Snapping Hip Syndrome

with Rehab

Snapping hip syndrome is a condition characterized by snapping that you may feel or hear. There are multiple causes of snapping hip syndrome, some involve soft tissue (tendon or ligament) passing over and being caught on a bony prominence. It may also be caused by loose pieces of bone or cartilage that are present in the hip joint that become caught on soft tissues.

SYMPTOMS

  • "Snapping" sensation in the hip that is either felt and/or heard.

  • Pain, tenderness, and/or inflammation of the outer hip (iliotibial (IT) band).

CAUSES

Snapping hip syndrome is caused by a mechanical disruption in the hip. Common mechanisms of injury include:

  • Tendons snapping off bony prominences. For example the iliotibial (IT) band snapping over the greater trochanter of the hip.

  • Loose fragments (bone or cartilage) being caught in the hip joint.

RISK INCREASES WITH:

  • Contact sports (football, hockey, or soccer).

  • Improperly fitted or padded protective equipment.

  • Endurance sports (distance running, triathlon, race walking).

  • Activities that require bending, lifting, or climbing.

  • Poor strength and flexibility.

  • Failure to warm-up properly before activity.

  • Flat feet.

  • Improper knee alignment (knock knees or bowlegged).

  • Compensation for other extremity injuries.

PREVENTION

  • Warm up and stretch properly before activity.

  • Allow for adequate recovery between workouts.

  • Maintain physical fitness:

  • Strength, flexibility, and endurance.

  • Cardiovascular fitness.

  • Learn and use proper technique. When possible, have a coach correct improper technique.

  • Wear properly fitted and padded protective equipment.

  • Wear arch supports (orthotics) if you have flat feet.

PROGNOSIS

If treated properly, then snapping hip syndrome usually resolves within 2 to 6 weeks.

RELATED COMPLICATIONS

  • Prolonged healing time, if improperly treated or re-injured.

  • Recurrent symptoms that result in a chronic problem.

TREATMENT

Treatment initially involves the use of ice and medication to help reduce pain and inflammation. The use of strengthening and stretching exercises may help reduce pain with activity. These exercises may be performed at home or with referral to a therapist. If you have flat feet, then your caregiver may recommend that you wear arch supports. Your caregiver may recommend corticosteroid injections to help reduce inflammation that may be causing the mechanical problems in the hip. If symptoms persist for greater than 6 months despite non-surgical (conservative) treatment, then surgery may be recommended.

MEDICATION

  • If pain medication is necessary, then nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen, or other minor pain relievers, such as acetaminophen, are often recommended.

  • Do not take pain medication for 7 days before surgery.

  • Prescription pain relievers may be given if deemed necessary by your caregiver. Use only as directed and only as much as you need.

  • Corticosteroid injections may be given by your caregiver. These injections should be reserved for the most serious cases, because they may only be given a certain number of times.

HEAT AND COLD

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain and immediately after any activity that aggravates your symptoms. Use ice packs or massage the area with a piece of ice (ice massage).

  • Heat treatment may be used prior to performing the stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or soak your injury in warm water.

SEEK MEDICAL CARE IF:

  • Treatment seems to offer no benefit, or the condition worsens.

  • Any medications produce adverse side effects.

EXERCISES

RANGE OF MOTION (ROM) AND STRETCHING EXERCISES - Snapping Hip Syndrome

These exercises may help you when beginning to rehabilitate your injury. Your symptoms may resolve with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Restoring tissue flexibility helps normal motion to return to the joints. This allows healthier, less painful movement and activity.

  • An effective stretch should be held for at least 30 seconds.

  • A stretch should never be painful. You should only feel a gentle lengthening or release in the stretched tissue.

STRETCH - Hip Rotators

  • Lie on your back on a firm surface. Grasp your right / left knee with your right / left hand and your ankle with your opposite hand.

  • Keeping your hips and shoulders firmly planted, gently pull your right / left knee and rotate your lower leg toward your opposite shoulder until you feel a stretch in your buttocks.

  • Hold this stretch for __________ seconds.

Repeat this stretch __________ times. Complete this stretch __________ times per day.

STRETCH – Iliotibial Band

  • On the floor or bed, lie on your side so your right / left leg is on top. Bend your knee and grab your ankle.

