Matthew Silvaggio, MSPT

Matthew Silvaggio, MSPT

with Matt Silvaggio MSPT, CFMT

When a patient brings to my attention that their hip is snapping, the first question I always ask is whether it causes pain. Often times the answer is no.

If the answer is yes, then it is investigated further or if there is no pain but the frequency seems abnormal and it affects function, then it needs to be assessed.

There are 2 main types of snapping hip syndromes, both of which occur outside of the hip joint and are referred to as internal and external snapping hip.

Internal snapping hip is when the hip flexor tendon snaps over a bony prominence on the pelvis. Other times this snap can be felt because the hip flexor tendon rolls over the head of you femur causing a deep snap. In both cases, the pop will feel like it is coming from the groin region or in front of the hip. Often times this is felt if the hip is moved in a certain way but if it is not painful or does not hinder you functional, then typically it should not be worried about.

If one is experiencing pain with the snapping of the tissue over its relative bony prominence, then it should be assessed by a physician or physical therapist as soon as possible. The reason for the urgency is the sooner you get it managed, the quicker it will often go away. The pain is either from the tendon becoming inflamed from the repetitive friction or from the bursa sac between the tendon and the bony prominence has become inflamed. Stretching, soft tissue and joint mobilization, and core and hip strengthening typically provide the necessary healing environment for resolution of the pain.

External snapping hip is when the IT Band (iliotibial band) and/or the tendon from the gluteus maximus muscle snaps over a bony prominence in the hip (greater trochanter). This pop feels like it is coming from the outside of the hip. With repetitive stress on the tissue, a thickening of the IT band and gluteus maximus tendon can result with subsequent pain and inflammation. Also, the bursa sac that normally provides cushioning between the IT band and greater trochanter of the hip can be irritated as well leading to bursitis.

Again, patients with this condition should seek assessment from a physical therapist. Here in CT, direct access is available so a patient can be assessed by a PT before going to see their physician.

There are usually compensations in the way a person functions that sets them up for increased strain on the tendon, bursa or IT band. Management of these weaknesses combined with soft tissue and joint mobilization, stretching and core/hip strengthening typically provides the necessary healing environment for resolution of the pain.

In conclusion, be aware of whether the snapping tissue causes pain or not and if so, get it looked at. It is important to recognize that the muscles of the hips and legs are designed to function with efficiency. When there is a break down in efficiency, whether coming from your low back region, pelvic girdle, hips, knees, or feet, other parts of your body have to compensate. When this happens, repetitive stress injuries occur and lead to inflammation and pain.

Physical therapy at Elite Health Services focuses not only on getting rid of the pain, but finding the ultimate source of the breakdown so that it does not happen again!

Elite Health Services, located in Old Greenwich, CT is a world-class provider of certified functional manual physical therapy, personal fitness, golf & triathlon performance training, massage therapy and wellness related services.  Our team of highly skilled and dedicated professionals take a no-excuses approach to providing exceptional care, and delivering exceptional results. To learn more visit EliteHealthServices.com

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