Why is my hip keep on making clicking sounds? What could it be?

Snapping Hip Syndrome (SHS), commonly known as dancer’s hip, is identified by a distinctive snapping sound or sensation during hip movement. This condition is often more of an annoyance for most individuals, with the primary symptom being the audible snap. However, dancers or athletes may experience additional symptoms such as pain and weakness, impacting their performance. SHS can be attributed to various causes, categorized as external, internal, or intra-articular. While it might be a minor inconvenience for some, the snapping hip syndrome can lead to discomfort and reduced mobility, particularly for those with active lifestyles.

How does it happen?

Snapping Hip Syndrome (SHS) affects around 10% of the population, showing a potential inclination towards females, although gender as a risk factor lacks statistical confirmation. This condition often results from overuse injuries, particularly in activities like dance, soccer, gymnastics, and running that involve repetitive hip movements. SHS has different types: 

1. External SHS: The most prevalent, involves the iliotibial band snapping over the femur’s greater trochanter. 
2. Internal SHS: Features the iliopsoas tendon snapping over a pelvic bony prominence.
3. Intra-articular SHS: The least common form, occurs when there’s a loose body in the hip joint. 

Understanding these causes helps identify and manage this condition, especially in those engaged in activities with frequent hip flexion and extension.

What’s the Signs & Symptoms? 

A) External SHS

1. Gradual Onset: Typically experiencing a slow development of snapping or pain on the outer side of the hip around the greater trochanter.
2. Non-Traumatic Origin: External SHS is not linked to a sudden traumatic event but is often associated with a minor mechanism of injury.
3. Sense of Dislocation: Individuals may describe a feeling that the hip is dislocating during movements.

Symptoms of External SHS:

1. Present with an audible snapping sound when individuals actively flex and extend the hip.

B) Internal SHS

1. Gradual Onset: Internal Snapping Hip Syndrome (SHS) develops gradually and is not typically linked to a traumatic event.

Symptoms of Internal SHS:

1. Individuals with internal SHS report pain originating deep within the anterior groin. This discomfort is often felt when moving the hip from flexion into extension or external rotation.
2. Present with an audible snap, which provides an additional diagnostic clue for internal SHS.

C) Intra-articular SHS

1. Sudden Onset: Intra-articular Snapping Hip Syndrome (SHS) is characterized by a sudden onset of snapping or clicking, often associated with a specific injury or traumatic event affecting the hip capsule.
2. Various Sources: The snapping in intra-articular SHS can stem from intra-capsular lesions, loose bodies settling in the acetabular fovea or synovial folds, a torn acetabular labrum, synovial chondromatosis, or a history of habitual hip dislocation in children or idiopathic recurrent subluxation.
3. Diverse Causes: Unlike other forms of SHS, intra-articular SHS has diverse underlying causes that need careful examination for an accurate diagnosis.

The management of Snapping Hip Syndrome (SHS) through physiotherapy often involves a combination of exercises to improve flexibility, strength, and biomechanics. Here are some general exercises that may be beneficial, but it’s crucial to consult with a healthcare professional or a qualified physiotherapist for an individualized treatment plan:

• Single-Leg Stance:
  • Standing on one leg helps improve balance and stability, working on the muscles supporting the hip joint.
    

• • Hip Circles:
    • Gently rotating the hips in circular motions can enhance flexibility and reduce stiffness.

• • Foam Rolling:
    • Using a foam roller on the IT band, hip flexors, and other relevant muscles can help release tension and improve flexibility.

• • Activity Modification: Advising patients on modifying activities that exacerbate symptoms, especially those involving repetitive hip movements.

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