Dancers: How to Fix a Clicking Hip – Snapping Hip Syndrome

At Sport & Spinal Physiotherapy we treat young dancers from the local Gungahlin community and beyond. We have dancers from as far as Junee who come and have assessments and treatment for their dance-related injuries. A common complaint is the hip that clicks and this is known as Snapping Hip Syndrome.

These clicks and other sounds have often started without pain but usually develop into painful clicks, clunks or chronic pain if the issue is not dealt with. Early treatment and rehabilitation will mean a faster recovery, but often we do treat this problem when it has developed into a more chronic issue. Correct rehabilitation will mean less risk of the injury becoming problematic in the longer term.

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Here’s what you’ll learn in this article:

• What causes the clicks in your hip
• The 3 types of Snapping Hip Syndrome – Internal, External and Intra-articular Snapping Hip
• How to treat clicking hips
• Stretches for clicking hips
• How to prevent Snapping Hip Syndrome from returning.

What causes the clicks in your hip?

Based on the location and the tissue (e.g. the tendon) involved, three kinds of snapping hip can be described by Dr. William C. Allan and Dr. Ray Cope in their article “Coxa saltans, the snapping hip revisited”.
• an internal snapping hip
• an external snapping hip or
• an intra-articular snapping hip.

Both internal and external snapping hips are extra-articular.

Internal Snapping Hip
The internal snapping hip occurs when the iliopsoas tendon snaps over the lower pelvic structures such as the iliopectineal eminence. With flexion of the hip, the iliopsoas tendon lies lateral to the center of the femoral
head.

 

External Snapping Hip


The external snapping hip occurs when the iliotibial tendon or the anterior fibers of the gluteus maximus snaps over the greater trochanter of the femur. With extension of the hip, the iliopsoas shifts medial to the
center of the femoral head.

 

Intra-articular Snapping Hip

The intra-articular snapping hip is caused by the iliofemoral ligaments as they slide over the head of the femur, a labral tear, chondral defect or intra-articular loose bodies.
 Pain symptoms are reproduced during specific movements of the hip, but most frequently when the hip moves from a position of flexion-abduction-external rotation to the neutral position or external rotation/abduction to internal rotation/adduction.

Watch this YouTube video that explains Snapping Hip Syndrome.

How to treat clicking hips?

In dancers, the clicking or painful movement comes from an imbalance of the muscles. We find that this injury will present with muscles tight in one area and weak in another. A stretching program alone will not fix this issue and a combination of strengthening the weak muscles and correcting postural dysfunction are essential for the long-term solution. As part of our treatment at Sport & Spinal Physiotherapy we assess each dancer individually and identify where the problem has originated from so that the rehabilitation is specific for each dancer that presents to us.
While there are 3 different kinds of Snapping Hips, in most cases, they all follow a similar treatment plan.

1. Rest and modification of activities. This means decreasing and modifying any activities that aggravate your hip and cause pain or discomfort.
2. Stretching and Strengthening. See the following section on some appropriate stretches. This is a key component of treatment. Your physiotherapist will let you know about specific rehabilitation activities.
3. Ice the area to help control any pain and inflammation.

When treating clients with Snapping Hip Syndrome, I  have found that in most cases a conservative rehabilitation program is very successful in treating the problem. However,  if these conservative treatment options are unsuccessful, corticosteroid injections and surgery are alternatives.

Stretches for clicking hips

Once you have a diagnosis of Snapping Hip Syndrome, these are two of the stretches you can do at home in conjunction with your physio treatment.
1. ITB Stretch – Illiotibial Band Stretch

• • Stand next to a wall for support
  • Cross the leg closest to the wall behind your other leg
  • Move your hip toward the wall – you should feel a stretch at the outside of your hip. Hold for 30 seconds.
  • Repeat on the other side.

Or you can use a foam roller to stretch out the area.

Take a look at this article about Foam Roller Stretches and how they can be an effective part of  your rehabilitation.

2. Piriformis stretch

• Lie on your back and Cross the foot of the affected hip over the opposite knee.
• Clasp your hands behind your thigh.
• Pull your thigh toward you until you feel the stretch in your hip and buttocks. Hold for 30 seconds.
• Repeat on the opposite side.

How to prevent Snapping Hip Syndrome from recurring.

Often the underlying issue in dancers with a painful clicking hip is a lack of core control. Part of our rehabilitation is to develop specific core exercises for the dancer that is done in addition to any regular conditioning classes they attend. Learning hip and leg control can also be incorporated into the student’s classes by working at 50% of the full movement. This aspect of the rehabilitation will help with developing better hip control.

At Sport & Spinal Physiotherapy our expertise in sporting injuries and our phased based rehabilitation will give you the intervention required to get you dancing at your optimal level sooner.

If you, your child or one of your students is complaining of a hip that clicks with or without pain, don’t wait for it to develop into a chronic problem. Call us on (02) 62624464 and make an appointment to see one of our Physiotherapists for an assessment.