Is The Snap, Crackle, or Pop of Your Hips Cause For Alarm?

Snapping Hip (also called Clicking Hip) is a relatively common problem among dancers.  

Generally, snapping hip is characterized by a pop or cracking sound (not dissimilar to “cracking” the knuckles of the hand) as you move from hip flexion to extension – in other words, when going from a position with the knee bent and pulled up towards the torso to the knee extended down toward the other leg.

I first noticed that I had snapping hip when I was about 16 and tried my first Pilates class.  Every time one or both legs were extended out a few inches from the floor (while lying on my back), I’d hear a pop in my hip joint.  Snapping hip is often a result of a tight tendon rolling over protrusions of the femur or pelvis.

While it can be annoying and a little disconcerting to hear that popping sound, there is not necessarily any cause for alarm.

In an article by Joseph P Garry, MD, he points out that nearly half of the female ballet dancers seeking treatment for hip complaints were experiencing snapping hip, but only one third of those were experiencing pain.  A 2008 article in Current Sports Medicine Reports found that about 10% of total dancers have snapping hip, and corroborated Dr. Garry’s figure of only 30% of them reporting associated pain.

A brief functional anatomy lesson: The Hip

IMAGE Sketch of the femur head - the ball of the 'ball and socket' hip joint IMAGE

Image via Wikipedia

 

The hip is a unique joint, joined only by its counterpart, the shoulder, as the ball and socket joints of the body.  This configuration allows for maximum flexibility and movement in all directions.

The “ball” or head of the femur bone revolves inside the “socket” of the hip, called the acetabulum.  The greater and lesser trochanters are implicated in snapping hip syndrome., as are the iliopectineal eminence (located along the pelvic border along the front of the hip) and the hip capsule (head of the femur in the acetabulum).

Snapping hip occurs when a tendon or ligament rolls over a bony prominence during movement.  Depending on where you hear a click, you can determine whether you have internal or external snapping hip.

Types of Snapping Hip

Internal snapping hip is perhaps the more frequent type of snapping hip among ballet dancers due to the amount of emphasis placed on external rotation. Composed of Iliacus and Psoas Major and Minor, the Iliopsoas muscle inserts at the lesser trochanter of the femur and is key in ballet technique because of its ability to lift and rotate the thigh.  Dancers with a tight Iliopsoas may experience snapping hip

IMAGE Sketch of the muscles affecting the hip joint IMAGE

Image via Wikipedia

External snapping hip is due to Gluteus Maximus or Iliotibial band (ITB) tightness and snapping in this case occurs as these tendons roll across the greater trochanter of the femur. Flexes and rotates the thigh (of obvious importance to dance).  More common overall, but less common among dancers. In this type, you’re likely to experience a click when loading the hip (landing from a jump or sinking into the hip).  The snap in this case can sometimes look and feel as though the hip is dislocating.  All the more reason to “get up on your leg”, I suppose!

A tight ITB can be problematic and can eventually lead to pain in the hip and knee. One easy way to stretch the ITB is using a foam roller (and if any of you happened to catch February’s Circle Time, then you know how much I love a foam roller).

Lay on your side propped up on one hand with the foam roller just above (but not on) the knee joint and roll toward the hip back and forth.

Make no mistake, this stretch is painful for those with especially tight IT bands, but it’s also one of the most effective ways to stretch the ITB and ease external snapping hip or other associated conditions.

The long and short of those short tendons…

Overall, I want to emphasize that snapping hip is not necessarily a big deal or something to be concerned about.  The word “Syndrome” can be deceiving.  If you don’t feel pain or aren’t otherwise too annoyed by the click, don’t worry about it too much.

If you do start to develop pain, don’t ignore it. Be sure to see a physician or physical therapist who can treat you and prevent a little pain from turning into something serious like tendinitis or bursitis.

The prevalence of snapping hip in the dance community is an important reminder that dance training alone (especially as concerns ballet technique) may not be enough to build well-balanced strength and musculature.

Dancers experiencing issues with the hips or knees, whether they are experiencing pain or not, might consider the addition of cross-training to their regimen to strengthen muscles such as the abductors and gluteals (muscles that, by the way, support the hip).

Going back to my story about discovering snapping hip in a Pilates class –at the age of 16 I was doing only ballet and wasn’t really encouraged to do anything in the way of cross-training.  The continual emphasis on the aesthetically beautiful and high-kick-capable externally rotated hips and legs unequally tone and tighten certain prime movers while leaving others ignored.

