The term “snapping hip syndrome” is used to describe a condition where a tendon of a muscle
moves over the hip bone to produce a snapping sound or sensation. This condition is often
non-painful, but at times can cause pain and weakness in the hip. It is very prevalent in dancers,
both competitive and recreational, due to the repetitive hip movements required. It is also
common in weight lifters, soccer players and runners. Rotating the hip outwards (external
rotation) and lifting the leg to the side (abduction) are the movements mostly associated with
snapping hip syndrome. It is important to note that a snapping or popping sensation in the hip
can also be caused by a labral tear, or other pathologies of the hip joint.

When snapping hip syndrome is painful or causes discomfort, you can approach your
physiotherapist to help you manage it. Your physiotherapist will perform a full evaluation to
determine what the possible cause is. The snapping can also cause irritation of an underlying
bursa (a fluid filled sack that separates tendons and bones in joints), leading to bursitis, where
the bursa becomes inflamed. Physiotherapy can also address bursitis.
Snapping hip syndrome can be divided into two categories, depending on the location of the
structures involved.

External snapping hip:
● Located on the outside or the back of the hip joint
● The iliotibial band (ITB) moves over a large bony prominence of the femur, referred to as
the greater trochanter
● Movements affected are moving the leg forward (hip flexion), moving the leg backwards
(hip extension) and turning the leg in or out (hip rotation)
● Other muscle’s tendons that can also be affected include the hamstrings, gluteus
maximus and psoas, and sometimes a combination of muscles are affected.
Internal snapping hip:
● Located at the front of the hip
● The iliopsoas muscle is most commonly involved
● Bringing your leg forward to your chest is the most common movement leading to pain
● Cysts close to the hip joint can also be a cause, as well as splitting of the iliopsoas
tendon (bifurcation)
● This condition is often difficult to distinguish form pathologies within the hip joint, and
imaging is often needed to differentiate

Physiotherapy:
When snapping hip syndrome is non-painful and no weakness or reduction in movement is
caused by it, treatment is not indicated and you can function normally. However, when the
condition causes pain, discomfort or loss of function, physiotherapy can be very effective. Initial
rest, with possible activity modifications are often needed at the start of your rehabilitation
programme. The use of antiinflammatories might also be beneficial. Steroid injections combined
with physiotherapy can be effective in treating very painful snapping hips. Your physiotherapist
will prescribe stretches and strengthening exercises to improve your hip strength and mobility,
and will also help you in returning to any sporting activities while preventing further
complications.