Description:
The hip can be referred to as an area or a joint (acetabulofemoral joint). It is the joint located between the femur and the acetabulum of the pelvis.
The hip is weight bearing, maintains balance and is subject to wear and tear. The iliotibial band (ITB) is a thick wide tendon that runs along the outside of the hip joint. It originates from the outside of the pelvis, the iliac crest and inserts just below the knee on the lateral condyle of the tibia. It is responsible for stabilising the knee during running.
Bursa are the fluid filled sacs that allow muscles to run smoothly over the bone. In snapping hip syndrome the trochanteric bursa become inflamed and this causes a snapping sound as the iliotibial tendon catches on the Greater Trochanter, the bony prominence on the outside of the hip.
Causes:
Snapping hip syndrome is an over use sports injury and can be caused by weak and inflexible medial hip rotators, and a tight ITB, tensor fascia latae (TFL) and gluteus maximus.
Vigorous activity, such as running, ballet dancers, gymnasts, football causes snapping hip syndrome, because the repetitive nature of the activity, puts strain on the ITB, TFL and the Glutes.
Snapping hip syndrome can be divided into different types:
In the Lateral extra articular type, the ITB, gluteus maximus or TFL have thickened and tightened through overuse (and insufficient stretching), catch as they run over the greater trochanter. With assistance of the bursa they slide easily over the greater trochanter, however this does not happen in this case, and they catch or rub the causing a snapping or popping sound/sensation as the bursa become inflamed causing bursitis.
Medial extra articular type, is less common and occurs when the iliopsoas tendon catches the anterior inferior iliac spine. With overuse, friction occurs, and the bursa become aggravated and cause pain.
A Hip Labral Tear (the labrum is the cartilage surrounding the hip joint, a ball and socket joint) can also cause a snapping or popping sound as the torn cartilage catches on the hip joint, as the hip moves, for instance, through flexion or extension. In this instance, the hip can become stiff and pain can be felt in the groin area.
Snapping hip syndrome is most typical in people aged 15-40.
Diagnosis:
A snapping or popping sound can be heard in the hip flexor tendon, when the knee is extended from the bent position. This sound occurs as a tendon (hip flexor tendon) or muscle moves abnormally over a bone.
Pain can be felt after exercise at the iliopsoas bursae. Pain can be felt in the pelvic area, or on the outside of the hip.
Pain eases with rest and reduced activity. The hip can be sore, tender and warm.
Snapping hip syndrome can be pain free.
The hip can feel unsteady, and there is a need to grab the hip.
If untreated pain can be severe and can last for months or years.
Treatment:
Recovery from Snapping Hip Syndrome can be slow and can take time to heal. It is important to seek medical advice to aid recovery. An X-ray can help confirm Snapping Hip Syndrome and rule out other injuries to the hip.
Rest: to prevent further damage. Try to avoid exercises that aggravate the condition (cycling, running up or down hills).
In the sub acute (3 days to 3 weeks) and the chronic stage (3 weeks to 2 years) it is important that training should be adapted to avoid jumping or any exercises that put excessive strain on the patellar tendon. A physiotherapist, doctor, osteopath or other therapist can advise when exercise should be resumed and what exercise would be appropriate.
Ice treatment: Ice, can be applied for 10-15 minutes, every 2-3 hours in the acute and sub- acute stage (frequency can be reduced according to recovery, and can be continued for as long as deemed necessary). In the sub-acute stage (3days – 3 weeks) heat therapy can be applied.
NSAIDS (anti-inflammatories) and paracetamol can be taken to aid pain relief. Medical advice should be sought, in case of possible side effects. Under medical supervision cortisone injections can given for pain relief.
Massage can help aid recovery, and improve joint mobility and flexibility and range of movement at the hip. It should not be administered during the acute stage. If there is any underlying medical condition, such as a heart condition, it is important to seek medical advice before receiving massage.
Kinesiology taping can help by assisting with lymphatic drainage, and the repair of damaged tissues.
Hip flexibility and strengthening exercises can prevent and aid recovery from hip snapping syndrome. A physiotherapist or sports massage therapist can recommend strengthening, flexibility and proprioceptive exercises in the sub acute and the chronic stage of recovery. Exercises should focus on strengthening, (e.g. the bridge). The intensity of the exercises should be increased gradually and in a measured way. It is important that when exercise is resumed, the athlete warms up and cools down sufficiently to prevent the ITB, TFL and Glutes tightening up and causing friction as they run over the Great Trochanter.
A physiotherapist or doctor might prescribe ultrasound or laser treatment to aid recovery; in certain cases surgery might be advised, to remove cartilage or stretch tendons.
Published: November 5, 2011Author: Sophia Cross, BA (Hons) MA
Snapping Hip Syndrome Treatments
