Snapping hip syndrome occurs when a muscle, tendon, or ligament rolls over a bony prominence in the hip, with or without causing pain. It can occur in different areas of the hip, including:

• Front. Snapping at the front of the hip can involve the hip flexor muscle rolling over the front of the hip bone, or the hip ligaments rolling over the thigh bone or tissues of the hip joint.
• Side. This condition involves the iliotibial band (ITB) rolling over the outer thigh bone, or the big muscle on the back of the hip (gluteus maximus) sliding over the outer thigh bone.
• Back. This condition involves 1 of the hamstring muscles rolling over the bottom of the hip bone.

Snapping hip syndrome can occur when the hip muscles are excessively used and become fatigued, tight, and/or swollen. Athletic activities like track and field, soccer, weight lifting, horseback riding, cycling, gymnastics, and dance can trigger the condition. It also can occur during everyday activities that require repeated lifting or rotating of the leg outward.

Snapping hip syndrome causes a snapping sensation and sound that can be felt in the front, the side, or the back of the hip. Often, the snapping can be pain free. If it causes pain, the pain usually ceases when the leg movement causing the snapping is stopped. The sensation is often experienced when an individual is required to use their hip to change positions. In athletes and dancers, the snapping can be accompanied by weakness and may diminish performance.

The snapping is most commonly felt when kicking the leg forward or to the side, when bringing the leg behind the body, when rising from a chair, or when rotating the body or the leg.

Often, walking and running in a straight line are snap free and pain free, although in some people, these activities are limited by the pain of the structure that is snapping.

With snapping hip syndrome, you may experience:

• Snapping or popping in the front, side, or back of the hip when lifting, lowering, rotating, or swinging the leg
• Weakness in the leg when trying to lift it forward or sideways
• Tightness in the front, back, or side of the hip
• Swelling in the front, back, or side of the hip
• Difficulty performing daily activities, such as rising from a chair and walking

If you see your physical therapist first, the therapist will conduct a thorough evaluation that includes taking your health history. Your physical therapist may ask you:

• How you injured your hip and if you heard a pop when you suffered the injury
• If you feel snapping, popping, or pain
• Where you feel the snapping, popping, or pain
• If you experienced a direct hit to the leg
• If you saw swelling in the first 2 to 3 hours following an injury
• If you experience pain when lifting your leg forward or backward, walking, changing directions while walking or running, or when lifting the leg
• If you participate in any repetitive, forceful, or plyometric (quick explosive jumping) sport activities

• Is this a preexisting sensation that is now becoming painful

Your physical therapist also will perform special tests to help determine whether you have a snapping hip, such as:

• Asking you to lift your leg quickly or rotate your hip outward
• Asking you to push against the physical therapist’s hand when the therapist tries to push your leg outward, backward, and forward (muscle strength test)
• Gently feeling the muscle to determine the specific location of the injury (palpation)
• Assessing your muscle flexibility

Your physical therapist may use additional tests to assess possible damage to other parts of your body, such as your hip joint or lower back.

To provide a definitive diagnosis, your physical therapist may collaborate with a physician or other health care provider. The physician may order further tests—such as an X-ray or magnetic resonance imaging (MRI)—to confirm the diagnosis and also to rule out other potential damage. However, these tests are not commonly needed to diagnose snapping hip syndrome.

Your physical therapist will design an individualized treatment program based on your specific condition, health history, and goals, to help you recover from snapping hip syndrome in the safest way possible. It may include exercises you can perform at home. The program will also focus on reconditioning and prevention of future injury.

The First 24-48 Hours

Your physical therapist may advise you to:

• Rest the injured hip by avoiding walking or any activity that causes pain. In rare cases, crutches may be recommended to reduce further strain on the muscles when walking.
• Apply ice packs to the affected area for 15 to 20 minutes every 2 hours to reduce swelling.
• Consult with another health care provider for further services, such as medication or diagnostic tests.

Your physical therapist will design your treatment program to ensure your safe recovery. It may include treatments and exercises to:

Reduce pain. Your physical therapist can use different types of treatments to control and reduce your pain including ice, heat, ultrasound, electrical stimulation, taping, exercises, or manual (hands-on) therapy techniques for your muscles and joints. Your physical therapist will determine the best treatments for your specific condition.

Improve motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in the leg and hip. These might start with movements of the leg and hip joint that the physical therapist gently performs for you, and progress to active exercises and stretches you perform yourself. Treatment for snapping hip syndrome often involves manual therapy techniques called trigger point release and soft tissue mobilization, as well as specific stretches for muscles that might be abnormally tight, and to correct any muscle imbalances.

Improve strength. Certain exercises will benefit you at each stage of recovery. Your physical therapist will choose and teach you the appropriate exercises that will restore your strength, power, and agility. These may be performed using free weights, resistance bands, weight-lifting equipment, and cardio-exercise machines, such as treadmills and stationary bicycles. Muscles of the hip and core may be targeted.

Speed recovery time. Your physical therapist is trained and experienced in choosing the treatments and exercises to help you heal, get back to your normal life, and reach your goals faster than you could on your own.

Return to activities. Your physical therapist will collaborate with you to decide on your recovery goals, including return to work and sport, and design your plan of care to help you reach those goals in the safest, fastest, and most effective way possible. Your physical therapist may use hands-on therapy and teach you exercises and work-retraining activities. Athletes may be taught sport-specific techniques and drills to help them return to their particular sports.

Prevent future re-injury. Your physical therapist can recommend a home-exercise program to strengthen and stretch the muscles around your hip, upper leg, and core (abdomen) to help prevent future injury. These may include strength and flexibility exercises for the hip, thigh, and core muscles.

If Surgery Is Necessary

Surgery is rarely necessary in the case of snapping hip syndrome. If it is required, your physical therapist will help you minimize pain, restore motion and strength, and return to normal activities in the speediest and safest manner possible after surgery.

Snapping hip syndrome can be prevented:

• Warm up before starting a sport or heavy physical activity. Your warm-up should include stretches taught to you by your physical therapist, including those for the muscles on the front, side, and back of the hip.
• Gradually increase the intensity of an activity or sport. Avoid pushing too hard, too fast, too soon.
• Follow a consistent strength and flexibility exercise program to maintain good physical conditioning, even in a sport’s off-season.
• Wear shoes that are in good condition and fit well.
• Modify activity when symptomatic snapping occurs. Call a physical therapist.

All physical therapists are prepared through education and experience to treat snapping hip syndrome. However, you may want to consider:

• A physical therapist who is experienced in treating people with snapping hip syndrome. Some physical therapists have a practice with an orthopedic, sports rehabilitation, or performing arts/dance focus.
• A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopedic or sports physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.

You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you're looking for a physical therapist (or any other health care provider):

• Get recommendations from family, friends, or other health care providers.
• When you contact a physical therapy clinic for an appointment, ask about the physical therapists' experience in helping people experiencing snapping hip syndrome.
• During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and describe what motions and/or activities make your symptoms worse.