Snapping Hip Syndrome

Snapping hip syndrome, also known as coxa saltans or dancer’s hip, is a condition where patients experience or hear an audible click or snap when moving the hip. The snapping can be painless or accompanied by discomfort. It happens when muscles or tendons slide over bony structures near the hip joint. Over time, this repetitive motion may irritate the surrounding tissues, causing inflammation and pain during everyday activities.

How Common It Is and Who Gets It? (Epidemiology)

Snapping hip affects about 5–10% of the population and is more common among athletes, dancers, and young active adults. It occurs more often in women and individuals who perform repetitive hip movements such as running, jumping, or lifting. Teenagers engaged in ballet or sports are also more susceptible due to muscle tightness and flexibility changes during growth.

MRI of the hip joint showing various structures

MRI of the hip joint showing various structures

Why It Happens – Causes (Etiology and Pathophysiology)


Snapping hip occurs when tendons or muscles repeatedly move over bony prominences, creating a clicking sensation. The causes can be divided into three types:

Internal snapping

Snapping is caused by tendons passing in front of the Hip joint. The patients’ illicit audible snapping by bending and extending their affected hip, pointing at the area in front of the Hip with their finger. This type of snapping is due to the tendon of the iliopsoas and rectus femoris passing over the knobby head of the femur bone repeatedly.

External snapping

Patients usually report the visible movement of snapping of structures around the later side of the Hip joint. The iliotibial band (ITB) acts like a tight band moving from behind to front over the outer side of Hip while bending the hip. 

The greater trochanter is a projection on the outer side of the Hip joint, the ITB when tight moves and accompanies a snapping sensation. Over time the bursae overlying the greater trochanter becomes inflamed and causes pain

The hamstrings are a large group of muscles behind the Hip joint. The tendon can sometimes cause snapping sound when passing over the ischial tuberosity, also known as the sitting bone. 

Intra-articular

Labrum tears and foreign bodies inside the joint capsule cause snapping of the Hip joint. Snapping is usually accompanied by a locking sensation. The labrum and lose bodies cause physical obstruction to the movement of the Hip joint in some positions of the hip. 

How the Body Part Normally Works? (Relevant Anatomy)

The hip is a ball-and-socket joint formed by the femoral head (ball) and the acetabulum (socket). Ligaments and muscles stabilize and move the joint, while tendons connect muscles to bone. Fluid-filled bursae cushion these tissues, allowing smooth motion. When the tendons or bands are tight or inflamed, they may rub or “snap” against the bone during hip movement.

What You Might Feel – Symptoms (Clinical Presentation)

The hallmark symptom is a snapping or popping sound during hip movement, such as when walking, standing up, or swinging the leg. Some patients also feel a visible flicking over the side or front of the hip. Pain may develop if bursae or tendons become irritated. Intra-articular snapping can cause catching, locking, or stiffness in the joint.

How Doctors Find the Problem? (Diagnosis and Imaging)

Diagnosis begins with a detailed medical history and physical examination. The doctor may ask you to reproduce the snapping motion to identify the source. X-rays rule out bony abnormalities, while ultrasound or MRI arthrograms visualize tendons, bursae, and the labrum. In some cases, diagnostic anesthetic injections help pinpoint whether the snapping comes from inside or outside the joint.

Classification

Snapping hip syndrome is classified into:

  • External: Caused by the iliotibial band snapping over the greater trochanter.
  • Internal: Caused by the iliopsoas or rectus femoris tendon sliding over the front of the joint.
  • Intra-articular: Caused by labral tears or loose bodies inside the hip.
    Each type has distinct movement patterns and physical exam findings.

Other Problems That Can Feel Similar (Differential Diagnosis)

Conditions that may mimic snapping hip include hip bursitis, gluteal tendinopathy, hip impingement, or labral tears. Lower back or sacroiliac joint disorders can also cause referred hip pain. Careful examination and imaging help distinguish between these causes.

