INTERNAL HIP SNAPPING SYNDROME                              KANDIL NOTES

INTRODUCTION

  • Internal hip snapping syndrome occurs when the Iliopsoas tendon snaps over bony prominences such as the femoral head or iliopectineal eminence

  • Internal hip snapping can lead to audible snapping of the iliopsoas tendon which can be heard with certain hip motions

  • Commonly referred to as the the hip snapping you can “hear from across the room”

  • Internal hip snapping is a sign that the iliopsoas tendonis too tight which leads to abnormal hip mechanics and oftentimes pain

  • Internal hip snapping is often associated with bursitis due to the repetitive inflammation and snapping

  • CAUSES

  • Internal hip snapping is usually an overuse phenomenon. However, it can also occur after trauma. It is also more common in patients with tight iliopsoas tendon

  • It usually occurs with the hip in flexion, extension, and external or internal rotation

  • It is very common in ballet dancers, runners, soccer players, and any athlete that does repetitive hip motions

  • SIGNS AND SYMPTOMS

  • Patients with internal hip snapping have pain in the inner part of the hip or groin. Can be confused with intra-articular hip pathology

  • They often report hearing the snapping of the iliopsoas tendon over the hip bone 

  • Difficulty walking and physical activities may result

  • TREATMENT​​

  • A course of rest, ice, anti-inflammatories, aggressive iliopsoas stretching, and a home exercise program is the mainstay of treatment for internal hip snapping. More than 90% of proximal hamstring injuries are treated with this program

  • Cortisone injections may be an option in patients with significant tendinitis or bursitis emanating from the snapping

  • Surgery is considered in patients with failure of extensive conservative management

  • Surgery consists of loosening the iliopsoas tendon, usually through Z lengthening or partial arthroscopic release of the tendon

        PREVENTION

  • Strengthening and stretching the iliopsoas tendon, avoiding repetitive hip motions, and warming up prior to physical activity can help decrease the chance of internal hip snapping

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