rectus femoris is the muscle that sits on the front of the thigh. The tendon of the rectus femoris muscle attaches just above the hip socket. When the hip flexes or when you bring your knees up to your chest, the tendon that attaches the rectus femoris to the hip passes along the head or top of the hip bone and strums — which can cause a snapping or clicking sensation. The clicking can be caused by either flexing or extending the hip. The tendon can also be strummed by attaching to the knobs of the front of the pelvis bone. Generally, this also occurs in individuals who engage in repeated flexing of the hip and individuals undergoing rapid growth of the thigh bones while engaging in regular and intense exercise (adolescent athletes). This type of snapping hip syndrome usually worsens gradually and is less commonly associated with pain.
Tightness of the hamstring tendon
The tendon that attaches the muscles at the back of the thigh (e.g. hamstring) to the sit bones (e.g. ischial tuberosity) may cause a snapping sensation when the tendon moves across the ischial tuberosity.
Damage to the cartilage of the femur socket
The femur head consists of a ball and fits into a socket that is shaped like a spherical cup. The femur moves within the cup when you flex your femur. To eliminate friction and ensure that the movement of the femur is smooth, both the head of the femur and the inside of the cup are lined with cartilage. Cartilage is a smooth substance that has very little blood supply and allows joints to move smoothly. When the labrum (e.g. the cartilage lining the cup) is torn from excess activity, it can impede this smooth movement and cause a “locking” or “freezing” sensation of the joint. That locking sensation can cause discomfort and even pain in some circumstances. Usually, this type of snapping hip syndrome is caused by initial trauma and damage to the hip, causing a tear in the labrum or some sort of debris settling in the acetabulum.
Treatment Options and Prevention for Snapping Hip Syndrome
At-home treatments may be appropriate if the symptoms of snapping hip syndrome are not severe enough to see your physician. Common solutions to try before visiting your physician include:
- Rest: Reduce your activity levels for a period of time.
- Ice: Apply ice to the affected region.
- Pain medication: Use over-the-counter pain relievers and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) as needed and directed.
- Activity modification: Modify how you exercise to reduce or eliminate repetitive motion of the hip. This may include screening out biking, swimming, dancing, or running.
stretch and release some of the tension placed on the tendons and ligaments of the thigh and pelvis. Exercises may include stretching the iliotibial band, stretching the gluteus medius or piriformis muscle, and stretching the rectus femoris muscle. Generally, it is necessary to stretch muscles before and after physical activity and to stretch even when no specific activity is planned for the day. Lengthening and releasing the tension placed on these muscles may take multiple weeks — or as long as months — of consistently stretching before improvements are made. Stretches may reduce pain, but if the pain continues to be a limiting factor in activity, it may be necessary to consult your physician about other interventions to reduce pain.
Pain may limit the effectiveness of rehabilitation. If this is the case, inflammation of the shock absorbers of the hip (bursa/bursitis) can occur over the course of weeks or months. To treat this pain, it may be necessary to reduce the inflammation by giving an injection of corticosteroids that can quickly and effectively eliminate inflammation. Usually, a physician will attempt a purely behavioral treatment plan before recommending corticosteroid injections.
In very rare circumstances, a snapping hip may require surgical treatment. Usually, when the defect is inside the joint (e.g. intra-articular), a surgeon can insert a small fiber-optic camera to examine the cartilage capsule around the hip joint. This camera may host or allow visualization for small tools to repair and assess the labrum as frayed cartilage is stripped away — ultimately allowing less friction as the femur moves within the joint.
When to Seek Further Consultation for Snapping Hip Syndrome
Snapping hip syndrome is usually not a medical emergency. If it is limiting or bothersome enough for you to seek care, you should plan a visit to a primary care physician and possibly search for a specialist.
If your leg or hip is locking and cannot bear weight
Consultation is necessary if your femur locks to an extent that it is unable to bear weight. A fall can be very traumatic and can lead to fractures.
If you have a fever and swelling of the hip
You should seek medical care if you experience severe fever and swelling of the hip joint as snapping develops in the hip. You may have a life- or limb-threatening infection.
Questions Your Doctor May Ask to Determine Snapping Hip Syndrome
- How long has your hip pain been going on?
- How severe is your hip pain?
- Is your hip pain constant or come-and-go?
- Do your symptoms get worse when you exercise?
- Is your hip pain getting better or worse?
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