Snapping hip syndrome: what it is and how to treat it
Snapping hip syndrome is a condition characterised by the perception of a snapping sensation during joint movement: the patient suffering from this condition, in fact, perceives the noisy snapping of the hip during movement
The causes of snapping hips may differ depending on the individual case
Frequently, however, this problem is caused by excessive muscle tension or trauma.
Snap hips affect many people, even of different ages.
Certainly, one risk factor is intense and constant physical exertion, particularly in patients who participate in sports that involve repetitive, high-intensity movements of this body district, such as football.
Types of snapping hip syndrome
The condition can be classified into two distinct entities.
Internal snapping hip is the least common and is caused by the iliopsoas muscle tendon rubbing against the lesser trochanter, the femoral head, or the iliopubic eminence.
The main difference with the external snap is the absence of the possibility for the patient to control the production of the snap by moving the hip.
This makes it complicated to perform, at the doctor’s command during the examination, an assessment of the condition and may delay the diagnosis.
External jerk hip is, on the other hand, the most common pathological entity among patients suffering from this condition.
The main cause is excessive tension in the iliotibial band, a tendon that acts as an insertion for the gluteus maximus muscle and the tensor fascia lata muscle.
The snap is noticeable when this tendon slips over the greater trochanter.
In this case, the noise can be reproduced by performing a certain hip movement.
Symptoms
The most typical symptom of a snapping hip is the noise that can be heard by both the patient and those standing next to him or her.
The noise can be evoked by a wide range of movements, sometimes even simply getting up from a chair can bring out this noise described as a ‘pop’ or ‘click’.
The symptoms of snapping hips are many, including:
- localised pain, which can be a symptom of ongoing inflammation;
- swelling of the area or the entire lower limb;
- muscle weakness, particularly of the lower limb corresponding to the affected hip;
- lack of independence and difficulty in performing everyday activities, such as walking, taking the stairs or simply standing up.
The combination of these symptoms may be indicative of an advanced stage of the condition, as well as the presence of possible complications and severe forms of trigger hip such as intra-articular inflammation.
Complications
Treatments for snapping hip are different and must be considered according to the type of disease and its stage of severity.
Some patients tend to underestimate the problem, considering it to be a passing condition and not worthy of further clinical-instrumental investigation.
This attitude can lead to a delay in diagnosis and an increased risk of complications that can worsen the clinical picture and, in the long run, preclude the possibility of a full recovery.
Among the complications of snapping hips, inflammatory states of the structures involved are of paramount importance.
In particular, underestimating this condition can lead to trochanteritis, an inflammation of the synovial bursa located at the top of the femur.
Symptoms of this condition are pain, stiffness on movement, redness and swelling.
This complication can lead to a loss of independence for the patient, as even the simplest activities can be uncomfortable or painful, such as sitting, walking and taking the stairs.
Particularly in the case of practising sport, symptoms may be experienced with increased intensity and frequency.
Causes
As mentioned above, the causes of jerk hip vary depending on the type of condition and the area affected by the jerk.
The main cause is excessive muscle and tendon tension, which causes the bones to move closer together and the joints to reproduce the typical snapping hip noise.
More rarely, the cause of a snapping hip may be trauma or an intra-articular injury.
Diagnosis
The diagnostic pathway starts with an accurate anamnestic collection during the visit with the general practitioner.
During this interview, the patient provides information regarding his or her general state of health and focuses, in particular, on the description of his or her symptoms.
The characteristics of the pain are crucial in directing the practitioner’s suspicion towards this pathology.
At this point, the physician may refer the patient to a specialist and prescribe further investigations using imaging tools.
The specialist responsible for the management of the patient with a snapping hip is usually an orthopaedist
Diagnostic tests include ultrasound, X-ray, and nuclear magnetic resonance imaging.
Thanks to these investigations, it will be possible to get an overview of the anatomy of this district and assess whether there are any signs indicative of inflammation, a sign that the pathology has been present for a long time.
During his examination, the orthopaedist carries out a thorough objective test during which, by means of passive and active mobilisation of the lower limbs, he tries to understand which movements are generating the noise or causing pain in the patient.
Treatment for clicking hips involves a period of rest, particularly for those who play sports.
Conservative treatment involves specific physiotherapy sessions, which increase the elasticity of the periarticular structures.
In addition, if pain is present, it may be useful to apply ice in order to experience immediate relief.
In addition to physiotherapy and stretching, there are also surgical remedies for trigger hip.
Through hip arthroscopy, the conflict leading to the pathological condition can be resolved.
This surgery is minimally invasive, but requires a period of rest and several sessions of physiotherapy in the post-operative period.
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