Hearing or feeling a “click” or “pop” in the hip is common. Often called snapping hip syndrome, it occurs during movements like walking or swinging a leg. While unsettling, the sound is frequently harmless and painless, affecting 5-10% of the population. Athletes and dancers may notice it more due to repetitive hip motions.
Common Causes of Hip Clicking Sounds
One common reason for hip clicking is the formation and collapse of gas bubbles within the joint, known as cavitation. Synovial fluid lubricates joints and contains dissolved gases. When hip joint surfaces separate rapidly, a vacuum effect causes these gases to form temporary bubbles, producing a pop. Similar to cracking knuckles, this mechanism causes no discomfort.
Another frequent cause involves tendons sliding over bony structures, categorized as external or internal snapping hip. External snapping occurs when the iliotibial (IT) band or gluteus maximus tendon glides over the greater trochanter, a bony prominence on the thigh. This creates a snapping sensation on the outer hip, particularly during running or climbing stairs.
Internal snapping, deeper within the hip, involves the iliopsoas tendon. This tendon, connecting inner hip muscles to the thigh, can snap over bony prominences like the iliopectinal eminence or the femoral head. This snapping is often felt at the front of the hip when rotating it away or flexing beyond 90 degrees. While generally painless, consistent friction can lead to irritation. Ligaments can also occasionally produce sounds as they shift or stretch around the joint.
When Hip Clicking Warrants Medical Attention
While often benign, certain hip clicking symptoms suggest medical attention. If clicking is consistently associated with sharp, persistent pain, it warrants further investigation. Pain increasing with activity or interfering with daily function indicates an underlying issue.
Other concerning symptoms include swelling or stiffness around the hip. A sensation of the hip catching, locking, or instability (where it seems to give out) prompts medical consultation. These symptoms suggest conditions such as a labral tear (damage to the cartilage rim of the hip socket), hip impingement, or cartilage damage. Persistent irritation from snapping tendons can lead to bursitis, inflammation of the fluid-filled sacs that cushion the hip.
Diagnosis and Management Approaches
A medical professional can determine the cause of hip clicking, especially with symptoms. Evaluation begins with a detailed medical history, where the doctor asks about the clicking’s nature, discomfort, or limitations. A physical examination is then conducted, where the doctor may ask the individual to perform specific hip movements to reproduce the snapping sound or sensation, allowing them to feel tendons and pinpoint the area. Imaging tests, such as X-rays, MRI, or ultrasound, may be ordered to rule out bone or joint problems, assess soft tissue, or identify conditions like labral tears or bursitis.
Once diagnosed, initial management involves non-surgical approaches like rest, activity modification, and ice to reduce inflammation. Physical therapy plays a significant role, addressing muscle imbalances or tightness through stretches for hip flexors or the IT band, and strengthening exercises for hip and core muscles. Nonsteroidal anti-inflammatory drugs (NSAIDs) may alleviate pain and inflammation, and corticosteroid injections can reduce localized inflammation. Surgical intervention is generally a last resort for persistent, painful hip clicking unresponsive to conservative treatments, particularly if a structural issue like a labral tear or tendon impingement exists.