Welcome back to the dancer blog, this week we’re looking at a common cause of hip pain that most dancers have experienced at one time or another: snapping hip syndrome. Snapping hip syndrome is caused by muscular tightness resulting in soft tissue compression and is almost always accompanied by a “snapping” or “popping” sound as well as pain in the hip. There are three types of snapping hip syndrome: Internal, External and Cartilage Injury. The location of pain and snapping can indicate which type a dancer is experiencing.

Let’s start with the internal type. This occurs along the anterior aspect or front of the hip. This happens when either: the iliopsoas (a large muscle belly that forms from the fusion of the iliacus and psoas muscles) tightens, causing it to rub against a part of the pelvic bone called the “iliopectineal eminence.” It can also occur when the rectus femoris (the largest of the four quadriceps muscles that lays closest to your hip) tightens, causing it to rub against the femoral head of the femur (the ball portion of the ball and socket joint that is the hip).

Symptoms of internal snapping hip syndrome include: popping or snapping along the front of the hip when moving the leg, pain along the front of the hip and into the groin region or pain with repetitive leg movements and activity. For dancers, pain often occurs when performing steps such as tendus or battements to the back. Movements such as dégagé, attitude derrière and développé derrière will frequently cause pain with this condition. The key with internal snapping hip syndrome is pain and snapping along the front of the hip caused by movements to the back.

Next we have the external type. External snapping hip syndrome results from tightness and compression along the lateral aspect or outside of the hip. This happens when either the iliotibial (IT) band OR the gluteus maximus muscle tightens, causing it to rub against the outside of the femur (thigh bone) called the greater trochanter.

Symptoms of external snapping hip syndrome include: snapping or popping along the outside of the hip, pain along the outside of the hip or feeling as if the hip will pop out of socket when it snaps. I should note at this point that external snapping hip syndrome will not actually cause the hip to pop out of socket! Additionally, the external type can also be seen along the outside of the hip. When the snapping occurs, the skin along the outside of the hip will often visibly shudder. The key with external snapping hip syndrome is pain and snapping along the outside of the hip caused by hip movements to either the front or the back. For dancers this means the same movements mentioned previously could cause pain but now the pain can occur when these movements are performed either derrière or devant.

Lastly, we have a type of snapping hip syndrome caused by damage to the cartilage deep within the hip joint. Now there are many different kinds of cartilaginous tissues located within the hip joint so this variant is a little more complex than the other two. Damage or tearing of the acetabular labrum (hey make sure to check out my blog on acetabular labrum tears), damage or tearing to the articular cartilage or loose bodies (tiny bone fragments) located in the joint space can each cause pain, snapping and popping deep within the hip.

Because this type is caused by damage to cartilage which lines the entirety of the hip joint, pain, popping and snapping can occur anywhere in the hip. As a result, the key with this variant isn’t where the pain is but rather the presence of a catching sensation within the hip that limits the hip’s overall range of motion. While there may be a desire to limit the range of motion of certain irritating dance steps with the internal and external types, a dancer suffering from either of those will still BE ABLE to move through a full range of motion.

With cartilage damage, this may not always be the case. OF COURSE sometimes even with cartilage damage, dances will still experience a full range of motion. Isn’t that frustrating! So how do you know what’s causing your hip to pop and snap? Tune in next month when we continue our discussion on snapping hip syndrome with Part 2 where we will be discussing diagnosis and treatment options for this condition.

In the meantime, let’s get to this month’s dancer shout out! This month we’re giving a shout out to Natalia Serra. Natalia is originally from Campinas – SP, Brazil. She grew up dancing at the Iris Ativa-Lina Penteado ballet school. From 2013-2016 Natalia trained at and ultimately graduated from the Miami City Ballet School. Throughout her career she has performed numerous principal and soloist roles including; the Black Swan (Swan Lake), Kitri (Don Quixote) and Gamzatti (La Bayadere). She is currently in her sixth season at the New York State Ballet Company where she will be performing the role of Sugar Plum Fairy during the company’s upcoming production of the Nutcracker. Make sure to check her out December 17-19th at Roberts Wesleyan Theater. The company will be performing with a live orchestra and tickets are available for in person viewing or digitally via live stream. Go to newyorkstateballet.org to get your tickets today!