How do you know when hip popping and snapping is something to be concerned about? A general rule of thumb is if you have pain in the joint along with popping sounds you want to see a qualified health practitioner.
There are three areas where snapping or popping may be felt and heard. The most common area is at the outside of the hip at the greater trochanter of the femur. Snapping hip syndrome is named for the clunking sound that occurs at the greater trochanter when the dancer stands and shifts their weight onto the leg, which creates the snapping sensation and clunking sound. Extremely tight lateral hip muscles create this clunk as they snap over the greater trochanter. This is not a desirable action as it’s an easy way to develop bursitis or tendonitis in the greater trochanter area over time due to the constant irritation. The solution is to stretch the lateral hip muscles. You can do this by standing on one leg and letting the hip move sideways as the upper body.
The second area of popping is around the front of the hip. This pop is often heard during a kick or battement. For some dancers their hip pops every time they lift their leg, and for others once they ‘pop’ their hip by standing on one leg tipping the pelvis forward as they lean to the side, it won’t pop for a while. This type of popping is generally related to the iliopsoas tendon. Sometimes the iliopsoas tendon snaps over the bony ridge of the pelvis or femur. There is always a bursa that acts like a pillow between the joint and a tendon and when the iliopsoas bursa gets irritated and inflamed you will also feel pain in the front of the hip besides hearing and feeling the pop. If you feel a popping sensation in the front of the hip try stretching out the iliopsoas by frequently doing a runner’s lunge stretch. This stretch can be done standing with your foot up on a surface, sitting (as shown) or on the floor in the more traditional stretch. If stretching the iliopsoas muscle helps decrease the popping, then briefly stretch before or after battements, and periodically during class between combinations and at the end of class. As with all tight muscles when you first begin to stretch, the muscle acts like a yo-yo. You stretch it out and then it wants to go back to its original shape. It takes time and commitment to truly change the flexibility of a muscle.
The third area where pops may be felt is within the joint. Labral tears are often the cause. What is a labral tear? Let’s start by remembering that the hip joint is a ball and socket joint. The head of the thigh bone is the ball, and the acetabulum is the socket. In latin ‘labrum’ means lip. So the acetabular labrum is the ring of cartilage that is attached to the edge of the acetabulum and acts to deepen the bowl shape where the head (or ball) of the femur rests.
Injuries to the labrum can occur from chronic trauma, such as a dancer working to turnout their leg through sheer muscular determination and force, and also acute trauma, such as a fall or violent motion at the joint.
Signs and symptoms that accompany a labral tear may be pain with certain movements, (usually in the groin area), loss of strength, decreased range of motion, and a ‘catching sensation’ in the hip.
I checked in with sports physician, Vernon Patterson, DO, and asked him about labral tears at the hips. He reported that the majority of patients with labral tears have a history of acute injury while weight bearing that resulted in a sudden onset of groin pain and a period of pain and disability. The initial injury may have been earlier in their career, but memorable. If the dancer did not have any significant injury history to the area then he would be concerned about structural problems that could make them highly susceptible to other joint problems, including labral tears.
While the majority of hip popping is benign and won’t cause painful problems, they are a signal that the muscle balance around the hip needs to be evaluated. But if there is pain with the popping sensation see a physician. Your hips will thank you for listening!