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Simple Snip for Snapping Hip

Coxa saltans . . . sounds like a new snack cracker, but it really means "snapping hip syndrome." As the hip is moved forward, a snapping or popping occurs. This can be felt and heard.

This is caused by a tendon snapping over the pelvic bone. Usually, the iliopsoas tendon is the problem. This tendon and its attached muscle bring the hip forward into flexion. If the tendon is tight as it passes over the rim of the bone, painful snapping occurs when the leg is flexed. This is present over the front of the hip close to the groin area. It often happens during or after exercise.

The initial treatment for coxa saltans is antiinflammatory medications and physical therapy. The therapist uses deep heat, massage, and stretching to treat this problem. Manual hip traction and exercise are also part of the program. This treatment works well for two thirds of the cases. The rest may need surgery to lengthen the muscle. In all cases, the problem is solved with either physical therapy or surgery.

A new method of releasing this tendon has been reported. Doctors use the crease of the groin to make an incision. The tendon is cut right where it enters the belly of the muscle. This allows the tendon to slide and gain length right over the rim of the bone. Doing it this way prevents muscle weakness afterwards and the scar can't be seen.

Persistent snapping hip can be treated successfully. Most cases respond well to physical therapy. When this isn't helpful, surgery to lengthen the iliopsoas muscle is done. The final results are usually favorable with complete relief from painful snapping. Rarely, a second operation is needed to shave a ridge of bone under the tendon.

References: Gary S. Gruen, MD, et al. The Surgical Treatment of Internal Snapping Hip. In The American Journal of Sports Medicine. July/August 2002. Vol. 30. No. 4. Pp. 607-613.

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