With a snapping hip syndrome, a patient typically will come in complaining of, just that, a snapping hip. The snapping hip can be painless or it can be painful. It can vary in the degree of time that it’s been going on for. Quite often, the patient knows that their hip has been snapping, and if it’s painless, hasn’t thought anything about it. Typically people will come in if the pain is starting to bother them, or they’re curious as to what’s going on and where is it coming from.
When a patient presents with snapping hip, typically they can voluntarily elicit the snapping hip. And usually this is when they flex the hip and externally rotate it. Normally, this type of snapping hip is not painful and you don’t have to do anything about it. When we’re diagnosing the cause of snapping hip, there are usually three main sources.
The first, and which is the most common, when a patient comes in with a painless snapping hip, is that the pain arises from one of the tendons on the outside of the leg that is snapping over the greater trochanter, or the small bone on the side of the femur. This is normal and normally is not associated with any kind of underlying irritation of that tendon. If the patient can do it voluntarily and elicits the snapping without pain, that’s usually not anything we do something about.
The second cause of snapping hip comes from, is also outside of the joint, but from the inside of the leg. This is called extraarticular medial snapping hip. So here, the muscle tendon is also rubbing against the inside of the leg and it’s a different, now it’s a different tendon that is causing friction. Normally this is the iliopsoas tendon and it’s rubbing against the small part of the lesser trochanter, which is the small bone on the inside of the thigh bone, or the femur.
The third cause of snapping hip syndrome is when there is actual pathology inside the hip joint. And that’s called intraarticular snapping hip. When snapping hip syndrome is coming from inside the joint, the most common cause of that type of pain is a labral tear. So a labral tear again is a tear within the cartilage that is lining the socket part of the hip joint.
Typically, snapping hip syndrome occurs in dancers, gymnasts, and athletes who really use the hip flexor muscles repetitively. Most commonly, it occurs as an overuse syndrome, so for dancers and gymnasts, they’re very often overusing their hip flexor muscles, which then secondarily tends to irritate the main flexor tendons of the joint and cause irritation.