Title: Chief complaint: "My hip snaps when I exercise"<br/>Author: Brian Corwell<br/><a href='http://umem.org/profiles/faculty/294/'>[Click to email author]</a><hr/><p>
Chief complaint: “My hip snaps when I exercise”</p>
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Both athletes and non-athletes may report a “snapping” sound with certain movements</p>
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This may affect up to 10% of the population</p>
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May be associated with activities than involve repetitive hip flexion</p>
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Symptoms may be due to an internal or an external cause</p>
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External causes are usually due to a tendon passing over a bony prominence</p>
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This can be felt as either an audible sensation and/or even a palpable snap</p>
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This may or may not involve pain or discomfort</p>
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This is most commonly due to a benign cause</p>
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During movements in flexion, extension or combined with internal rotation the iliotibial band may move over the greater trochanter.</p>
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Alternatively, the hamstring tendon may pass over the ischial tuberosity</p>
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There are several other causes with similar mechanisms</p>
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Symptoms are usually minimal and not serious</p>
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This can be reproduced on bedside clinical exam</p>
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Ask the patient to identify the area of snapping with one finger which will help with anatomic localization</p>
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First line therapy is physical therapy which focuses on:</p>
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Improving muscle length if muscle is too tight OR</p>
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Improving neuromuscular activation if problem is due to excessive muscle activation</p>
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