Treatment Options

Non-Surgical Care – Most cases improve with conservative treatment:

  • Modify or avoid activities that trigger snapping.
  • Use over-the-counter pain relievers like acetaminophen or NSAIDs for short-term relief.
  • Apply ice to reduce inflammation in acute cases.
  • Physical therapy focusing on stretching tight muscles (especially iliotibial band and hip flexors) and strengthening hip stabilizers.
  • Corticosteroid injections may relieve bursitis and reduce inflammation.

Surgical Care – Surgery is reserved for persistent cases that do not respond to therapy:

  • Arthroscopic surgery uses a camera and small instruments to release tight structures or remove loose bodies. This minimally invasive procedure allows patients to walk the same day.
  • Open surgery may be needed for more complex cases to release tight tendons or repair damaged tissues. Recovery is longer but typically successful.

Recovery and What to Expect After Treatment

Most patients recover well with rest and physical therapy, often within weeks to months. Pain relief after steroid injections may occur quickly, while full recovery from arthroscopic surgery typically takes a few months. Consistent stretching and strengthening are key to preventing recurrence.

Possible Risks or Side Effects (Complications)

Potential complications include persistent snapping, inflammation, or temporary weakness from surgery. Recurrence can occur if tightness returns or if stretching is not maintained. Serious complications are rare.

Long-Term Outlook (Prognosis)

The prognosis for snapping hip syndrome is excellent. With appropriate therapy and rehabilitation, most patients regain full hip function and return to normal activities. Surgery has a high success rate when required, and recurrence is uncommon with continued stretching and strengthening.

Out-of-Pocket Costs

Medicare

CPT Code 27006 – Open Iliopsoas Tendon Release (Tenotomy, Hip Flexor, Open): $167.71

CPT Code 27001 – Open Adductor or Iliotibial (IT) Band Release (Tenotomy, Adductor or Fascia Lata): $129.11

CPT Code 20610 – Corticosteroid Injection (Major Joint or Bursa – Hip): $15.12

Medicare Part B typically covers 80% of the approved cost for these procedures once your annual deductible has been met, leaving you responsible for the remaining 20%. Supplemental Insurance plans such as Medigap, AARP, or Blue Cross Blue Shield usually cover that remaining 20%, minimizing or eliminating out-of-pocket expenses for Medicare-approved treatments. These plans coordinate with Medicare to fill the coverage gap and reduce financial responsibility.

If you have Secondary Insurance, such as TRICARE, an Employer-Based Plan, or Veterans Health Administration coverage, it acts as a secondary payer. These plans typically cover any remaining balance, including coinsurance or small deductibles, which generally range between $100 and $300, depending on your plan and provider network.

Workers’ Compensation

If your snapping hip syndrome is related to a work injury or repetitive movement at work, Workers’ Compensation will cover all related medical expenses, including surgery, corticosteroid injections, and rehabilitation. You will not have any out-of-pocket costs, as the employer’s insurance carrier directly covers all approved treatments.

No-Fault Insurance

If your snapping hip was caused or worsened by an automobile accident, No-Fault Insurance will typically cover the total cost of treatment, including injections or tendon release surgery. The only potential out-of-pocket cost may be a small deductible or co-payment depending on your insurance policy.

Example

Samantha Brooks suffered from snapping hip syndrome and underwent an open iliopsoas tendon release (CPT 27006) after unsuccessful conservative treatment. Her estimated Medicare out-of-pocket cost was $167.71. She also received a hip corticosteroid injection (CPT 20610) with an additional $15.12 cost. Since Samantha had supplemental insurance through AARP Medigap, her remaining balance was fully covered, leaving her with no out-of-pocket expenses for her procedures.

Frequently Asked Questions (FAQ)

Q. Is snapping hip dangerous?
A. No. It’s usually harmless, but if pain or inflammation develops, it should be evaluated by a doctor.

Q. Can snapping hip go away on its own?
A, Yes, many cases resolve with rest, stretching, and strengthening exercises.

Q. Will I need surgery?
A. Surgery is rarely needed. It’s only considered when conservative measures fail to relieve symptoms.

Summary and Takeaway

Snapping hip syndrome causes a clicking or popping sound in the hip due to tendons or muscles moving over bony structures. It’s common in athletes and active individuals but rarely serious. Most cases improve with rest, physical therapy, and stretching. For persistent cases, arthroscopic or open surgery can effectively relieve symptoms and restore mobility.

