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Snapping Hip Syndrome
Dr. Ambrose Yung
Snapping Hip Syndrome, also called “coxa saltans” or “dancer’s hip,” is a condition where individuals experience a snapping sensation or sound in the hip during movement.
This snapping occurs when tendons or muscles rub over bony structures in the hip. It is often caused by structural imbalances or repetitive hip motions. While usually painless, it can become uncomfortable or painful over time, particularly with increased activity.
Symptoms of Snapping Hip Syndrome
Symptoms can vary depending on how often and how severely the hip snaps. Common symptoms include:
Snapping Sensation or Sound
The primary symptom is a noticeable snapping or popping sound in the hip during movement, such as standing up, walking, or rotating the hip. The snapping may be felt on the outside or front of the hip, depending on the tendons or muscles involved.
Pain or Discomfort
In some cases, particularly when snapping occurs frequently, discomfort or sharp pain may develop. This pain typically worsens with repetitive hip movements or prolonged activity.
Weakness or Limited Movement
Over time, the affected hip may become weak, or individuals may experience a limited range of motion due to repeated irritation or inflammation in the tendons.
Causes and Risk Factors
Snapping Hip Syndrome is generally caused by one of three main issues related to the movement of tendons or muscles around the hip joint.
- Tendon or Muscle Movement Over Bone - Snapping most often occurs when tendons move across bony prominences in the hip joint. The iliotibial (IT) band may snap over the outside of the hip, while the iliopsoas tendon can catch on the front of the hip joint, causing internal snapping.
- Repetitive Motion and Overuse - Athletes, dancers, and those who engage in repetitive hip movements are more prone to developing Snapping Hip Syndrome. Overuse of the hip can lead to muscle and tendon tightness, increasing the likelihood of snapping.
- Structural or Developmental Factors - Some people may have unusual hip structures from birth, like shallower hip sockets or tight bands of tissue, that increase the chance of snapping in the hip as tendons rub over bones during movement.
Types of Snapping Hip Syndrome
Snapping Hip Syndrome is classified based on where the snapping occurs. Determining the type of snapping hip helps guide treatment.
External Snapping Hip
This occurs on the outer side of the hip, often caused by the iliotibial (IT) band or the gluteus maximus muscle moving over the bony part of the hip (greater trochanter). People with external snapping may hear or feel a distinct “pop” during movements like walking, climbing stairs, or getting up from a seated position.
Internal Snapping Hip
This type of snapping happens at the front of the hip, usually caused by the iliopsoas tendon (a hip flexor muscle) moving over bony structures near the hip joint. Those with internal snapping often feel the pop or snap when lifting the knee or bending at the waist. It can occur during activities like sitting up, cycling, or dancing.
Intra-articular Snapping Hip
This type involves issues within the hip joint itself, often due to loose fragments of cartilage or labral tears (damage to the cartilage rim around the hip socket). Intra-articular snapping can feel deeper within the hip and may cause a more complex or painful snapping sensation. It is less common but can lead to more intense pain or a feeling of the hip “catching” or “locking”.
Diagnosis of Snapping Hip Syndrome
Diagnosing Snapping Hip Syndrome typically involves a combination of a physical examination and imaging tests to identify the cause and type of snapping.
- Physical Examination: The doctor will begin by discussing symptom patterns, including the timing, location, and severity of the snapping. Specific hip movements, such as bending, rotating, or lifting the leg, may be used to replicate the snapping sensation. This helps identify whether the snapping is external, internal, or intra-articular (inside the joint).
- Imaging Tests: Imaging tests are used to diagnose the underlying causes of Snapping Hip Syndrome when symptoms are painful or suggest internal joint issues. Ultrasound can visualise tendons and muscles in motion, making it effective for external and internal snapping. X-rays help rule out bone-related abnormalities like fractures. MRI scans provide detailed images of soft tissues, detecting intra-articular issues such as labral tears or loose cartilage fragments.
Treatment Options for Snapping Hip Syndrome
Non-Surgical Treatment
Treatment for Snapping Hip Syndrome typically starts with non-surgical methods, focusing on symptom relief and preventing further irritation of the hip structures.
Physical Therapy
A targeted physical therapy programme can help stretch tight muscles and tendons around the hip and strengthen supporting muscles. Specific exercises may focus on improving hip stability and reducing snapping sensations.
Medication
Inflammation, or swelling, can occur when tendons are repeatedly irritated from snapping over bones. Non-steroidal anti-inflammatory drugs can help relieve pain and decrease inflammation during flare-ups.
Corticosteroid Injections
Corticosteroids are anti-inflammatory medications injected directly into the irritated tendon or tissue near the hip joint. These injections can temporarily relieve pain and reduce inflammation in the affected area. However, because repeated corticosteroid injections can weaken tendons over time, their frequency is typically limited.
Surgical Treatment
Surgery may be considered if non-surgical options fail to provide adequate relief or if structural issues require correction.
Tendon Release
This surgery loosens or lengthens the problematic tendon to reduce tension and friction over the bone, alleviating the snapping sensation. Typically performed arthroscopically, it minimises scarring and allows for faster recovery compared to open procedures.
Arthroscopic Surgery
This is a minimally invasive method used to treat intra-articular issues like loose cartilage or labral tears. It involves the use of a tiny camera and specialised surgical tools inserted through small incisions around the hip. This allows surgeons to visualise and address the damage precisely, repairing or removing damaged tissue while minimising pain and promoting a quicker recovery.
Open Surgery
For more complex cases, open surgery may be needed. This involves a larger incision, allowing the surgeon direct access to the hip joint for reshaping bones or making adjustments to tendons and muscles. Although it has a longer recovery time, it is necessary for addressing severe abnormalities or damage effectively.
Preventing Snapping Hip Syndrome
Preventing Snapping Hip Syndrome involves maintaining flexibility, avoiding repetitive hip motions, and strengthening surrounding muscles. Regularly stretching the hip flexors, IT band, and other key muscles keeps tendons flexible. Warm-ups before intense activities and gradual conditioning can prevent tightness, while proper movement techniques in sports help minimise hip strain.
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Frequently Asked Questions (FAQ)
Is it harmful to leave Snapping Hip Syndrome untreated?
While Snapping Hip Syndrome is usually not harmful, leaving it untreated can lead to ongoing discomfort, reduced range of motion, and, in some cases, chronic inflammation or joint irritation. Addressing symptoms early can prevent complications and improve long-term outcomes.
Do I need to stop exercising if I have Snapping Hip Syndrome?
Not necessarily. Low-impact exercises, such as swimming or cycling, are usually safe and may even help strengthen the hip without causing snapping. High-impact activities and exercises that worsen symptoms should be avoided or modified to prevent strain on the hip.
What is the typical recovery time after surgery for Snapping Hip Syndrome?
Recovery time depends on the type of surgery. Arthroscopic surgery generally requires a shorter recovery period (about 4 to 6 weeks), while open surgery may take several months. Physical therapy is often part of the recovery process to restore strength and flexibility.