There are two main causes of a snapping sensation around the hip. Depending on where the athlete notices a snapping sensation, a sports medicine physician can usually make the diagnosis. One source of a snapping hip is on the outside (lateral side) of the hip, where the iliotibial band can snap in front of and behind the greater trochanter. The other source of a snapping hip is in the anterior aspect of the hip, where the iliopsoas tendon snaps across the anterior capsule of the hip joint. Occasionally an athlete will complain that her hip is popping in and out of the joint, when in fact the problem is a snapping iliotibial band or iliopsoas tendon.
Laterally a snapping iliotibial band occurs when this tendon and the tensor fascia lata and gluteus maximus move across the greater trochanter. It is usually fairly easy for physician to diagnose and recreate in the office. Often the athlete can make the tendon do it herself, and the snapping is visible and palpable. Usually the snapping persists despite any nonsurgical treatments, but the goal is usually to decrease the discomfort that occurs with the snapping. Stretching and strengthening exercises, physical therapy, and occasional cortisone injections into this tendon can be helpful. Very rarely surgery to partially release the iliotibial band can relieve symptoms. Athletes with a snapping iliotibial band are allowed to play sports, as the problem does not prevent successful participation despite the discomfort.
A snapping iliopsoas tendon manifests as a snapping sensation in the groin or front of the hip. A physician can recreate it by bringing the hip into flexion and internally and externally rotating the hip. Occasionally injecting a local anesthetic into the iliopsoas bursa can relieve symptoms. Also injecting contrast into this area can actually identify the snapping if the maneuver is performed under fluoroscopy. Like a snapping iliotibial band, medical treatment can alleviate the discomfort of the snapping tendon although the snapping often persists. In very rare cases, releasing the iliopsoas tendon can eliminate the snapping. Also like with a snapping iliotibial band, sports are not discouraged despite discomfort with the problem.