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Snapping Hip
A snapping sensation rarely comes from the hip joint itself. Disorders of the hip joint can cause catching, locking or sharp pain in the groin, but true snapping usually is a result of one of two structures: the iliopsoas tendon or the iliotibial band.
The iliopsoas muscle originates in the pelvis and becomes tendinous just above the hip joint and is a very powerful hip flexor. Approximately 10% of the active population has a snapping psoas tendon. It is heard and felt as a large snap in the groin as the hip goes from a flexed to extended position. If this condition becomes painful, it can be very challenging to treat. Nonoperative treatment consists of exercises designed to stretch the muscle. If nonoperative treatment fails to provide adequate relief, the snapping tendon can be released through the arthroscope.
The iliotibial band is formed by two muscles: the tensor fascia latae and the gluteus maximus. These muscles originate on the pelvis and come together to form a large fascial band that crosses both the hip and knee joint and inserts on the tibia just below the knee. This tendon typically glides over the bony prominence of the greater trochanter. If snapping results, the tendon can often be seen to snap over the greater trochanter, giving the patient the sensation that the hip is unstable. This problem typically responds very well to a physical therapy protocol that focuses stretching the iliotibial band and strengthening of the muscles. Very rarely is surgical intervention required for this condition.
Reviewed By: G. Peter Maiers II, MD
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