Now that I incorporate many types of exercise to my regime in addition to dance, my hips don’t click!

References:

Garry, J.P. (2010). Snapping Hip Syndrome. Medscape Reference. http://emedicine.medscape.com/article/87659-overview

Morgan, V. (2010). Common Lower Extremity Injuries Affecting Female Dancers and a Proposed Screening Tool for Identifying Dancers Prone to Injury, 17-19. http://www.lulu.com/items/volume_67/8564000/8564329/1/print/Dance_Injuries.pdf

Shah, S. (2008). Caring for the dancer: special considerations for the performer and troupe. Current Sports Medicine Reports 7, 128-132.

Do your hips pop? When?

What have you done (if anything) about it?

Lauren Warnecke

Lauren Warnecke

Dance writer, educator at Art Intercepts
Lauren Warnecke is a dance writer based in Chicago, IL, and is a contributing author at 4dancers.org, danceadvantage.net, Windy City Times, and SeeChicagoDance.com. In 2009 Lauren created Art Intercepts, a blog for dance-based discourse that incorporates dance and movement research, editorial commentary, and critical reviews. She is a full-time faculty member at the University of Illinois at Chicago.
Lauren Warnecke
Lauren Warnecke
Lauren Warnecke

Comments

  1. This article came at a great time for me, I was just googling what to do about my current hip flexor pain. :-)

    Can you describe this stretch in more depth?
    “Lay on your side propped up on one hand with the foam roller just above (but not on) the knee joint and roll toward the hip back and forth.”

    Thanks!

  2. jennifer says:

    my hip pops but I know now it is due to a torn labrum, which is becoming a very common problem with athletic women and men. Ballet is one of the top activities to cause it. After a labral debridement surgery I still have a lot of pain and clicking but I have not given up dance. Making modifications, trying out tap and modern instead of daily ballet class has helped and kept me able to still dance.

    • Jennifer, I’m glad to hear you’re not giving up dance completely! Your story is definitely an important reminder that pain with a clicking hip should be checked out by a physician.

  3. Excellent information! I was looking for this exact type of article a few months ago. My snapping hip had become painful (overuse as an instructor always demo’ing on 1 side!) and it helped to do some parallel floor exercises, and to keep the leg very low.

    • Thanks, Leigh! Try out some of the stretches I suggested and if pain persists I would definitely recommend seeing a physician. Thanks for reading!

  4. Thank you for this, it s really short and simple, but giving all the right information. the various medical texts I ve been reading so far often don t refer to dancers specifically and they make me feel like everything they wrote is what I got. :D
    I m hyperflexible and what I found to help my hips most is yoga – downward dogs and planks. even so, nothing, not yoga, not pilates helps if I turn out too much and go beyond my safe comfort zones in barre class.

  5. David Haas says:

    Hi,
    I have a quick question about your blog, do you think you could email me?
    David

  6. I have been experiencing this popping in both of my hips for as long as I can remember. I finally have medical insurance and am seeking treatment from a doctor and pool therapy. I’m so glad to have run across this site for more information and what I can do and what I can’t do. I hate the thought of not being able to dance anymore.

  7. Emily Tataryn says:

    My hip (most likely anyway, I’m not sure) pops every time I extend either leg to the side, and then pull it back in. It pops twice every time, and I’m not sure if I should be concerned… I also do ballet, and I’m wondering if you think dancing is affecting my leg so it pops?

  8. Hi Emily,

    If it’s not causing pain, there’s not too much cause for concern, but you may want to consider flexibility training in the area of your hip that’s popping, or foam rolling. If in doubt, see a doctor or a physical therapist to give you some personal insight on your individual situation. Good luck!

  9. Thanks you so much for this. I am thinking of taking up ballet again after a little break, but I was concerned about my hip, which often pops (painlessly) as I walk. I think I’m still going to see a physio about it but this encouraged me that taking up dancing again isn’t out of the question!

  10. Hello I am in pain right now with my hip and I need to pop it. It doesn’t seem to be popping and I have a recital for dance today and it is bothering me whilst dancing. Please let me know if you have other methods without foam rollers

  11. When I was about 14 I seriously increased my hours of ballet. My hips weren’t strong enough, and I ended up with bursitis – crazy painful. I couldn’t do anything high impact (jumping, running, etc..) for a month. Now I’m a lot stronger and I never have problems.

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