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Internal Snapping Hip Syndrome

Athletes with internal snapping hip syndrome, also called “dancer’s hip,” hear a snapping or popping sound and often feel a snapping sensation in their hip during certain movements. It is experienced most often while straightening the hip from a flexed position The snapping is caused by the hip flexor tendon rubbing over a bony structure in the hip.

Internal Snapping Hip Syndrome Hero Image 2

Athletes with internal snapping hip syndrome, also called “dancer’s hip,” hear a snapping or popping sound and often feel a snapping sensation in their hip during certain movements. It is experienced most often while straightening the hip from a flexed position. It typically does not occur while walking. The snapping is caused by the hip flexor tendon rubbing over a bony structure in the hip. It usually doesn’t cause any harm but, for some people, the condition can be painful and limit athletic performance.

What causes Internal Snapping Hip Syndrome?

Internal Snapping hip syndrome typically results from tightness in the hip flexor muscle and tendon in front of the hip. This type of snapping occurs when the tight hip flexor muscle or tendon moves over a protrusion at the front of the hip joint. This movement creates tension between the two structures, causing a “snap” when they move apart. Internal snapping hip results when either of these happens:

• The iliopsoas tendon, which connects the two inner hip muscles to the femur (thighbone), moves over the iliopectineal eminence, a protrusion of the pelvic bone.
A quadriceps muscle, called the rectus femoris, goes over the ball of the ball-and-socket joint (femoral head) of the hip.

Sports associated with internal snapping hip syndrome include:

• Dancing (especially ballet)
• Gymnastics
• Short distance running
• Soccer
• Rowing
• Martial arts

Symptoms

People with internal snapping hip syndrome experience a snapping sound or sensation when engaging in certain sports-related activities. Usually they feel no pain at first. But over time, snapping hip syndrome can lead to inflammation of the hip flexor tendon, called tendinitis, which may be painful. Other symptoms that may be associated with snapping hip include:

• Occasional instability and sense of giving way
• Occasional sense of locking of the hip
• Muscles weakness
• Frequent limp especially after exercising.

When to see a doctor

Often, people with snapping hip syndrome do not seek medical treatment unless they experience pain. If you are bothered by the snapping or popping sound or sensation, or have mild pain, there are home treatments you can try. These include:

• Applying ice to the front of your hip
• Taking a nonsteroidal anti-inflammatory (NSAID) medication like Ibuprofen as directed for a few days
• Limiting your athletic activity, including sports that involve a repetitive movement of the hip

If your symptoms don’t improve, see your doctor. He or she will ask about your symptoms, the sports you play, and activities that cause the snapping. Your doctor will examine your hip, looking for signs of malalignment, weakness, or tightness of the muscles, and may ask you to move your hip to prompt the snapping sound. He or she may also order an x-ray to help rule out other factors causing you pain.

Non-operative treatment

Your doctor may recommend several treatment options, including:

• Rest
• Ice
• Over-the-counter medications, such as a nonsteroidal anti-inflammatory (NSAID) medication like ibuprofen
• Corticosteroid injections into the bursae, or fluid-filled sacs around the hip flexor tendon, to reduce inflammation and pain
Physical therapy for stretching and other soft tissue modalities.

You can also try these exercises at home:

Snapping Hip

Surgical Treatment

Snapping hip syndrome is usually treated without surgery. In rare cases where the popping is extreme, and the pain has been persistent for months non-responsive to non-surgical options, surgical release of the flexor tendon – either as an open or arthroscopic procedure – may be helpful in alleviating the painful snapping and popping.

Recovery

Athletes can return to play when they can perform their usual sports-related activities without pain. To hasten your return to sports, you may consider substituting repetitive motion activities (e.g. cycling, running) with other forms of exercise or sport (e.g. swimming) that are less likely to aggravate your hip. Many times, the snapping sound may persist, but as long as the pain resolves it is safe to return to play. Following your doctor’s guidance on stretching and exercises, even after symptoms have resolved, will help prevent a recurrence of the inflammation and pain.

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