So, you’re at the gym doing your regular workout, but something doesn’t feel right. Your hip seems to get tighter every time you stand up from your squat. And then suddenly, SNAP! Something deep in your hip clunks and scares you. You’re pretty sure you just dislocated your hip! But instead of the pain you were expecting… it actually feels better. Sounds like you’ve got snapping hip syndrome!
Dr. James Larson is an orthopedic surgeon specializing in sports medicine and arthroscopic surgery. He also holds a CF-L1 certificate and is a Certified BFR Specialist. He supports weight training and high-intensity exercise throughout the lifespan. He started LSO to keep more people moving better, longer.
The Most Common Causes Of Hip Snapping
Whether you call it clunking, snapping, popping, or cracking it’s always concerning when your hip starts making new noises. Many people (including physical therapists and other doctors) worry that this is caused by labrum tears. But that isn’t usually the case. And sometimes the patients think their hip is dislocating. But don’t worry, that is almost impossible.
As one of the few orthopedic surgeons performing hip arthroscopy in my area, I see a lot of these kinds of problems. We usually group them into two broad categories:
- Snapping hips that you can HEAR from across the room are due to Internal Snapping Hip
- Snapping hips that you can SEE from across the room are due to External Snapping Hip
Internal Snapping Hip
If other people can hear the hip snapping as you move, walk, squat, or workout we are Dealing with Interal Snapping Hip. This is usually due to a tight iliopsoas (ill-ee-oh-so-as) tendon. We call it a Snapping Psoas for short. (It’s pronounced “so as” with a silent “p.”)
The iliopsoas is a hip flexor muscle; it brings your knee toward your chest. It starts near your spine, goes over the front of the hip, and ends on your thigh bone. And when it’s too tight, it can snap over a bony ridge on the front of the hip joint when you are moving.
It usually happens when you start in a flexed position and then extend the hip. This often happens during squats, on the stairs, or during burpees. It’s more common in women and can lead to difficulties with intimacy.
Treating Internal Snapping Hip Syndrome
Since I am such an advocate for HIIT and functional training, I often see people from these kinds of gyms because of snapping hip. And I try to keep them working out while still addressing the causes of the tight iliopsoas. But it may take some adjustments:
- Decrease aggravating exercises like toes-to bar, V-ups, mountain climbers, running, and the rowing machine. You don’t have to stop entirely. But you need to find a level that you can do them without being worse the next day.
- Increase your anterior hip stretching. Couch stretches, scorpion stretch, and frog stretches are all great ways to help loosen the psoas muscle and tendon.
- Try some yoga poses to loosen that hip as well. Warrior pose, High Lunge, Low Lunge, and Revolved Side Angle Pose can be a good progression for getting the hip flexors stretched out.
- Use anti-inflammatories like ibuprofen for mild pain. You can also try turmeric or ginger if you prefer a more natural approach. Check out this article to find the best lead-free turmeric.
If these don’t work, I usually perform a steroid injection of the tendon and continue stretching. If it comes back after that, we do arthroscopic surgery to lengthen the tendon and let it move freely.
Simple tips to improve your form and stop your hip from hurting while rowing.
Other Causes of Audible Internal Hip Snapping
There can be other sources of internal snapping, but they are pretty rare. These include snapping of the lesser tuberosity against the pelvis, loose pieces of cartilage in the joint, or bone spurs rubbing against tendons.
Many surgeons still think that a torn labrum can cause a snapping hip. And physical therapists too. I’ve never seen a labrum tear that’s actually been the source of snapping. Early in my practice, I would fix the labrum tear but the hip would still snap loudly. Now I treat the iliopsoas in addition to fixing any tears in the labrum and take care of it all at once – no more pain or snapping.
If you can see the hip “jump” or shift when it pops, it is due to external snapping hip. In external snapping hip syndrome, the iliotibial band (IT Band) snaps over the trochanter on the side of the hip. Because the IT Band is close to the skin, you can actually see it jump as it pops over the side of the hip.
External snapping usually happens with twisting and turning movements. It happens most commonly in very flexible people who have imbalalnces around the hips. Dancers seem particularly prone to this problem, often because their training strengthens the muscles that tighten the IT band while also stretching the rest of the hip.
Treating External Snapping Hip
External snapping hip is much less common than internal snapping hip. But the principles of treatment are still pretty similar.
- Avoid the motions that cause the hip to pop. Many people ignore the popping and keep doing their exercises anyway. Or they treat it like a party trick to gross out friends and family. Please don’t!
- Stretch the IT band. Use both standing and sitting IT Band stretches. If your IT band is loose enough, it will slide over the hip easily without snapping.
- Use a foam roller or trigger point ball to release the tensor fascia latae muscle.
If these don’t work, then surgery may be the best option. Usually, a release or lengthening of the IT band is performed to loosen it enough to slide smoothly over the hip. We then get people into physical therapy to continue the stretching and be sure that the IT band doesn’t scar back down as it heals.
The most common causes of hip pain while squatting
This does not constitute specific medical advice and does not indicate a physician-patient relationship between Dr. Larson and readers of this website. Please consult your own physician regarding any of these recommendations before starting them.
Looking to schedule an appointment with Dr. Larson? You can contact his office HERE for an evaluation. His office is easily accessible from Maryland, Virginia, West Virginia, and D.C.
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