Hip clicks, or snapping hip syndrome, are common occurrences where a sensation or sound emanates from the hip joint or surrounding tissues during movement. This phenomenon often affects individuals engaged in activities requiring repetitive hip bending, such as dancers and athletes. While frequently harmless, a hip click can occasionally signal an underlying issue that warrants attention.
Understanding the Causes of Hip Clicks
Hip clicks can arise from several sources, ranging from benign to those indicating specific conditions. One common reason is external snapping hip syndrome, where the iliotibial (IT) band or gluteus maximus tendon glides over the greater trochanter, a bony prominence on the side of the thigh bone. This often produces a snap on the outside of the hip during activities like walking or climbing stairs. Tightness or overuse of these muscles can increase tension on the tendons, causing this sensation.
Another cause is internal snapping hip syndrome, which occurs deeper within the hip. This type involves the iliopsoas tendon, connecting inner hip muscles to the thigh bone, snapping over the iliopectineal eminence or femoral head. This internal click is felt in the front of the hip during hip flexion and extension movements, like running. Tightness or inflammation of the hip flexor muscles can contribute to this snapping.
Clicking can also originate from within the hip joint itself, referred to as intra-articular causes. These include a labral tear, which is damage to the cartilage rim around the hip socket. Loose bodies, such as small fragments of bone or cartilage floating within the joint, or damage to the articular cartilage covering the bones, can cause catching or locking sensations accompanied by a click. These intra-articular issues are less common but more serious.
Less frequently, gas bubbles forming and collapsing within the synovial fluid can produce a popping sound, known as cavitation. This is a normal and harmless occurrence, similar to cracking knuckles. Other muscular or tendon imbalances can also contribute to hip clicking due to altered biomechanics or friction during movement.
When Hip Clicks Warrant Medical Attention
While many hip clicks are harmless, certain accompanying symptoms suggest a need for medical evaluation. If the hip click is consistently accompanied by pain, it indicates a potential underlying problem. Swelling around the hip joint can signal inflammation or injury, prompting a medical visit.
Stiffness, limping, weakness, or instability in the hip joint, especially when these symptoms interfere with normal activities, warrants professional attention. If the clicking sensation begins suddenly, particularly after an injury, seek medical advice. Persistent clicks that change or become painful over time, even if initially benign, should be evaluated by a healthcare professional.
Common Diagnostic Approaches and Management Strategies
When a hip click causes concern, a healthcare professional begins with a thorough medical history and physical examination. During this assessment, the doctor inquires about the symptoms, their onset, and activities that elicit the clicking sound. They also perform specific movements to observe the hip’s range of motion and identify the location and cause of the click.
Imaging tests may be ordered. X-rays can rule out bony abnormalities or arthritis, while a magnetic resonance imaging (MRI) scan provides detailed images of soft tissues like tendons, ligaments, and cartilage, to detect tears or inflammation. An ultrasound may be used to visualize tendon movement in real-time or to guide injections.
Management strategies for hip clicks begin with conservative approaches. Rest and activity modification are recommended to reduce stress on the hip, which may involve avoiding movements that trigger the click. Nonsteroidal anti-inflammatory drugs (NSAIDs) can alleviate pain and reduce inflammation. Physical therapy plays a role, focusing on stretching tight muscles like the IT band and hip flexors, strengthening surrounding musculature, and improving hip biomechanics.
If conservative measures do not provide relief, other interventions may be considered. Corticosteroid injections, containing anti-inflammatory medication, can be administered into the affected area, such as a bursa, to reduce pain and inflammation. Hyaluronic acid injections may be used to lubricate the joint, particularly for osteoarthritis-related pain. Surgery is considered a last resort for persistent and severe cases that have not responded to conservative treatment, such as significant labral tears or recalcitrant snapping hip syndrome.