3 Types of Snapping Hip Syndrome

People who pop, click, or snap their hips during particular movements have snapping hip syndrome, also known as coxa saltans or dancer’s hip. Some people make an audible click when they bend at the hip. For other people, hip snapping can be seen, and their hip muscles visibly shudder with certain movements. Still others may feel a popping or catching in their hip joint.

Why does hip snapping occur? This page reviews the three types of snapping hip and their underlying causes. While often harmless, these conditions can sometimes lead to joint damage and pain.

Watch What Is Snapping Hip Syndrome? Video

1. Internal Snapping Hip (at the Front of the Hip)

The first type of snapping hip occurs when a tendon slides over protruding bony structures at the front of the hip joint, creating tension and then releasing with a “snap.”

Internal hip snapping is typically caused when either:

• The iliopsoas tendon, which connects two inner hip muscles to the femur (thighbone), moves over a protrusion of the pelvic bone called the iliopectineal eminence.
• The rectus femoris, commonly called a quadriceps muscle, moves over the rounded femoral head, commonly known as the “ball” of the hip’s ball-and-socket joint.

Both the iliopsoas tendon and rectus femoris are commonly called hip flexors.

People with internal snapping hip syndrome may experience:

• Hip popping when running; when the hip is extended from a flexed position of more than 90 degrees, such as when rising from a seated position; or when the hip rotates the leg away from the body.

  See Common Running Injuries: Hip or Thigh Pain

• Hip popping accompanied by a sharp, sudden pain at the front of the hip, deep within the groin,

  See Signs and Symptoms of Athletic Groin Injury

• Pain that worsens with activity, as repeated irritation causes the tendon to become inflamed.
• Gradual onset of painful symptoms—the pain may have begun as a mild annoyance and worsened over weeks or months.

Internal snapping hip is the most common type of snapping hip. It is associated with painful inflammation of a bursa located at the front of the hip joint. This inflammation is called iliopsoas bursitis.

2. External Snapping Hip

The second type of snapping hip occurs when a muscle or tendon slides over the knobby bone at the top of the femur (thighbone), called the greater trochanter. This sliding creates tension followed by a release and snapping sensation at the outside of the hip.

External snapping hip is caused when either:

• The iliotibial band (IT band) slides over a rounded protrusion of the femur (thighbone) called the greater trochanter. The IT band is a wide strip of fibrous tissue that extends down the outside of the upper leg, from the pelvis to below the knee.
• The gluteus maximus muscle slides over the greater trochanter.

External snapping may be a sign that the iliotibial band or gluteus maximus is tight.

People with external snapping hip syndrome may notice:

• The snapping typically occurs during hip flexion and extension, such as when running and climbing stairs. Hip snapping may also be noticeable when playing golf or carrying a heavy load, such as groceries or a heavy backpack.
• Hip popping is accompanied by sharp, sudden pain felt at the outside of the hip.
• The hip feels like it is about to pop out its socket when snapping (it is not).
• Pain that worsens with activity, as repeated irritation causes the tendon to become inflamed.
• The popping hip can often be seen as the IT band or gluteus muscle snaps and causes the overlaying skin to shudder.
• Painful symptoms develop gradually; the pain may begin as a mild annoyance and worsen over weeks or months.

External snapping hip syndrome is often associated with painful tenderness at the outside of the hip, which suggests the athlete may have a type of hip bursitis called trochanteric bursitis.

This syndrome is also associated with a tight IT band, sometimes called IT band syndrome.

See IT Band Syndrome Symptoms

3. Snapping Hip Due to Cartilage Injury

A problem within the hip joint itself can cause this third type of snapping hip. For example, a snapping hip may be caused by:

• An acetabular labral tear is an injury to the tough, flexible cartilage that rings the hip socket, like a gasket. A tear can cause a snapping sensation as well as pain in the groin area. One study found acetabular tears accounted for 80% of intra-articular snapping hip cases.¹Yamamoto Y, Hamada Y, Ide T, Usui I. Arthroscopic surgery to treat intra-articular type snapping hip. Arthroscopy. 2005;21(9):1120-5.

  See Diagnosing a Hip Labral Tear

• An injury to the articular cartilage, which covers bones' surfaces where they articulate, or meet up with one another. This cartilage reduces friction between the bones at the joint, and it can be damaged suddenly from a traumatic injury or over time from arthritis.
• Loose bodies of material in the hip that interrupt the joint’s normal biomechanics and cause a catching or snapping sensation. For example, following a trauma, a fragment of soft tissue or bone can break away and get trapped between the hip’s ball and socket.

Snapping hip due to a cartilage injury may develop suddenly, and may be caused by a fall or other trauma. It is often accompanied by a catching sensation and/or a limited range of motion in the hip.

People who have snapping hip syndrome with painful symptoms should consult a physician. A medical professional can give an accurate diagnosis and help develop a treatment plan to alleviate pain and minimize possible future joint damage.

Diagnosing Snapping Hip

Keep in mind that before treatment can begin, an accurate diagnosis must be made. The hip is a complex joint located deep within body, so diagnosing hip problems can be challenging. A doctor will begin by interviewing the patient and performing a physical exam. Medical imaging, such as X-rays and MRIs, may be ordered.

Watch: Hip Pain Diagnosis Video

To diagnosis snapping hip syndrome a doctor must rule out other conditions that can cause similar symptoms. These conditions include but are not limited to:

• Hip arthritis, a degeneration of the hip joint that may cause pain and limit movement.
• Meralgia paresthetica, a compression of the lateral femoral cutaneous nerve, causes pain and numbness on the thigh.
• Tumors in the hip that may change the biomechanics of the hip.
• Hip joint synovitis, or inflammation of the hip joint’s membrane lining, which causes swelling and symptoms that sometimes mimic those of snapping hip syndrome.

Once the diagnosis is decided then treatments can be recommended.