One of my favourite joints is the hip. Hip wear and tear with or without pain is multifactorial in its presentation. Common comments when talking to my patients are ‘my hips click’ or ‘my hips pop out’. Now depending on what you read online and who you speak to these symptoms can start to raise concerns regarding the cause and long-term outcomes. This blog aims to address these concerns and discuss the main causes of things that go click in the hip. The three causes highlighted below are, more often than not, pain-free and harmless however should you start to feel discomfort, then physiotherapy to address muscle imbalances around the hip joint is highly effective.
Symptoms felt at the front of the hip – Snapping hip syndrome or iliopsoas (il-i-o-pso-as) snapping.
This form of snapping is often felt at the front of the hip as you are lowering the leg down from a bent position such as rising from sitting. It is thought that the iliopsoas muscle tendon snaps over a bony prominence on the pelvis or head of the femur (thigh bone). The condition is usually associated with hip flexor muscle tightness or muscle overactivity. Treatment may involve muscle strengthening exercise and addressing muscle imbalance (some weak muscles and some overly strong muscles) around the pelvis.
Symptoms felt at the side of the hip
One of the main causes of snapping is the iliotibial (il-i-o-tib-ial) band or gluteus maximus tendon moving over the greater trochanter of the femur. This can often be heard when weight bearing through the leg, for example squatting, walking, and climbing stairs. The sensation is often described by patients as ‘my hip dislocates and/or pops out’ and can be reproduced when standing on one leg whilst moving the pelvis. The important point here is that if symptoms are not painful then there is no need to worry. If painful, physiotherapy can address the issue with targeted strengthening. Either way if you wish to discuss please get in touch.
Symptoms felt at the back of the hip – ischiofemoral (is-chio-fem-o-ral) impingement
Symptoms are often present during a long stride at the point where your toes leave the floor when walking. The impingement refers to one of the deeper muscles in the hip called your quadratus femoris which becomes pinched between two bones. A less common condition than the previous two however can still cause discomfort. Treatment is aimed at reducing stride length when walking, reducing load and addressing muscle imbalances (muscles working too much or too little) around the hip.
Conclusion
We have listed the common causes of clicking hips that are situated outside of the hip joint. The majority of these conditions are noisey, possibly embarrassing, yet pain free and should not cause concern. Should you experience pain with these symptoms then physiotherapy is highly effective in their management. Key strategies through physiotherapy include education, looking at movement patterns, pelvic muscle strengthening and reducing loads through the hip.
If you have any concerns then we are more than happy to discuss with you!
Duncan