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