The Dancer’s Hip: ‘Clicky or Snapping Hip’
“Clicking” or snapping hip is a common complaint amongst many ballet dancers. Snapping hip syndrome or coxa saltans (latin for dancer’s hip), is a condition characterised by a clicking sensation that can be heard or felt during movement of the hip joint. It is usually pain free however it can develop over time and become painful in some dancers. So what is happening, and what you can do about it?
What causes it?
There are multiple causes of snapping hip, and it is determined based on the anatomical structure that is causing the source of the snapping sensation: It can be divided into two main categories:
- External snapping hip
- Internal snapping hip
External snapping hip – is most often caused by aspects of the iliotibial band and gluteus maximus snapping over the greater trochanter of the femur during movements that involve flexion, extension, and external or internal rotation. This is why Dancers will often feel their hip click during movements such as “grande battement, passé”, or “developpe a la seconde”.
Internal snapping hip – is most often caused by the illopsoas tendon snapping over underlying bony structures – such as the iliopectinal eminence or the anterior aspect of the femoral head. 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.
Why Dancers?
It is not just Dancers who experience snapping hip syndrome. Approximately 5% to 10% of the population is affected by Coxa Saltans. It is more common in women than men, and most often affects those who perform very frequent hip motions such has dancers, gymnasts, soccer players, weight-lifters and runners.
Contributing factors
Repetitive, poor co-ordination of the muscles around the hips, putting excessive load on some muscles while others remain weak can contribute to the symptoms. Weak “core” muscles, Iliotibial band tightness, shorter muscle or tendon lengths, muscle tightness, or inadequate relaxation of the muscles may contribute to snapping hip development.
Diagnosis
Snapping hip is most often diagnosed through a history of your symptoms and physical examination by a physiotherapist or health professional. Sometimes imaging can be used to help rule out other hip pathology and confirm the diagnosis to determine what is the best treatment pathway.
What can I do for it?
Studies show that conservative treatment is a reasonable approach. Symptom management through relative rest, ice and activity modification, manual therapy and addressing any contributing factors with the help of a physiotherapist can successfully alleviate dancers symptoms and improve their strength and performance.