  • Slowly bring your knee back so that your thigh is in line with your trunk. Keep your heel at your buttocks and gently arch your back so your head, shoulders and hips line up.

  • Slowly lower your leg so that your knee approaches the floor/bed until you feel a gentle stretch on the outside of your right / left thigh. If you do not feel a stretch and your knee will not fall farther, place the heel of your opposite foot on top of your knee and pull your thigh down farther.

  • Hold this stretch for __________ seconds.

Repeat __________ times. Complete this exercise __________ times per day.

STRETCH - Hip Adductors, Sitting

  • Sit on the floor and place the bottoms of your feet together. Keep your chest up and look straight ahead to keep your back in proper alignment. Slide your feet in towards your body as far as you can without rounding your back or increasing any discomfort.

  • Gently push down on your knees until you feel a gentle stretch in your inner thighs. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times per day.

STRETCHING - Hip Flexors, Lunge

  • Half kneel with your right / left knee on the floor and your opposite knee bent and directly over your ankle.

  • Keep good posture with your head over your shoulders. Tighten your buttocks to point your tailbone downward; this will prevent your back from arching too much.

  • You should feel a gentle stretch in the front of your right / left thigh and/or hip. If you do not feel any resistance, slightly slide your opposite foot forward and then slowly lunge forward so your knee once again lines up over your ankle. Be sure your tailbone remains pointed downward.

  • Hold this stretch for __________ seconds.

Repeat __________ times. Complete this stretch __________ times per day.

STRENGTHENING EXERCISES - Snapping Hip Syndrome

These exercises may help you when beginning to rehabilitate your injury. They may resolve your symptoms with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Muscles can gain both the endurance and the strength needed for everyday activities through controlled exercises.

  • Complete these exercises as instructed by your physician, physical therapist or athletic trainer. Progress with the resistance and repetition exercises only as your caregiver advises.

  • You may experience muscle soreness or fatigue, but the pain or discomfort you are trying to eliminate should never worsen during these exercises. If this pain does worsen, stop and make certain you are following the directions exactly. If the pain is still present after adjustments, discontinue the exercise until you can discuss the trouble with your clinician.

STRENGTH - Hip Abductors, Straight Leg Raises

Be aware of your form throughout the entire exercise so that you exercise the correct muscles. Sloppy form means that you are not strengthening the correct muscles.

  • Lie on your side so that your head, shoulders, knee and hip line up. You may bend your lower knee to help maintain your balance. Your right / left leg should be on top.

  • Roll your hips slightly forward, so that your hips are stacked directly over each other and your right / left knee is facing forward.

  • Lift your top leg up 4-6 inches, leading with your heel. Be sure that your foot does not drift forward or that your knee does not roll toward the ceiling.

  • Hold this position for __________ seconds. You should feel the muscles in your outer hip lifting (you may not notice this until your leg begins to tire).

  • Slowly lower your leg to the starting position. Allow the muscles to fully relax before beginning the next repetition.

Repeat __________ times. Complete this exercise __________ times per day.

STRENGTH - Hip Abductors, Quadriped

  • On a firm, lightly padded surface, position yourself on your hands and knees. Your hands should be directly below your shoulders and your knees should be directly below your hips.

  • Keeping your right / left knee bent, lift your leg out to the side. Keep your legs level and in line with your shoulders.

  • Position yourself on your hands and knees.

  • Hold for __________ seconds.

  • Keeping your trunk steady and your hips level, slowly lower your leg to the starting position.

Repeat __________ times. Complete this exercise __________ times per day.

STRENGTH - Hip Abductors, Standing

Be aware of your form throughout the entire exercise so that you exercise the correct muscles. Sloppy form means that you are not strengthening the correct muscles.

  • Tie one end of a rubber exercise band/tubing to a secure surface (table, pole) and tie a loop at the other end.

  • Place the loop around your right / left ankle. Turn your body sideways so that your opposite side faces the table or pole and your right / left leg away from the table or pole. Step away from the pole or table until there is tension in the tube/band.

  • Hold onto a chair as needed for balance.

  • Keeping your back upright, your shoulders over your hips, and your toes pointing forward, lift your right / left leg out to your side. Be sure to lift your leg with your hip muscles. Do not "throw" your leg or tip your body to lift your leg.

  • Slowly and with control, return to the starting position.

Repeat exercise __________ times. Complete this exercise __________ times per day.