Snapping Hip Syndrome

Over the past several weeks, 16 year-old Libby had been experiencing a snapping sensation over the outside of her hip, especially after running long distances. She noticed an audible pop with some pain that went away with rest. She believed it was more of an annoyance than anything else. Her parents had some concerns for her athletic future so they sought care from the specialists at the Adolescent Hip Preservation Program at Rocky Mountain Hospital for Children.

What is snapping hip syndrome?

Sometimes referred to as ‘dancer’s hip’, it is a condition characterized by a snapping sensation when the hip is flexed and extended. It may even be accompanied by a popping or snapping noise. For some this as an unusual sensation while others have pain or discomfort. This often is improved with rest and reduction in activity. The snapping sensation can be concerning because it feels as if the hip is dislocating.

Is this common?

Snapping hip syndrome is frequently seen in teenagers, with it being more prevalent in females. However, any age group can be affected especially during growth spurts.   For children with limb length discrepancies, the snapping hip tends to be noticed on the shorter leg. Athletes are particularly prone because the increased tension of the muscles around the hip can produce this snapping sensation. 

What causes snapping hip syndrome?

The most common cause is tightness in the iliotibial band (the fibrous tissue that extends from your pelvis to your knee on the outside of your leg) that causes it to snap over the prominent top of the femur bone (greater trochanter). As the tightness changes in the iliotibial band (IT band) as a result of growth or training, it can’t slip smoothly over the trochanteric prominence and instead gets a little hung up on one side and then moves suddenly creating a snapping sensation.

In rare cases, the pain and snapping occurs at the front of the hip rather than at the side. This may represent an entirely different problem associated with a tear in the hip joint or impingement (femoral acetabular impingement or labral tear).

How is it diagnosed?

The pediatric orthopedic specialist at Rocky Mountain Hospital for Children will perform a physical exam that can cause the IT band to move back and forth across the greater trochanter reproducing the snapping sensation. In some instances, an x-ray will be ordered when there is a concern for bony abnormality. If the history and physical indicate a complication within the joint itself, an MRI may be necessary to evaluate the cartilage and labrum of the hip.

How is snapping hip syndrome treated?

Stretching exercises are frequently used to gain better mobility of the muscles and soft tissues which can lessen both the snapping frequency and the discomfort. A short course of anti-inflammatory medication, such as ibuprofen, may be helpful.       

What is the long-term outlook for my child?    

In most cases, this is a benign condition with no long-term complications. Most children can continue their activities without restrictions. Stretching and awareness of the cause will most often get your child through these episodes without further concern. When rapid growth is a contributing factor, this syndrome can resolve once that phase passes. Especially for high demand athletes, a routine program of stretching the IT band will help to prevent recurrences.

Libby and her parents were relieved to learn that her hip was not truly dislocating. After completing a physical therapy course, she resumed her training with the added stretching exercises. She and her parents were enthusiastic about the upcoming track season and went to bed at night dreaming of Olympic gold medals.