External Snapping Hip Syndrome: 8 BEST Exercises for Symptom Relief

What is Snapping Hip Syndrome?

Snapping Hip Syndrome, also known as Dancer’s Hip, is an overuse condition that occurs from excessive tightness in the myofascial (muscles and fascia) structures in the hip. Typically, Snapping Hip Syndrome is more of an annoyance to people as it produces an audible and palpable popping or snapping sensation in or around the hip. There are two types of Snapping Hip Syndrome:

1. External Snapping Hip Syndrome
   • Structures Involved: IT Band and Tensor Fascia Latae
2. Internal Snapping Hip Syndrome
   • Structures Involved: Iliopsoas Muscle Group or Rectus Femoris Muscle

Causes of External Snapping Hip Syndrome

External Snapping Hip Syndrome is caused by excessive tightness in the Iliotibial Band (IT Band) and the Tensor Fascia Latae (TFL) muscle.

When you stand up straight, the IT Band and TFL lie just behind the Greater Trochanter bone. However, when you flex your hip forward, the IT Band and TFL glide over the Greater Trochanter and move in front of this bone.

As you perform activities that repetitively use the hip muscles, these muscles will gradually tighten up over time. Eventually, these structures become so tight that they can begin to “pop” or “snap” over top of the Greater Trochanter bone that they normally just glide over.

Without properly stretching or mobilizing these structures, the tightness will continue to build. Additionally, External Snapping Hip Syndrome is most commonly seen in younger, active patients as they are predisposed to have increased muscle tightness due to their growth spurts.

What is Internal Snapping Hip Syndrome?

Internal Snapping Hip Syndrome is an overuse condition that occurs with hip flexion or external rotation movements of the hip. It is caused by excessive tightness in the hip flexor muscles, more specifically the Iliopsoas muscle group or the Rectus Femoris muscle. The Iliopsoas is formed by the joining of the Psoas and Iliacus muscles. Other contributing causes include muscle imbalances between the hip, pelvis, and core muscles.

Internal Snapping Hip Syndrome results in a snapping or popping sensation of the Iliopsoas muscle group as it passes over the top of the internal bony structures within the pelvis OR the snapping of the Rectus Femoris tendon over the head of the thigh bone (the ball part of the ball-in-socket joint). This snapping or popping sensation will occur more towards the front side of the pelvis when compared to External Snapping Hip Syndrome, which occurs on the far outside part of the hip.

Symptoms of External Snapping Hip Syndrome

Symptoms of External Snapping Hip Syndrome include:

• Popping or Snapping Sensation That Can be Felt or Heard Originating Near the Outside of the Hip When Performing Active Hip Movements
• Dull, Ache-Type Pain with Periodic Sharp Pain Related to Episodes of Popping/Snapping

Typically, these popping or snapping symptoms do not produce pain unless it has gone on long enough where the repetitive friction created between the muscle/tendon rubbing against the bone begins to cause inflammation and irritation in the tissue.

Activities That Can Aggravate External Snapping Hip Syndrome

Snapping Hip Syndrome is also known as “Dancer’s Hip” as it commonly occurs in the active patient population such as dancers. This active group of people routinely perform repetitive hip motions that is also experienced while playing soccer, speed walking, long-distance running, cross-country skiing, etc.

Ultimately, any sport or activity that requires repetitive hip motions, especially hip flexion, could be potentially aggravating as the repetitive use of these muscles will only cause a further tightening of the tissues resulting in increased snapping hip symptoms.

External Snapping Hip Syndrome: Treatment Options

Since Snapping Hip Syndrome is typically caused by the overuse of the hip muscles and tendons, there are some critical first steps to take when first treating this condition.

1. Temporary Rest or Reduce Activity Participation
   • Snapping Hip Syndrome is caused by excessive tightness of the muscles and tendons, so you should rest from the aggravating activity or at least reduce the intensity/frequency of participation to focus on the therapeutic exercises seen below until the symptoms subside.
2. Substitute the Exercise or Sport
   • Higher-level athletes should modify the aggravating activity by substituting it with alternative exercises or sports that do not require repetitive hip motions. [i.e. Have a runner perform cardio on an upper-body ergometer (a.k.a. arm bike) to continue to challenge the cardiovascular system without aggravating the hip].
3. Use a Cold Pack
   • When dealing with External Snapping Hip Syndrome specifically, using a cold pack or ice pack on the outer hip can help to reduce pain and/or soreness.
   

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4. Physical Therapy
   • If self-treatment does not improve the snapping hip symptoms or you begin to have increased hip pain, you should seek out a medical provider (doctor or physical therapist) to rule out other conditions and develop a more customized treatment plan.
5. Non-Steroidal Anti-Inflammatory Oral Medications
   • NSAIDs such as Advil, Aleve, and Ibuprofen can be beneficial for short-term use as they can provide a reduction in pain, soreness, and inflammation in the muscles and tendons. Be sure to check with your doctor before taking NSAIDs to make sure that they are safe for you to consume.
6. Hip Arthroscopy or Hip Tenotomy Procedure
   • Ultimately, if your Snapping Hip Syndrome symptoms have failed to improve after several conservative treatment attempts (physical therapy, therapeutic exercises, and stretches, rest from aggravating activities, etc.) you may need to see an orthopedic surgeon for a consultation. Certain procedures can be performed such as a hip arthroscopy or hip tenotomy that may be beneficial to relieve the symptoms, though these should be reserved after all other attempts have failed.

Alternative Hip Conditions to Rule Out

While Snapping Hip Syndrome is unique in that it causes an audible or palpable popping or snapping sensation with active hip movements, there are other hip conditions and injuries that can cause alternative hip pain symptoms such as a labral tear or a sports hernia. You can learn more about how to differentiate the most common hip pain conditions by checking out my article, “Why Does My Hip Hurt?”