Dance is a beautiful combination of exercise and art. It’s a relatively safe sport as many of the serious, traumatic injuries we see with other sports rarely occur in dancers. What we do see in dance, however, is overuse injuries from hours upon hours of repetitive extreme motion at the joints.
Snapping and popping at the front of the hip is extremely common in dancers, especially with ballet dancers. In one study of 87 elite ballet dancers, 91% of the dancers reported snapping to the front of the hip with 50% of them having it in both hips. The fancy medical term for this is “coxa saltans interna,” but it’s commonly referred to as internal snapping hip.
Internal snapping hip occurs when the large hip flexor muscle at the front of the hip gets tight and it snaps over a bone in the front of the hip (most commonly the femoral head). It usually occurs when the hip is flexed (bringing the hip and knee up towards the chest) followed by extending the hip (bringing the hip and knee straight). It will usually make a “clunking” sound that can actually be heard by others.
Dancers are known to have larger hip flexor muscles than the general population due to the large amount of repetitive hip flexion required. This increase in size – as well as tightness – are what can lead to the hip flexor snapping.
In most cases, snapping hip is safe and doesn’t require formal treatment if the dancer has no symptoms.
In the study of the elite ballet dancers, only 58% of those with snapping hip had pain. However, if there is pain associated with the snapping, then this should be evaluated.
In treating painful internal snapping hip, the first thing that must be tried is rest from dance until there is no pain at the front of the hip. You should also use ice, heat, massage and stretching during this period of rest.
An occasional over-the-counter anti-inflammatory pill can be helpful as well. If these fail to resolve the pain, then formal physical therapy that focuses on stretching of the hip flexors and strengthening of the supporting muscles can be very successful.
In some locations, there are specialized dance therapists that can be extremely beneficial. Occasionally, an injection may be required to calm down chronic inflammation around the hip tendon.
Rarely, when these conservative treatments fail, an X-ray and MRI may be ordered. The physician who orders these is looking for evidence of hip impingement and/or a labral tear. Those found to have hip impingement and/or labral tear may benefit from surgery by someone trained in hip arthroscopy.
Most dancers, however, don’t need surgical treatment for hip pain.
If you’re a dancer or your child is a dancer and has painful snapping hip, call Akron Children’s Hospital at 330-543-3500 and request to see one of our dance specialists.