Snapping Hip Syndrome Treatment Options

What is snapping hip syndrome?

Snapping hip syndrome, also known as coxa saltans, is a condition characterized by an audible or palpable snapping sensation in the hip joint during movement. This snapping or popping sensation may be accompanied by pain or discomfort and can occur with certain activities such as walking, running, or bending the hip. The condition is typically classified into two main types: internal snapping hip and external snapping hip. Internal snapping hip involves the iliopsoas tendon or the iliofemoral ligament snapping over bony prominences within the hip joint, while external snapping hip involves the iliotibial band or the gluteus maximus tendon snapping over the greater trochanter of the femur. Snapping hip syndrome can result from a variety of factors, including anatomical variations, muscle imbalances, repetitive movements, and overuse injuries. Diagnosis is usually made through physical examination, and treatment may involve conservative measures such as rest, physical therapy, and anti-inflammatory medications, as well as surgical intervention in severe or refractory cases. With appropriate management, most individuals with snapping hip syndrome can achieve symptom relief and return to their normal activities.

What nonoperative treatment options are available?

1. Rest and Activity Modification: Resting the hip joint and avoiding activities that exacerbate symptoms can help reduce inflammation and irritation of the affected tissues. Activity modification may involve modifying exercise routines, avoiding repetitive movements, or using assistive devices such as crutches or braces to support the hip joint.
2. Physical Therapy: Physical therapy plays a crucial role in the management of snapping hip syndrome, focusing on stretching, strengthening, and neuromuscular retraining to improve hip joint mechanics and reduce snapping. Specific exercises may target the hip flexors, hip abductors, hip external rotators, and core muscles to address muscle imbalances and improve hip stability.
3. Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be used to alleviate pain and reduce inflammation associated with snapping hip syndrome. These medications are typically used short-term and under the guidance of a healthcare professional.
4. Corticosteroid Injections: In cases of persistent or severe symptoms, corticosteroid injections may be considered to provide temporary relief of pain and inflammation. These injections are typically administered under ultrasound or fluoroscopic guidance to ensure accurate placement and minimize the risk of complications.

What operative treatment options are available?

In cases where conservative measures fail to provide adequate relief, or if there is significant functional impairment or structural abnormalities contributing to snapping hip syndrome, surgical intervention may be considered. Surgical options for snapping hip syndrome may include:

1. Iliopsoas Tendon Release: In cases of internal snapping hip caused by tightness or hypertrophy of the iliopsoas tendon, surgical release of the tendon may be performed to alleviate snapping and improve hip joint function. During this procedure, the iliopsoas tendon is partially or completely released from its attachment site, allowing for smoother movement within the hip joint.
2. IT Band Release: In cases of external snapping hip caused by tightness or friction of the iliotibial band, surgical release of the band may be performed to alleviate snapping and reduce irritation of the surrounding tissues. During this procedure, the iliotibial band is lengthened or released to prevent impingement over the greater trochanter of the femur.

What does rehabilitation and return to activity entail?

Rehabilitation and return to activity after snapping hip syndrome focus on addressing underlying muscle imbalances, improving hip joint mechanics, and gradually restoring function and mobility. Physical therapy plays a central role in the rehabilitation process, with a tailored exercise program aimed at stretching tight muscles, strengthening weak muscles, and improving neuromuscular control of the hip joint. Specific exercises may target the hip flexors, hip abductors, hip external rotators, and core muscles to address imbalances and promote optimal hip function. Additionally, techniques such as manual therapy, modalities, and gait training may be utilized to enhance recovery and alleviate symptoms. As symptoms improve and functional capacity increases, a gradual return to activity is initiated, starting with low-impact exercises and gradually progressing to more challenging activities. Close monitoring by a healthcare professional is essential throughout the rehabilitation process to ensure proper progression, minimize the risk of re-injury, and facilitate a safe and successful return to desired activities.

What prevention strategies exist?

Preventing snapping hip syndrome involves maintaining optimal hip joint mechanics, addressing muscle imbalances, and avoiding activities that increase the risk of injury or irritation. Some preventive strategies may include:

1. Warm-up and Stretching: Prior to engaging in physical activity, it is important to perform a thorough warm-up and stretching routine to improve flexibility, mobility, and joint mechanics. Focus on stretching the hip flexors, hip abductors, hip external rotators, and iliotibial band to reduce tension and friction around the hip joint.
2. Strengthening Exercises: Incorporate strengthening exercises targeting the hip muscles, core muscles, and lower extremities to improve hip joint stability and reduce the risk of muscle imbalances. Exercises such as squats, lunges, hip bridges, and clamshells can help strengthen the muscles surrounding the hip joint and prevent snapping hip syndrome.
3. Proper Technique and Body Mechanics: Practice proper technique and body mechanics during activities that involve repetitive hip movements, such as running.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of snapping hip syndrome. If you believe you are affected by snapping hip syndrome, schedule a consultation today with our experienced orthopaedic care team.