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Dr.Crystal Draper

Toronto Chiropractor

Snapping Hip Syndrome – Why does my hip click?

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Snapping Hip Syndrome (SHS, sometimes called coxa saltans or dancer’s hip) is a condition where you hear a ‘snapping’ sound or feel a ‘snapping’ sensation in your hip.  It occurs during movement; when walking, running, standing from seated position, or swinging your leg around.  Most people experience only the annoyance of the ‘snapping’ sound without any pain.  But for others, like dancers or athletes, symptoms can include pain and weakness that hinders performance.

What makes the ‘snapping’ sound?  In most cases, the ‘clicking’, ‘snapping’ or sometimes ‘clunking’ sound is caused by a muscle or tendon moving over a bony prominence in the hip.  This is called the ‘extra-articular’ type because the sound is coming from outside of the joint.  Within the extra-articular type of SHS, there are sub-types, commonly referred to as the ‘external’ and ‘internal’ type.

Outside the Joint…

External type – This type of SHS involves the muscles and tendons on the outer portion of the hip, namely the iliotibial band, tensor fascia lata or the gluteus maximus.  These muscles are the most common culprits of the musical sounds of SHS.  They create the ‘clicking’ or ‘snapping’ sound when the hip is moved in certain directions.  It is their thickened tissue sliding over the bony prominence on the outer portion of the hipbone (greater trochanter) that makes the snapping sound.

Internal type – This is the other offender of SHS occurring outside of the joint.  In this case it is the main flexor of the thigh, the iliopsoas, which slips over the bony prominence on the inner portion of the hipbone (lesser trochanter).  This jingle is also heard with certain movements of the hip.

Those are the common sources of extra-articular SHS.  The remaining snapping hip cases are ‘intra-articular’, meaning the sound is coming from within the joint.

Within the joint…

The ‘snapping’ sound in the intra-articular type comes from pieces of broken cartilage or bone, also known as ‘loose bodies’, in the joint space of the hip.  Sounds very unpleasant, doesn’t it?  Especially when these free-floating nuisances cause problems and an annoying “catching” in the joint.  To diagnose, X-rays, CT and MRI are beneficial because they can visualize the loose bodies that occur within the hip joint.    

Treatment

Despite the different culprits and sources of SHS, both Outside the Joint and Inside the Joint cases follow similar treatment plans:

  1. First and foremost is reassurance!  It is important to know that SHS is a common occurrence and is a variation on normal anatomy.  The ‘snapping’ sound may be unsettling, but is not indicative of future hip problems.
  2. Next, you want to ‘active rest’.  This means decreasing or modifying any activities that aggravate your hip and cause pain or discomfort.
  3. Stretching and Strengthening.  This is a key component of treatment.  While you don’t want to aggravate your symptoms, you do want to engage in a rehabilitation program that will strengthen and ultimately protect the area from future injury.
  4. Ice to help control any pain and inflammation in the area.
  5. If these conservative treatment options are unsuccessful, corticosteroid injections and surgery are alternatives.  The majority of cases that do require surgery commonly have an associated problem within the joint.

Overall, most people do not experience pain with SHS, just the annoying sound.  For those that do suffer from a painful snapping hip, please talk to your chiropractor or healthcare provider to establish an appropriate treatment plan for you.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed healthcare provider.  Consultation with a Chiropractor or other primary care provider is recommended for anyone suffering from a health problem.

References

Byrd, J.W.T. Evaluation and Management of the Snapping Iliopsoas Tendon. Techniques in Orthopaedics. 2005; 20(1): 45-51.

Choi, J.E. External Snapping Hip Syndrome: Emphasis on the MR Imaging. Journal of the Korean Society of Radiology. 2010; 62: 185-190.

Macintyre, J. Groin Pain in Athletes. Competitive Sports and Pain Management. 2006; 5: 293-299.

Smith, D.V. Hip Injuries in Young Athletes. Current Sports Medicine Reports. 2010; 9(5): 278-283.

WebMD. Snapping Hip Syndrome. Online. <www.webmd.com>

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Author: Crystal

Toronto based Chiropracter

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