A Guide to Physical Therapy for Snapping Hip Syndrome
Snapping Hip Syndrome, also known as Coxa Saltans, is characterized by a snapping or popping noise when the hip moves in a particular direction. It affects an estimated 10% of the population, with it being more common in athletes that perform powerful hip movements, such as gymnasts, dancers, and soccer players.1
In most cases, the snapping accompanying this syndrome is more of an annoyance. However, it can lead to pain and stiffness that limits an individual's ability to participate in their sport or daily life the way they'd like to. Plus, a snapping hip can lead to anxiety and activity avoidance if the underlying mechanism is not well understood.
A CityPT clinician can help guide you in understanding what is causing your hip to snap and effectively managing any symptoms experienced. This guide will discuss the causes, symptoms, diagnosis, treatment, and prevention tips for snapping hip syndrome. Keep reading to learn more.
- Understanding Snapping Hip Syndrome
- Symptoms of Snapping Hip Syndrome
- What are the Most Common Causes of Snapping Hip Syndrome?
- Diagnosing Snapping Hip Syndrome
- What to Expect from Physical Therapy Treatment for Snapping Hip Syndrome
- What If Conservative Treatment Doesn't Work?
- Preventing Snapping Hip Syndrome
- Is It Time to Seek Treatment?
Snapping hip syndrome (SHS) can elicit a popping sensation in different areas around the hip. It is most often caused by taut connective tissue, such as a tendon, rolling or snapping over a hard bony surface.
It can be identified by location ‐ either on the front (anterior), side (lateral), or back (posterior) of the hip. Additionally, the identification of which tissues are actually causing symptoms can help determine if the cause is external, internal, or intra-articular.
- External SHS: Most often associated with the iliotibial band (ITB), a strong ligament that extends from the pelvis to the side of the knee. It is the most common cause of SHS.
- Internal SHS: Associated with symptoms in the pelvis/groin region, such as the iliopsoas (hip flexor) tendon rolling over the front of the hip/pelvis
- Intra-articular SHS: Rare and caused by trauma to the hip joint, leading to a clicking, snapping, clunking, or catching sensation within the joint itself from dislodged cartilage or other debris.
As mentioned above, snapping hip syndrome is most often harmless and pain-free. However, when symptoms do arise, the snapping or popping sensation can be accompanied by pain.
Other less common symptoms include:
- Stiffness of the hip and local muscles
- Weakness of the muscles around the hip
- Difficulty with fully extending, flexing, or rotating the hip
There are many potential causes of snapping hip syndrome. These include:2
- Bony abnormalities such as extra bone growths (i.e. osteophytes)
- Inflammation of local tissue or the bursa (a fluid-filled sac that acts as a cushion between tissues)
- Tightness in the iliotibial band (ITB), a strong band of tissue that runs along the side of the thigh to provide power and stability with daily movement
- Tightness in the iliopsoas (hip flexor) tendon
- Biomechanical imbalances of the muscles around the hip joint
- Hip overuse, typically from sport
- Damage to the cartilage in the hip joint (rare)
If you are experiencing SHS symptoms, your CityPT clinician will first obtain a thorough history and ask you about your symptoms. Diagnosis is relatively straightforward by assessing the actual activities that make your hip audibly snap.
A physical therapist will also complete a physical examination of the affected area. This will include looking at your range of motion, strength, movement, and any areas of tenderness or pain. Plus, they will perform special tests to rule out other causes of hip pain.
The primary goal of physical therapy for snapping hip syndrome is to reduce pain and improve function.3 In fact, snapping itself is not a concern unless there are other symptoms limiting daily life or your participation in sports. Treatment will likely include one or more of the following:
- Education: The key to recovery is to help you understand what's causing SHS, how to manage symptoms, and what you can do to prevent it from returning.
- Manual therapy: Such as soft tissue mobilization and dry needling to help release any tightness in the muscles and connective tissues around the hip joint.
- Stretching and strengthening exercises: These are designed to help improve the range of motion, flexibility, strength, and coordination in the muscles around the hip joint.
- Biomechanical training: To reduce the onset of tissue friction with daily movements in affected areas that are causing snapping, pain, and inflammation.
- Modalities: Such as ice, heat, ultrasound, and electrical stimulation to help reduce pain and inflammation.
- Activity modification: To help you modify activities, particularly repetitive movements, that may aggravate symptoms until they have resolved.
Conservative care is very effective for managing SHS. If needed, your doctor can discuss options like injections for short-term pain relief. Additionally, in very rare cases, surgery may be warranted to release tight or even scarred tissues, such as the iliotibial band.
Firstly, it's important to note again that SHS, in and of itself, is not a concern. It is only a concern when debilitating symptoms that are affecting your quality of life are present.
The best way to prevent SHS is by maintaining good hip muscle flexibility and strength. A well-rounded physical therapy program will help improve your range of motion, flexibility, and strength in the muscles around the hip joint.
Additionally, you can:
- Stretch the muscles around the hip joint regularly
- Cross-train to reduce the repetitive nature of movements
- Use proper technique when participating in sports or other activities
- Temporarily modify (or biomechanically optimize) activities that aggravate symptoms
- Maintain a healthy weight to reduce the amount of stress on the hip joint (and body)
- Make healthy lifestyle choices to manage overall tissue health throughout the body, including staying hydrated, eating a nutrient-dense diet, getting enough sleep, avoiding tobacco, etc.
If you're experiencing any of the symptoms associated with Snapping Hip Syndrome, it's time to seek treatment.
CityPT is here to help. Our experienced and knowledgeable clinicians will provide personalized care and design a comprehensive treatment program tailored just for you. Our goal is to help you continue to fully participate in your own life on your own terms.
This guide is intended for informational purposes only. We are not providing legal or medical advice and this guide does not create a provider-patient relationship. Do not rely upon this guide (or any guide) for medical information. Always seek the help of a qualified medical professional who has assessed you and understands your condition.
Walker P, Ellis E, Scofield J, Kongchum T, Sherman WF, Kaye AD. Snapping Hip Syndrome: A Comprehensive Update. Orthop Rev (Pavia). 2021 Jun 22;13(2):25088. doi: 10.52965/001c.25088. PMID: 34745476; PMCID: PMC8567760. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8567760/ ↩ ↩2
Idjadi J, Meislin R. Symptomatic snapping hip: targeted treatment for maximum pain relief. Phys Sportsmed. 2004 Jan;32(1):25-31. doi: 10.3810/psm.2004.01.82. PMID: 20086388. https://pubmed.ncbi.nlm.nih.gov/20086388/ ↩