Why does my hip click when I move? Learn what snapping hip (coxa saltans) is.

Why does my hip click when I move? Learn what snapping hip (coxa saltans) is

Do you feel or hear a snapping sound in your hip when you move?

You could be experiencing snapping hip, medically known as coxa saltans or snapping hip syndrome (SHS). This common condition, which can be painful or painless, is characterized by a noticeable sound or sensation in the hip joint. Although often harmless, understanding its causes and treatments is crucial for those experiencing pain or limited mobility.

What is snapping hip (coxa saltans)?

Snapping hip occurs when a tendon or muscle slips over a bony structure in the hip, creating an audible or palpable "snapping" sound. It is a multifactorial condition and can be classified into two main types, primarily extra-articular:

• External (Iliotibial) Snapping Hip: This occurs when the iliotibial band slips over the greater trochanter (the most prominent part of the femur in the hip). It is often palpable and visible, although the snap is usually inaudible.
• Internal (Iliopsoas) Snapping Hip: This is due to the movement of the iliopsoas tendon over bony structures such as the femoral head or the iliopectineal eminence. This type usually produces an audible snap.

There is also an intra-articular snapping hip, which is less common and more serious, caused by problems within the hip joint, such as labral tears, loose bodies (fragments of bone or cartilage), or osteochondral fractures. These conditions are usually more painful and acute in onset.

What are the causes and risk factors for snapping hip?

The etiology of snapping hip is varied. Although it may occur incidentally in 5-10% of people, certain groups are at higher risk:

• Athletes and athletes: Especially those who perform repetitive hip movements and extreme rotations, such as ballet dancers, gymnasts, and runners.
• Anatomical factors: Hypertrophy (enlargement) of muscles such as the psoas or gluteus maximus, or excessive tightness of the iliotibial band, can increase friction. Alterations in bone structure, such as an enlarged iliopectineal eminence or hip anteversion, can also contribute.
• Trauma and inflammation: Inflammation of the iliopsoas bursa (bursitis) or muscle damage can contribute to internal snapping hip.
• Sex differences: Internal snapping hip (iliopsoas) is diagnosed more in women, possibly due to differences in pelvic anatomy.

How is snapping hip diagnosed?

The diagnosis of snapping hip is based on the patient's medical history and a thorough physical examination. The physician can reproduce the sensation of snapping through specific hip maneuvers. To confirm the diagnosis and rule out other causes, imaging tests may be used, including:

• Dynamic ultrasound: Very useful for observing the tendon's movement on the bone in real time.
• Magnetic resonance imaging (MRI): It identifies enlargement of the affected muscle and excludes other pathologies such as iliopsoas tendonitis.
• X-rays and computed tomography (CT): They help evaluate the bony anatomy of the hip and pelvis, detecting conditions such as dysplasia or femoroacetabular impingement.

What treatment options are there for snapping hip?

Management of symptomatic snapping hip begins with conservative approaches, which have a high success rate.

Conservative/Medical Treatment

This is the first line of action and aims to relieve pain and inflammation:

• Rest and Activity Modification: Avoid movements that trigger the snapping hip to allow the muscles and tendons to recover. Low-impact activities such as aquatic exercises may be recommended.
• Physical Therapy for Snapping Hip: A cornerstone, which includes stretches to lengthen the affected tendon, deep tissue massage, myofascial release, and exercises to strengthen the core and stabilize the pelvis.
• Medication: Use of nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation.
• Injections: If pain persists, corticosteroid and anesthetic injections can be performed into the bursa or sheath of the affected tendon. Ultrasound guidance is highly recommended. These injections not only relieve pain but also help confirm the diagnosis.

Most cases of painful snapping hip resolve with 6 to 12 months of conservative treatment.

If conservative treatment does not provide improvement after 2 or 3 months, minimally invasive procedures or open surgery may be considered.

Can you live normally with a snapping hip?

Snapping hip is a manageable condition. Thanks to advances in diagnosis and treatment options, most symptomatic patients experience significant relief and can return to normal activities.

If you experience snapping hip symptoms or pain, it is essential to consult a specialist for an accurate diagnosis and a personalized treatment plan. Proper management can help you regain mobility and improve your quality of life.