Hi, this is Andrew Arnold, Chiropractor at Cranbourne Family Chiropractic and Wellness Ctr. and today I’m talking about a snapping sensation which is felt when the hip is flexed and extended.
Sometimes patients report a noticeable snapping or popping noise accompanies with pain and/or discomfort.
It’s aggravated in general by activity in particular movements where the leg is taken to the side of the body, e.g. kicking in karate or boxing, breaststroke swimming, yoga, and Pilates to name a few.
This may be felt both within and outside the hip joint.
Typically, this involves thickening of the iliotibial band (ITB) or gluteus Medius tendon sliding over the greater trochanter eventually leading to bursitis.
It may also involve the iliopsoas tendon catching on the anterior inferior iliac spine (AIIS), the lesser trochanter, or the iliopectineal ridge during hip extension. Again, overuse may lead to friction creating pain and eventually bursitis.
Further complications include labral tears, hip impingement and loose bodies due to the anatomical relationship between the iliopsoas tendon and superior labrum of the hip. This can then lead to swelling which further exacerbates the snapping sensation.
According to the research, causes are still unclear, not limited to athletes on account of the repetitive nature of sports. As I have mentioned the lateral movement of the hip and leg, i.e. out to the side seem to be a problem and can affect pretty much any age.
Clinically, what I see in practice is an increased incidence with leg length differences, weak hip abductors and external rotators, weak low back muscles and poor foot mechanics (very flat feet).
Diagnosis is certainly clinical, i.e. observing leg length differences both in the room and on x-ray; muscle testing; the location of the snap; Ultrasound and MRI.
Treatment includes managing spine, pelvic and lower limb alignment, possibly introducing foot Levellers orthotics; physical therapy to manage the actual snapping region; electrotherapy to assist with bursal inflammation and home exercises to create resistance and hopefully free the adhesions.
Often times patients report spontaneous relief however, it is imperative patients engage in the rehabilitee process. This involves avoiding aggravations and consistently engaging in those exercises that help to stretch and strengthen.
Rarely surgical intervention is necessary however, anti-inflammatories may be needed particularly if the pain is preventing sleep or interrupting work and activities of daily living.
If you think you have this condition and would like to discuss either call to make an appointment with one of our Myotherapists or Chiropractors or simply call for a chat.
About the Author:
Andrew is married to Dr. Linda Wilson, the Stress Specialist and has two children, Isaac and Bella. He lives in Melbourne, Australia.