Snapping hip syndrome causes a snap or pop in the hip with everyday movement. Sometimes it’s painful, but often it’s just annoying. So what is snapping hip syndrome, how do we diagnose it, and how do we treat clicking hip syndrome?
What is snapping hip syndrome?
Snapping or popping in the hip can occur during everyday activities — walking, running, getting out of a chair, or swinging the leg. In most cases, the snapping comes from a tendon and is harmless, though it can be irritating. Occasionally, though, it’s due to a cartilage or labral injury inside the hip joint, which matters more.
There are three types, depending on where the snapping comes from.
What causes clicking hip syndrome?
Snapping happens wherever a muscle or tendon rubs over a prominent bone. There are three main sites:
Front of the hip (internal snapping hip)
This occurs when the large hip flexor tendon — the iliopsoas — slides over the front of the hip bone. As the hip moves from bent to straight, the psoas and iliacus tendons flip over each other and the bone, causing a snap. Everyday movements such as walking or standing up can trigger it, and it’s sometimes painful when associated with iliopsoas tendonitis.
Side of the hip (external snapping hip)
This is the commonest type. It happens as the iliotibial (IT) band passes over the bony prominence on the outer side of the hip — the greater trochanter. When the hip is straight, the IT band sits behind the bone; as the hip bends, it moves in front of the bone. If the band is tight, that movement causes a snap, typically with running or climbing stairs. Pain here can come from associated gluteal tendinopathy or trochanteric bursitis, and it can be hard to lie on that side at night.
Inside the joint (intra-articular)
Here the snapping or clicking comes from within the hip joint — usually a cartilage or labral tear, or a loose body catching in the joint. An injury often triggers these, and this is the type that warrants closer assessment.
People who are tight or who do frequent, repetitive hip movements — dancers, runners, and footballers — are the most prone to a snapping hip.
How is snapping hip syndrome diagnosed?
A full assessment begins with a history and clinical examination to confirm the source of the snapping.
The snap usually occurs with hip flexion, with or without pain. Some people also feel unable to keep exercising, or that the hip “isn’t sitting right” or might give way. The examination locates the snap and — importantly — works out whether it’s coming from outside the joint (a tendon) or inside it (cartilage or labrum), because that changes everything.
Snapping hip tests
Specific tests help confirm the source:
- For an external snap, you lie on your side (affected side up), and the hip is moved back and forth to reproduce the pop.
- For an internal snap, you lie on your back; the affected knee is bent up and rotated outwards, then brought back to neutral, and a snap is felt at the front of the hip.
Feeling the snap is key to pinpointing where it’s from.
Imaging
- X-ray — shows the shape of the hip bones.
- MRI — shows tendon swelling or a labral injury.
- Dynamic ultrasound — often the most useful of all, because it shows the tendon actually flicking over the bone, and the snap, in real time. This is a real strength of assessing a snapping hip with ultrasound in clinic.
How is snapping hip syndrome treated?
In most cases, a snapping hip isn’t painful — and reassurance is all that’s needed. Knowing it’s a harmless tendon flicking over bone, rather than something damaging, is often the most useful “treatment”.
For a painful snapping hip, simple measures come first: rest from the aggravating activity, ice, and ibuprofen. Massage or soft-tissue therapy can ease the tightness.
Snapping hip exercises
Stretching is the mainstay. Stretching the hip flexors, quadriceps, hamstrings, and IT band on most days reduces the tightness that drives the snap, and yoga helps lengthen the muscles. Alongside stretching, strengthening the glutes, hamstrings, and hip flexors improves control and reduces the abnormal hip movement when walking and running.
Are injections an option?
Injections play only a small role. But for acute pain that hasn’t responded to simple treatment, a targeted cortisone injection can help — a psoas sheath injection for an internal snapping hip, or an IT band injection for an external one. We perform these under ultrasound guidance for accuracy.
Surgery is a last resort, only for cases that fail conservative treatment — hip arthroscopy for a labral tear, iliopsoas release for internal snapping, or IT band lengthening for external. These carry real risks, including infection, scarring, and chronic pain, so the bar for surgery is high.
Frequently asked questions about snapping hip syndrome
Is snapping hip syndrome serious?
Usually not. Most snapping hips are a harmless tendon flicking over bone, and need only reassurance. The exception is snapping from inside the joint — a cartilage or labral tear — which is worth assessing properly. If your snapping is painful or followed an injury, it’s worth getting checked.
Why does my hip snap when I walk or get up?
Most often because a tight tendon — the iliopsoas at the front, or the IT band on the side — is flicking over a bony prominence as the hip moves; it’s mechanical, not a sign of damage in most cases, and it’s especially common in people who are tight or do a lot of repetitive hip movement.
How do I get rid of a snapping hip?
For most people, stretching the hip flexors, quads, hamstrings, and IT band on most days, plus glute and hip strengthening, reduces the snapping over time. A painful snap also benefits from rest, ice, and anti-inflammatories, and occasionally a guided injection. Surgery is rarely needed.
Can a snapping hip cause damage?
An external or internal snapping hip (tendon) doesn’t usually damage the joint — it’s mainly a nuisance, sometimes accompanied by tendonitis. An intra-articular snap from a labral or cartilage problem is different, and left unassessed, it can be associated with ongoing joint symptoms — another reason to identify which type you have.
Which specialist should I see for a snapping hip?
A doctor experienced in sports and musculoskeletal medicine can assess the hip, use dynamic ultrasound to visualise the snap in real time, and determine whether it’s coming from a tendon or from inside the joint — which determines the treatment. Your doctor may also use additional imaging tests to rule out other causes of hip snapping, such as X-ray and/or MRI.
Final word from Sport Doctor London about snapping hip syndrome
Snapping hip syndrome is common, especially in young athletes and dancers. In most cases it’s harmless, and reassurance is all that’s needed. Where there’s pain, rehabilitation exercises are effective, and ultrasound-guided injections help in more challenging cases. The key is to identify which type you have — particularly by ruling out an intra-articular cause.
If you have a painful or persistent snapping hip, Dr Masci can assess you in London, including dynamic ultrasound in clinic. Contact the team here or call +44 (0) 203 488 0350.
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