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  • Writer's pictureSuyi the physio

Do you have a noisy hip? Part 1: External "Snapping Hip"

Snapping hip, also known as coxa saltans or Snapping Hip Syndrome (SHS), is a condition characterised by a snapping or popping sensation in the hip joint during certain movements. It can be accompanied by an audible sound or a visible movement of the hip. SHS can occur both on the outside (lateral) or front (anterior) of the hip, and the causes can vary depending on the location.


In this 3 part series - we’re going to go over the primary types of snapping hip beginning with external (lateral) snapping hip.



This type involves the snapping of the iliotibial (IT) band or the tensor fasciae latae muscle over the greater trochanter, which is the bony prominence on the outside of the hip. It is commonly seen in athletes who engage in activities requiring repetitive hip flexion and extension, such as runners or cyclists.


External SHS is often caused by tightness or thickening of the IT band or tensor fasciae latae muscle, which can result from overuse, muscle imbalances, or improper training techniques.



The IT band is a thick band of connective tissue that runs along the outside of the thigh, connecting the hip to the knee. The TFL muscle is a hip muscle that attaches to the IT band. During certain movements, such as walking, running, or hip flexion and extension, the IT band can glide back and forth over the greater trochanter. In some individuals, the IT band can become tight or inflamed, leading to SHS.


The causes and contributing factors of external SHS include:

  1. Tightness of the IT band: When the IT band is tight, it has less flexibility, and it is more likely to snap or pop over the greater trochanter during movement.

  2. Muscle imbalances: Weakness or tightness in the muscles around the hip, such as the gluteal muscles, can alter the movement patterns and increase the risk of IT band snapping.

  3. Overuse or repetitive activities: Engaging in activities that involve repeated hip flexion and extension, such as running, cycling, or activities with frequent changes in direction, can strain the IT band and contribute to snapping hip.

  4. The main symptom of external snapping hip is a snapping or popping sensation on the outside of the hip, often accompanied by pain. The snapping sensation may be audible or palpable, and it can occur during activities such as walking, running, climbing stairs, or swinging the leg out to the side.


A physiotherapist can diagnose, provide guidance on proper stretching and strengthening exercises and give you specific advice for you regarding:


  1. Rest and activity modification: Avoiding activities that exacerbate the snapping hip can help reduce symptoms and allow for healing. Physiotherapists can help modify movements or encourage proper form during activities.

  2. Manual therapy techniques: to address muscle imbalances and reduce pain.

  3. Stretching exercises: Stretching the IT band, hip muscles, and surrounding structures can help improve flexibility and reduce tension in the IT band. Common stretches include IT band stretches, hip flexor stretches, and gluteal stretches.

  4. Strengthening exercises: Strengthening the hip muscles, particularly the gluteal muscles, can help improve muscle balance and stability, reducing stress on the IT band. Exercises such as hip abductions, bridges, and clamshells are often prescribed.

  5. Use of assistive devices: In some cases, the use of rehab tools such as foam rollers or massage balls can help release tension in the IT band and promote healing.



If conservative measures are ineffective in managing the symptoms of external SHS, further interventions, such as corticosteroid injections or surgical options, may be considered. However, these are typically reserved for severe cases.


If you’re experiencing these symptoms it's important to consult with a physiotherapist, for an accurate diagnosis and personalised treatment plan for external SHS. We can assess your specific condition, provide appropriate recommendations, and guide you through the recovery process.


Stay tuned for the next instalment in our noisy hips series!


References


  • Cheatham, Scott W. PT, DPT, OCS, CSCS, NSCA-CPT; Cain, Matt MS, CSCS; Ernst, Michael P. PhD. Snapping Hip Syndrome: A Review for the Strength and Conditioning Professional. Strength and Conditioning Journal 37(5):p 97-104, October 2015. | DOI: 10.1519/SSC.0000000000000161



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