Snapping-hip syndrome and trochanteric bursitis

What It Is

Snapping hip occurs when a muscle or tendon moves over a bony protrusion in the hip, causing a snapping or popping sensation. It can be painless or accompanied by discomfort, especially during physical activity like running, jumping, or dancing.

What Causes It

Several factors can contribute to snapping hip in children, including:

• Tight Muscles or Tendons: Overuse or growth spurts can cause muscles and tendons to tighten, leading to snapping.
• Repetitive Movements: Activities that require repetitive hip movements, such as dancing, gymnastics, or soccer, can lead to this condition.
• Hip Structure: Some children have anatomical variations that make them more prone to snapping hip.

Types of Snapping Hip

There are three main types:

• External Snapping Hip: Caused by the iliotibial (IT) band or gluteus maximus tendon snapping over the outside of the thigh bone (greater trochanter).
• Internal Snapping Hip: Occurs when the hip flexor (iliopsoas tendon) moves over the front of the hip joint.
• Intra-articular Snapping Hip: This is less common and is due to issues within the hip joint, such as a labral tear or loose cartilage.

Symptoms

Common symptoms include:

• A snapping or popping sensation around the hip.
• Pain or discomfort, especially during movement.
• Tightness in the hip or thigh.
• Swelling or tenderness (in some cases).

Possible Complications

While snapping hip is usually harmless, it can lead to:

• Pain that interferes with daily activities or sports.
• Inflammation of the affected tendon or surrounding area.
• Reduced range of motion or flexibility.

How It Can Be Diagnosed

A healthcare provider, such as a pediatric orthopedic specialist, may:

• Conduct a physical examination and ask about your child’s activity level and symptoms.
• Request imaging tests like X-rays, ultrasound, or MRI to rule out other conditions or see internal structures.
• Perform specific movements to reproduce the snapping sound for accurate diagnosis.

Treatment Options

Non-Surgical Treatments:

• Rest and Activity Modification: Limiting activities that trigger snapping.
• Stretching and Strengthening Exercises: Physical therapy to improve flexibility and strengthen surrounding muscles.
• Ice and Anti-inflammatory Medication: To reduce pain and swelling.
• Orthotics or Supportive Shoes: In some cases, to improve hip alignment.

Surgical Treatments:

Surgery is rare but may be recommended if:

• Pain persists despite non-surgical treatment.
• There is significant structural damage (e.g., labral tears in the hip joint).
• Types of surgery include tendon release, lengthening, or arthroscopic procedures to remove loose cartilage.

Recovery

• Non-surgical recovery: Usually involves a few weeks to a few months of physical therapy and gradual return to activity.
• Surgical recovery: May take several months, including rest, physical therapy, and a gradual return to sports.
• Prognosis: Most children recover fully with proper treatment and rehabilitation.

How It Can Be Prevented

• Encouraging regular stretching and warm-up exercises before physical activities.
• Strengthening core and hip muscles to provide better support.
• Ensuring gradual increase in activity levels to avoid overuse.
• Using proper sports techniques and equipment.

Frequently Asked Questions

Q: Is snapping hip dangerous for my child?
A: Most cases are harmless and don’t cause long-term damage. However, if pain or swelling occurs, it’s best to consult a healthcare provider.

Q: Can my child continue sports with snapping hip?
A: It depends on the severity. If pain is minimal, modified activity might be okay. If pain persists, rest and treatment are recommended.

Q: Will my child need surgery?
A: Surgery is rare and usually only considered if non-surgical treatments fail or if there is significant damage within the hip joint.

Q: Can snapping hip come back after treatment?
A: Yes, especially if preventive measures are not followed, such as stretching and strengthening exercises.