Do you hear your hip snapping/popping during activities such as running, pilates, yoga or sport? In this blog article I cover what a Snapping Hip is, causes and treatments.
What is Snapping Hip Syndrome?
A ‘Snapping Hip’ is characterised by a snapping feeling/sound from the hip. You may feel it along the side of the hip or in the front of the hip (anteriorly). A tight ITB or anterior Gluteus Maximus Tendon cause the snapping on the outside of the hip. An anterior snapping is often due to a tight iliopsoas or Rectus Femoris tendon. Tightness or overactivity of muscles causes the tendon to run over a bony prominence. This creates a ‘snapping’ sound. Over time, with repeated movement, it can lead to inflammation and pain of underlying structures.
Another reason for Snapping Hip is intra-articular causes such as cartilage and labral tears. However, I will not discuss this further in this blog post.
What can I do?
Firstly, I would suggest to reduce the aggravating activity. Especially if it is causing you pain/significant discomfort. Go and see a physiotherapist or similar, as this will allow you to get a detailed examination to establish the cause. The earlier you can nip it in the bud, the better.
First cause of treatment often focuses on stretching and mobility drills to reduce tightness. However, I would lay off intensive stretching if the area is very sore. In these cases, stretching could lead to excessive irritation of potentially inflamed structures through compression.Stretching on it’s own does not address the root cause of the problem. Further investigation is needed to establish the cause of the tight/overactive muscles. Your therapist should look at your overall posture together with strength, symmetry and control of movement.
In clinic, I find that overactivity of muscles occur due to reduced control and weakness. When you lack the strength and control to carry out a specific movement, you are going to cling on to the stronger muscles. Through continuous firing, the muscles develop an increase in tone and will feel rather sore.
There is a link between weakness/control issues and the core muscles. A thorough review of the pelvicolumbar area is therefore needed. As a physiotherapist, I am interested in the ability to move this area. Whether there is any reduction in movement, or preference to move in one direction over another. Your posture is very important to consider here. Depending on whether you tilt your pelvis posteriorly or anteriorly, this is going to either lengthen or shorten your hip flexors. Furthermore, I will look at the ability to contract and maintain contraction of the deeper abdominal muscles. You can find a video to help you retrain your core muscles here.
I also look at the hip muscles in more detail. I am especially interested in the eccentric strength and control of the hip flexors. The eccentric strength of your hip flexors is your ability to straighten the leg from the hip joint in a smooth and controlled way without an audible clunk. The strength of the glute muscles are also important. You can read more on this topic here.
When considering return to sport, the rehab does not end here. Everything is integrated together to replicate the movement patters of your sport. Depending on your foundations, this may start immediately as you commence your rehabilitation or later down the road.
If you are a fitness, pilates or yoga instructor and you recognise these issues among your clients, then cueing can be a powerful tool to use. For example, a position in which snapping can often occur is extending the leg from double table top position. Typically people will also feel that holding their legs in double table top position causes strain on their hip flexors and top of thighs. A cue I like to use is; ‘imagine your thighbone sinking into your hip socket’. This tends to help switch weaker muscles on and allow overactive muscles to relax. Similarily, if your clients are more tactile learners, give them some feedback through making the exercise closed chain. For example, adda pilates ball underneath their feet or a theraband around the foot.
I hope you found this post beneficial! Please let me know what topic you would like me to cover next!
Jacobsen, J. S., Thorborg, K., Søballe, K., & Ulrich-Vinther, M. (2012). Eccentric hip abductor weakness in patients with symptomatic external snapping hip. Scandinavian Journal of Medicine and Science in Sports Online, 22(6).
Yen, Y. M., Lewis, C. L., & Kim, Y. J. (2015). Understanding and Treating the Snapping Hip. Sports medicine and arthroscopy review, 23(4), 194-9.