Dancer’s Snapping Hip

How to Treat a Dancer’s Snapping Hip

This blog post explains the cause of clicking and snapping hips, which is a common occurrence in the dancer population. External snapping hip is caused by the tendons of the iliotibial band and gluteus maximus snapping over the greater trochanter of the femur. Internal snapping hip is the most common snapping hip dysfunction in ballet dancers and is often caused by a tight iliopsoas. Options for treating snapping hip in dancers is explored.

“My hip snaps when I do grande battement, passé, or developpe a la seconde.”

Dancers commonly complain of clicking and snapping of the hips.  Snapping is often audible and occurs as a muscle or tendon passes over a bony structure during movement. Coxa saltans, Latin for “dancer’s” or “jumpers” hip, can be classified as either external or internal.

External snapping hip is due to the iliotibial band or gluteus maximus tightness and snapping occurs as these tendons roll across the greater trochanter of the femur. External snapping is more common in the general population.

Internal type of snapping hip is attributed to movement of the iliopsoas tendon over the anterior capsule of the femoral head, the iliopectineal eminence (located along the pelvic border along the front of the hip), or lesser trochanter of the femur.  The iliopsoas tendon inserts at the lesser trochanter of the femur and is key in ballet technique because of its ability to lift and externally rotate the thigh. With the hip in extension, adduction, and internal rotation, the iliopsoas tendon remains medial to the center of the femoral head in the groove between the iliopectineal eminence and the AIIS. As the hip flexes, abducts and externally rotates (such as in passé or developpe), the ilipsoas tendon moves over the anterior femoral head and capsule to the lateral aspect of femoral head, creating a snapping or clicking sound.

Hip Anatomy:

Dancers with a tight iliopsoas may experience snapping hip.  Internal snapping hip is the more frequent type of snapping hip among ballet dancers due to the amount of emphasis placed on external rotation. Repetitive flexion of an externally rotated hip often results in painless internal coxa saltans.  However, if there is accompanying pain or weakness it is referred to as iliopsoas syndrome.

The anatomical positioning required by dance often creates muscle imbalances at the hips of most dancers. Dance emphasizes gross motions of hip external rotation, flexion, and abduction. Most dance regimens do not address hip internal rotation and adduction.  Overtime, this can lead to shortening of the prime movers with weakening and lengthening of their antagonistic muscular counterparts. The prevalence of snapping hip in the dance community is an important reminder that dance training alone, especially with ballet techniques, may not be enough to build well-balanced strength and musculature.

Recommended Treatment for Iliopsoas Syndrome

Studies have shown that conservative treatment by a comprehensive physical therapy program can successfully alleviate iliopsoas syndrome symptoms and improve strength.  Physical therapy that specifically focuses on strengthening hip and core musculature, ilioposas lengthening, ilioposas progressive strengthening, pelvic mobilization, and dance modification (limiting passe developpe and grand battement for a period of 4-6 weeks) has been shown to have high success rates among dancers.

If you’re a dancer struggling with clicking or snapping hips, Body Gears has a number of physical therapists with extensive experience treating dancers and performers. We look forward to serving you and helping you get back on your toes! 877-709-1090.

 

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