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SNAPPING HIP SYNDROME
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What Is It?

“Snapping hip” is a medical condition that describes the catching of tendons across the hip joint on movement of the hip. Because this condition often occurs in dancers (ballet dancers in particular), it is often referred to as “dancer’s hip.” Nevertheless, a variety of athletes can be affected, including gymnasts, short-distance runners, soccer players and rowers. The typical age range is 15-35 years, although it occurs more frequently in adolescents.

Symptoms

There are two main subtypes:

• Internal: caused by the iliopsoas tendon rubbing over the lower part of the pelvic bone with extension and inward rotation of the hip, leading to an audible “snap” or “pop” in the groin area.

• External: caused by a fibrous band of tissue over the side of the thigh (the iliotibial or “IT” band) rubbing over part of the thigh bone (femur) with extension of the hip. This type has been reported to be more common and may be associated with both an audible sound as well as a visual deflection in the muscle tissue itself.

Affected individuals usually are found to have very tight muscles, in particular the hip flexor and abductor muscle groups. Frequently, this tightness follows a growth spurt in teenagers, since the bone grows faster than tendon and muscle.

Sports Medicine Evaluation and Treatment

Although snapping of the muscles is often not painful, over time, it may lead to irritation and inflammation of the tendons (“tendonitis”) or bursa (“bursitis”). The diagnosis should be made starting with a physical examination to assess joint movement and muscle tightness, as well as look for any problems with posture or gait. Radiographs (x-rays) and magnetic resonance imaging (MRI) typically do not aid in making the diagnosis but may be helpful to rule out other conditions in individuals with persistent symptoms. Ultrasound can reveal evidence of bursitis or snapping of the IT band itself.

Treatment usually does not require surgery and involves rest as well as non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. Deep tissue massage can be helpful, but the focus should be on stretching the hip flexors, abductors, and IT band, as well as strengthening the gluteal (“butt”) and core muscles. Persistent cases may warrant a course of formal physical therapy.

Return to Play

Return to play can occur once the individual is able to perform sport-specific activities without pain. Limiting or modifying certain exercises that cause the symptoms, such as traditional sit-ups and leg lifts, may help facilitate an earlier return. Even after symptoms resolve, a daily stretching program should be incorporated to prevent recurrence.

AMSSM Member Authors
Jason Brucker, MD and Craig Young, MD

References
Kovacevic D, Mariscalco M, Goodwin RC. “Injuries about the hip in the adolescent athlete.” Sports Med Arthrosc. 2011 Mar;19(1):64-74.
Laible C, Swanson D, Garofolo G, and Rose D. “Iliopsoas Syndrome in Dancers.” Ortho J of Sports Med. 2013 Aug 21; 1(3): 1-6.

Category: Hip and Groin,

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