Clinical Insight & Recent Findings

Snapping hip syndrome, particularly external snapping hip, can be a bothersome condition, especially for athletes and those engaging in repetitive motions like running, dancing, or weightlifting. While conservative treatments such as stretching and physical therapy often provide relief, persistent cases may require surgical intervention.

A recent study demonstrated the effectiveness of endoscopic iliotibial band (ITB) release in treating external snapping hip syndrome. In the study, patients who had not found relief through conservative methods experienced significant improvement in their hip function and pain following the endoscopic procedure.

This minimally invasive approach provided relief with minimal complications, making it a viable surgical option for managing this condition. (“Study on endoscopic iliotibial band release for external snapping hip syndrome – see PubMed.“)

Who Performs This Treatment? (Specialists and Team Involved)

Snapping hip syndrome is managed by orthopedic surgeons, particularly those specializing in sports medicine or hip arthroscopy. Physical therapists, radiologists, and rehabilitation specialists play important roles in diagnosis and recovery.

When to See a Specialist?

If hip snapping becomes painful, limits activity, or persists despite home exercises, you should see an orthopedic specialist. Early evaluation prevents chronic irritation and inflammation.

When to Go to the Emergency Room?

Seek emergency care if hip snapping is accompanied by sudden severe pain, inability to move the leg, or symptoms suggesting joint dislocation or infection.

What Recovery Really Looks Like?

Recovery involves consistent physical therapy and gradual stretching of tight muscles. Pain relief may occur within weeks, while full flexibility and strength may take several months. After arthroscopic surgery, walking is allowed immediately, and most patients return to sports in a few months.

What Happens If You Ignore It?

Ignoring snapping hip syndrome can lead to chronic inflammation, bursitis, or persistent pain. Over time, it may limit mobility or affect athletic performance.

How to Prevent It?

Regular stretching of hip flexors, iliotibial band, and gluteal muscles can prevent tightness. Warm up before exercise, use proper technique, and gradually increase activity levels. Avoid repetitive hip movements without rest.

Nutrition and Bone or Joint Health

A balanced diet rich in calcium, vitamin D, and lean protein supports joint health and muscle recovery. Staying hydrated and maintaining a healthy weight reduce stress on the hip joint.

Activity and Lifestyle Modifications

Low-impact activities like swimming or cycling are ideal during recovery. Incorporate flexibility exercises such as yoga or Pilates to maintain mobility. Avoid repetitive, high-impact activities until full strength and flexibility return.

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Dr Mo Athar md

El Dr. Mohammad Athar, cirujano ortopédico con amplia experiencia y especialista en pie y tobillo, atiende a sus pacientes en las consultas de Complete Orthopedics en Queens/Long Island. Con formación especializada en reconstrucción de cadera y rodilla, el Dr. Athar cuenta con una amplia experiencia en prótesis totales de cadera y rodilla para el tratamiento de la artritis de cadera y rodilla, respectivamente. Como cirujano ortopédico, también realiza intervenciones quirúrgicas para tratar roturas de menisco, lesiones de cartílago y fracturas. Está certificado para realizar reemplazos de cadera y rodilla asistidos por robótica y es un experto en técnicas de vanguardia para el reemplazo de cartílago.

Además, el Dr. Athar es un especialista en pie y tobillo con formación especializada, lo que le ha permitido acumular una vasta experiencia en cirugía de pie y tobillo, incluyendo el reemplazo de tobillo, nuevas técnicas de reemplazo de cartílago y cirugía de pie mínimamente invasiva. En este ámbito, realiza cirugías para tratar la artritis de tobillo, las deformidades del pie, los juanetes, las complicaciones del pie diabético, las deformidades de los dedos de los pies y las fracturas de las extremidades inferiores. El Dr. Athar es experto en el tratamiento no quirúrgico de afecciones musculoesqueléticas en las extremidades superiores e inferiores, como aparatos ortopédicos, medicamentos, ortesis o inyecciones para tratar las afecciones mencionadas anteriormente. Capacidades de edición limitadas.

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