What Causes the Orthopedic Condition Called “Snapping Hip”?
If you hear a snapping sound or feel a snapping sensation in your hip when you walk, run, get up from a chair, or swing your leg around, you may be experiencing an orthopedic condition called a “snapping hip”. For most people, the condition is little more than an annoyance and the only symptom is the snapping sound or sensation itself. Occasionally, snapping hip symptoms may also include pain and weakness.
If you are experiencing “snapping hip,” one of several causes may be at fault. In most cases, snapping is caused by the movement of a muscle or tendon over a bony structure in the hip. Called ‘coxa saltans’ by the medical community, the snap may be internal, external or intra-articular.
Internal Snapping Hip
In orthopedic terminology, the internal snapping hip is caused by the iliopsoas tendon. Within the pelvis, this muscle and tendon unit rubs on the bone while the leg moves. As the tendon runs over the brim of the pelvis and the femoral head area, it can snap and cause a sound, click and pain. This is the ‘snapping’.
The iliopsoas is a combination of the psoas muscle (from the low spine area) and the iliacus (from the deep pelvic area). This muscle is important in stabilizing the core, walking, running and standing and any time the legs flex or rotate.
There is a large bursa around the iliopsoas tendon, which can become inflamed as well. A bursa is a normal structure in the body much like a water balloon with little or no water in it. When these become inflamed or irritated, it is like the balloon fills with water. The bursa around the iliopsoas tendon is large and so when it is irritated, it hurts and snaps.
External Snapping Hip
This type is caused by the IT (iliotibial) band sliding over the greater trochanter of the hip (bony part of hip that can be felt on the side of the body). If the front of the gluteus maximus (buttock muscle) or the back of the IT band is thick, this snapping is more pronounced. Sometimes, the bursa can become inflamed with this snapping at the hip. This is called ‘trochanteric bursitis’.
Intra-articular Snapping Hip
Caused by a problem with the cushion of the hip joint called the labrum, intra-articular snapping hips are usually due to a torn labrum (the cushion around the outside of the ball-and-socket hip joint). Unlike other reasons that cause snapping, a labral tear in the hip is almost always painful. Labral tears occur with abnormal pelvic anatomy or severe trauma. Often, your orthopedic specialist will order an MRI to diagnose this problem.
How Orthopedic Specialists Treat a Snapping Hip
The treatment of snapping hip, whatever the cause, starts with a focused course of physical therapy. It is extremely important to get the body’s core strong, meaning that all of the trunk muscles (front and back) must be conditioned and stretched. Usually, any pain will resolve and the snapping will occur less frequently after this treatment.
The length of time with these exercises and stretches can be twelve months until treatment is done, so patience with treatment is necessary. On occasion, the snapping is so often and so irritating that an injection of steroid may be necessary. Only very rarely is orthopedic surgery needed and then only in specific sub-sets of patients.
Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net
Dr. Meredith Warner is a board certified, Fellowship Trained Foot and Ankle, Orthopedic surgeon practicing in Baton Rouge, Louisiana. Dr. Warner is committed to offering her patients an accurate diagnosis along with a comprehensive treatment plan in order to get them back to a pain free life. Dr. Meredith Warner specializes in the treatment of orthopedic issues, providing operative and non-operative treatment plans of orthopedic problems, including musculoskeletal pain such as chronic back, neck and foot pain, reconstructive surgery of the foot and ankle, arthritis, diabetic, hammer toe, bunion, wound care, work injuries, fitness and nutrition and osteoporosis issues.