Overview
what it is and why it mattersSnapping hip is exactly what it sounds like: a snap, click, or pop you can hear or feel at the hip when you move it a certain way. There are three flavors. External is when the thick band of tissue running down the outside of your thigh (the IT band) flips over the bony bump on the side of your hip. Internal is when one of the deep hip-flexor tendons in your groin (the iliopsoas) catches on a bony ridge inside the front of the hip. Intra-articular is when something loose inside the joint itself (a piece of cartilage, a tear in the rim of the socket) is what's snapping.
External and internal snapping are common in dancers and gymnasts and often do not hurt at all. A painless snap is usually harmless. When the snap is painful, or when we suspect something is loose inside the joint, that is when it is worth a workup.
After Hip Replacement
iliopsoas impingement after THASnapping hip is a known issue after a total hip replacement. It usually comes from a deep hip-flexor tendon in the groin (the iliopsoas) catching on the edge of the new joint parts. Many cases settle on their own and never need specific treatment.
The usual pattern is pain in the front of the groin when you use the hip flexor against resistance: getting up from a low chair, climbing stairs, putting on socks or shoes, or getting in and out of a car. You may notice a snap or click in the front of the hip. Pain at rest is unusual; pain with movement that loads the hip flexor is the rule.
Imaging usually starts with X-rays, and a CT scan can show the position of the new joint parts in more detail. The most useful test is an image-guided injection that temporarily numbs the tendon: if that relieves the pain, the tendon is confirmed as the source.
Care starts without surgery. The first step is avoiding the specific positions and loads that bring on the pain. Physical therapy works on lengthening the hip flexor and improving how you move. An image-guided injection can both confirm the source and give lasting relief. If the pain does not settle, the options are a small surgical release of the tendon or, when the position of the new joint parts is clearly the cause, surgery to revise them.
OSI evaluates hip pain after a hip replacement and coordinates the workup. Image-guided injections and revision surgery are referred out when those steps become the right call.
Symptoms
what you may notice- An audible or palpable snap, click, or pop at the hip, typically with a specific reproducible movement
- External type: snapping on the outside of the hip when you walk, run, or swing your leg forward
- Internal type: a deep snap or click in the groin when you bring your hip from a bent to a straight position
- Pain may or may not accompany the snap, many cases are painless and just noticeable
- Aching at the side of the hip or in the groin after repetitive activity (dance, running, cycling)
- A sensation of the hip "giving way" or catching during certain movements
Diagnosis
exam first, imaging secondYour provider can usually reproduce the snap on exam. External snapping you can both see and feel at the side of the hip; internal snapping is felt in the groin and is often audible. The most useful imaging is a live ultrasound (the technician moves your hip while watching the screen), which lets us actually see the tendon flicking over bone. If we suspect a problem inside the joint, an MRI with contrast injected into the joint (MRI arthrography) shows the labrum and any loose bodies.
Treatment Path
what we try first, in orderA painless snap usually needs nothing more than reassurance. When the snap is bothersome or painful, care is conservative and starts with the simplest measures. The steps below build on each other: each one is added on top of the ones before, not instead of.
First steps we try
1
Activity modification
Cut out the specific motion that triggers the snap for a stretch. It is often a single position or movement that drives the irritation, so backing off it is the first move.
2
Stretching
Stretching the IT band on the outside of the thigh and the hip flexors at the front of the hip releases the tension that is causing the tendons to snap in the first place.
3
Physical therapy
Physical therapy focuses on strengthening the muscles around the hip, especially the glutes, and cleaning up movement patterns so the tendons track smoothly without catching.
If the first steps are not enough
Corticosteroid injection
An image-guided steroid injection placed into the inflamed bursa next to the snapping tendon takes the edge off when stretching alone has not quieted the pain.
Surgical Options
if non-operative care isn't enoughSurgery is rarely needed for snapping hip. When the snap is painful and hasn't quieted with six months or more of stretching, therapy, and injection, we can lengthen or release the offending tendon through small incisions (an endoscopic procedure).
Frequently Asked
questions we hear in clinicIs a snapping hip dangerous?
Usually not. External and internal snapping are common in dancers and gymnasts and often do not hurt at all. A painless snap is usually harmless. It is worth a workup when the snap is painful, or when we suspect something loose inside the joint.
What is actually snapping?
It depends on the type. In the external type, the thick band of tissue down the outside of the thigh (the IT band) flips over the bony bump on the side of the hip. In the internal type, a deep hip-flexor tendon in the groin (the iliopsoas) catches on a bony ridge inside the front of the hip. In the intra-articular type, something loose inside the joint itself, such as a piece of cartilage or a tear in the rim of the socket, is what snaps.
Do I need an MRI?
Often no. Your provider can usually reproduce the snap on exam, and a live ultrasound, where the technician moves your hip while watching the screen, lets us actually see the tendon flicking over bone. An MRI with contrast injected into the joint (MRI arthrography) is reserved for when we suspect a problem inside the joint, because it shows the labrum and any loose bodies.
Will I need surgery?
Rarely. Surgery is reserved for a painful snap that has not quieted with six months or more of stretching, therapy, and injection. When it is needed, we can lengthen or release the offending tendon through small incisions.
Can a hip replacement cause snapping?
Yes. Snapping hip is a known issue after a total hip replacement, most often from a deep hip-flexor tendon (the iliopsoas) catching on the edge of the new joint parts. Care starts without surgery, and an image-guided injection both confirms the source and often gives lasting relief.
Providers Who Treat Snapping Hip
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: