Snapping Hip Syndrome (SHS), also known as coxa saltans, is characterized by a snapping or clicking sensation felt around the hip joint during movement. This occurs when a tendon or muscle glides over a bony prominence. While often painless, the snapping can cause discomfort or lead to inflammation of the nearby bursa, a fluid-filled sac that cushions the joint. Effective treatment begins with identifying the source of the snap, typically starting with at-home care before progressing to professional interventions.
Identifying the Source of the Snap
Successful resolution of Snapping Hip Syndrome depends on pinpointing the anatomical structure responsible for the movement. The condition is categorized into three types based on the location of the snapping.
The most frequent type is the External Snapping Hip, felt on the side of the hip over the greater trochanter. This snap occurs when the iliotibial band (ITB) or the anterior fibers of the gluteus maximus tendon slide across the trochanter during hip movement.
The Internal Snapping Hip is experienced deep in the groin or at the front of the hip. This involves the iliopsoas tendon, a major hip flexor, catching or rolling over bony structures on the front of the pelvis.
The final and least common category is Intra-articular Snapping, which originates from inside the hip joint itself. This snapping is typically painful and is often caused by mechanical issues like a torn acetabular labrum, a loose piece of cartilage, or other damage within the joint.
Conservative Home Management
Initial management focuses on modifying daily activities and targeted exercises. Temporarily avoid or significantly reduce activities that repeatedly provoke the snapping sensation, such as running or certain repetitive movements. Applying ice to the affected area for 10 to 15 minutes after activity helps reduce inflammation if pain is present, particularly in cases where tendinitis or bursitis has developed.
The core of non-medical treatment involves specific stretching to lengthen the tight structures catching on the bone. For external snapping, targeted stretches for the iliotibial band and gluteal muscles restore flexibility on the side of the hip. A common ITB stretch involves crossing the affected leg behind the other and leaning away from the snapping side.
Internal snapping, which involves the iliopsoas tendon, requires consistent hip flexor stretching. A kneeling hip flexor stretch, where the back knee is on the ground, effectively lengthens this deep muscle group. Holding these stretches for 30 seconds and repeating them several times a day helps the tendon glide smoothly.
Strengthening the surrounding musculature is important for long-term stability and preventing recurrence. Exercises focusing on hip abductors, such as clamshells or side-lying leg raises, stabilize the hip joint and control movement mechanics. Engaging the deep abdominal muscles through exercises like bridging or the bird dog promotes core stability, which maintains proper pelvic alignment during movement.
Professional Rehabilitation and Medical Interventions
If dedicated home management, including rest and targeted exercises, does not lead to improvement after four to six weeks, professional help is often the next step. A physical therapist can provide a gait and movement analysis to identify subtle biomechanical factors contributing to the snap. They use manual techniques, such as soft tissue mobilization and trigger point release, to address excessive tightness in the involved tendons and fascia.
Physicians may recommend pharmacological management to control pain and inflammation associated with a symptomatic snap. Nonsteroidal anti-inflammatory drugs (NSAIDs), available over the counter or by prescription, help reduce tendon irritation and any associated bursitis.
When inflammation is localized and persistent, a corticosteroid injection may be delivered directly into the inflamed bursa or tendon sheath for localized relief. A newer professional option is a Platelet-Rich Plasma (PRP) injection, which involves drawing the patient’s own blood, concentrating the platelets, and injecting the solution into the injured tissue. PRP stimulates the body’s natural healing processes for chronic tendon issues that have not responded to other treatments.
When Surgery Becomes Necessary
Surgical intervention is considered the final course of action for Snapping Hip Syndrome. It is reserved for cases that are chronically painful, significantly limit daily function, and have failed to respond to a comprehensive program of non-surgical care over many months. The specific surgical approach is tailored to the source of the snapping.
For external snapping caused by the iliotibial band, the goal of surgery is typically to lengthen the tight band to prevent catching over the greater trochanter. This is often achieved through a minimally invasive endoscopic procedure that creates a small, diamond-shaped defect or a Z-plasty lengthening in the band.
Internal snapping is addressed by surgically lengthening or releasing a portion of the iliopsoas tendon. This is usually performed arthroscopically near its insertion point on the lesser trochanter. This fractional lengthening reduces the tendon’s tension and prevents it from snapping over the underlying bone.
If the snapping is intra-articular, hip arthroscopy is performed to directly address the problem inside the joint, such as repairing a torn labrum or removing loose cartilage fragments. These minimally invasive techniques offer a lower risk profile and a faster recovery than traditional open surgery.