The Dancer's Hip

Clicking in joints is very common and usually harmless. If you get a big clunk in your hip when you dance or walk- you might have the dancer's hip!

What is a dancer's hip?

The dancer's hip is the snapping hip or coxa saltans. It is characterised by an audible pop/ snap in the hip during certain movements. In some cases, this can cause pain and difficulty in carrying out usual activities/ training. The pop/ snapping sensation is caused by tendons flicking over the bony structures in the hip due to tightness. As the name suggests, this condition is common among dancers due to repetitiveness in deep hip flexion and external rotation.

Types

External

• Most common type

• The iliotibial band (ITB) or front of the gluteus maxiumus muscle flicks over the thigh bone, creating a 'pop' or 'snap' sensation at the side of the hip
  

Internal

• May cause greater trochanteric pain syndrome

• The flicking of the iliopsoas (hip flexor) tendon over the iliopectineal eminence of the pelvis creates a popping sensation at the front of the hip.

Signs and Symptoms

About 40% of dancer's hips are asymptomatic and do not require any treatment. But symptomatic ones can look like:

• Painful clicking during movement (hip extension/ rotation)

• Giving way feeling/ feeling of instability

• Weak gluteus medius

• Pain when lying on the side

Management

Let me bring you some good news- this condition rarely requires surgery and can be managed conservatively. Here are some things to try:

• NSAIDs for any pain and inflammation in the tendons

• Reduce loading or activities that cause pain

• Ice/ heat

• Exercises to reduce tightness and strengthening to provide stability in the hip

• For external type
  

• Piriformis stretch: Cross symptomatic leg over the asymptomatic leg in lying with knees bent. Hold the thigh of the good leg and pull both legs towards you. Hold for 30s.
  

Standing isometric hip external rotation:

Standing on your good leg, raise the other leg, bending at the knee to a 90-degree angle as if marching. Hold your bent leg up and then push it against the wall. Hold for 30 seconds.

• For internal type:

Short lever Copenhagen: Support your affected thigh on a chair. Lower yourself onto your elbow and straighten your top knee. Lift your bottom leg to the chair and hold. For a challenge, lift and lower your bottom leg to burn your adductors!

Hip flexor stretch:

Kneel on your mat and bring the unaffected leg forward. Stretch the affected leg backwards. Tuck your pelvis and lean forward to feel the stretch.

Please consult your physio if symptoms are not improving 6-8 weeks after trying these exercises.

Take Home Messages:

1. The dancer's hip is caused by muscle tightness and when tendons flick over bony structures of the hip.

2. There are 2 types: external (flicking of ITB over femur) and internal (flicking of iliopsoas over iliopectineal eminence of the pelvis)

3. The dancer's hip is often asymptomatic. If it is irritable, it can usually be managed conservatively with load management and exercises.

References

Yen, Y. M., Lewis, C. L., & Kim, Y. J. (2015). Understanding and treating the snapping hip. Sports medicine and arthroscopy review, 23(4), 194-199.

East Sussex Healthcare NHS Trust (2020). Snapping Hip Syndrome- Children Leaflet. https://www.esht.nhs.uk/wp-content/uploads/2020/10/0844.pdf accessed 13/7/2024.

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Our blogs and articles are not designed to replace medical advice. If you have an injury, we recommend seeing a qualified health professional. We offer both in-person assessments and online consultations!