Hip > Snapping Hip Syndrome

What is Snapping Hip Syndrome?

Snapping hip syndrome results in an audible popping or snapping sensation as bands of ligaments or tendons slip over the bony protuberances on your upper thighbone, called the greater and lesser trochanters. This friction causes a localized inflammation or swelling in the soft tissue that is rubbing against your bones. Ligaments, tendons, or muscles are held taut against bony bumps in your hip. As you move your thighs, these bumps shift position and the popping sensation occurs as the soft tissue bands snap from one side of a bony bump to the other. If the bands are too tight or the bone surface is not well lubricated, the popping sensation becomes uncomfortable. Snapping hip syndrome also may be associated with a tear in the acetabular labrum, which is a horseshoe-shaped lip of fibrocartilage that attaches to the rim of your shoulder socket.

Overuse is the most common cause of snapping hip syndrome. Any activities that require repetitive leg and hip motions, particularly distance running, may cause this syndrome. Snapping hip syndrome is most often seen in women who have increased looseness, or laxity, in the hip joint and who participate in sports that require a great deal of hip rotation. The snapping or popping sensation is usually noticed on either the outside (external) or inside (internal) of your hip and upper thigh when you move your leg. The two common causes are as follows:

   External snapping – generally caused by friction as the ITB (iliotibial band), which runs along the outside of your thigh from your knee to your hip, pops over your greater trochanter on the outside of your hip.

   Internal snapping – less common, this popping sensation is usually caused by friction as the iliopsoas tendon, which runs along your inner thigh, slips over bony protuberances in your inner thigh at the top of your thighbone.

Muscles in your thigh that pop over hipbone surfaces, like the ischial tuberosity, may less frequently cause snapping hip syndrome. In rare cases, mild hip dislocations or loose bone chips cause the popping sensation during leg movement.

There are usually three parts to an orthopedic evaluation: medical history, physical examination, and tests your physician may order.

Your physician may ask you about the following information to help make the diagnosis:

   Your age and history of other medical conditions.

   The nature of your pain – when it began; how long it lasts; its location and severity; whether it radiates; and any factors, like running or climbing stairs, that relieve or increase the pain.

   Your physical and athletic goals – information that will help determine what treatment might be best for you in achieving those goals.

   Whether you have recently increased the duration or intensity of your workouts or training.

Your physician usually performs a number of physical tests while your hip is in various positions: Standing – your posture, stride, hip alignment, muscle tone, and ability to move from a standing to sitting position will be observed for abnormalities. Lying in your back – your abdomen, lower back, pelvis, and hip joint may be put through range of motion tests where your physician moves your hips and legs in different directions. Lying on your side – your physician may press on your ITB (iliotibial band) to check for any damage. Ober manuever - while laying on your unaffected side, your physician will have you rotate and hyperextend the affected hip and leg to determine what causes pain. Sitting – your physician may test your muscle strength, reflexes, and sensitivity to touch. Your physician may also check your pulse in your hip.

Imaging tests are rarely used to diagnose snapping hip syndrome. If your physician suspects the snapping in your hip is caused by a tear of the acetabular labrum, he may order MRI (magnetic resonance imaging) or arthrogram.

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