Snapping hip

Internal – Iliopsoas flicking over the femoral head

Seen in athletes with repeated flexion and extension combined with abduction and ER – martial arts and dancers

Presentation :

  • Clicking in the groin
  • Reproducible
  • Generally unilateral
  • Isolation of rectus femoris is associated with no pain, but isolation of iliopsoas  causes pain

Treatment :

  • Non-op – Avoid intentional snapping, NSAIDs, iliopsoas stretching
  • Surgical lengthening – rarely required

External – ITB flicking over the GT

Seen in runners and cyclists

Predisposition :

  • Genu varum
  • LLD
  • Poorly positioned cycle cleats

Presentation :

  • Gradual onset
  • Pain and snapping over GT
  • Unilateral
  • May have
  • A trochanteric bursitis component – tender, painful to lie on,pain with adduction but no pain with resisted abduction
  • Pure tendinosus – non-tender, , pain with adduction, pain on resisted abduction
  • Positive Obers test

Treatment :

  • Non-Op – Rest, activity modification, NSAIDs, ITB stretching
  • Operative – ITB lengthening