Snapping Hip Syndrome

Iliopsoas tendonitis/iliopsoas bursitis

What is it?

Snapping hip syndrome is a condition where either the iliopsoas tendon gets caught on the thigh bone or iliopsoas bursa when trying to move the hip. It can also be caused by the rectus femoris tendon moving over the ball in the ball and socket joint of the hip when it is bent and then straightened. It is caused by tightness of the hip and repeated movements that involve bending the hip.

Anatomy of the Hip

There are many different muscles that are involved in the movement of the hips or attach to the hip:

Muscles that are involved in the flexion of the thigh at the hip:

Iliopsoas group-consists of the iliacus and psoas major. Psoas major originates in the vertebra from L1 to L5

Quadriceps Femoris group- consists of the rectus femoris, vastus intermedius, vastus lateralis, and vastus medialis

Muscles that are involved in the extension of the thigh:
Gluteus maximus

Hamstring group- consists of biceps femoris, semimembranosus, semitendinosus muscles

Muscles involved in the abduction and adduction of the hip:

Adduction: Adductor group/groin muscles- adductor longus, adductor brevis, adductor magnus, pectineus, and gracilis muscles

Abduction: piriformis, superior gemellus, inferior gemellus, tensor fasciae latae, sartorius, gluteus medius, and gluteus minimus

Symptoms and Signs

  • Pain and clicking in the front of the hip/groin
  • Tenderness to touch in the front of the hip/groin
  • Weakness of the hip and upper leg


  • Athletes between the age of 15 and 40
  • Involved in activities that involve repeated hip flexing such as dance (ballet), soccer, cheerleading, gymnastics, running (hurdles), martial arts etc.
  • Contact or collision sports (football, hockey)

Basically, anyone who could be overworking their hip muscles or tendons.

Diagnosis and Prognosis

Sports medicine physicians can usually tell simply by performing a physical examination of the hip. Occasionally an MRI or ultrasound will be used.

Steps can be taken to treat the hip and in most cases it will be cured. Iliopsoas bursitis can develop because of the close proximity of the tendon and bursa. If that happens, it can be treated the same way.


  • Most cases of snapping hip syndrome can be treated through physical therapy.
  • In some cases, the patient can be given a cortisone injection (corticosteroid) directly into the bursa or the area surrounding the tendon, depending on what type of snapping hip syndrome they have. The steroid will reduce the inflammation of the area and ideally keep the tendons/bursa from rubbing.
  • There are some very extreme cases where, if all of the options have been tried, a surgery can be performed to completely remove the inflamed tendon. In all of the cases, the patient should be healed relatively quickly.
  • Anti-inflammatories; such as aspirin, ibuprofen, and naproxen, can be taken as well and will usually relieve the pain temporarily.

Disruption of Homeostasis

Normally, the iliotibial band, iliopsoas tendon, or rectus femoris tendon move smoothly over the areas of the hip (bursa and bones). Snapping hip syndrome occurs when muscles around the hip have been overused. The muscles get used to the point where the nerves in these muscles never stop sending the signals that cause the muscles to contract. The muscles then use up all of the ATP so the calcium cannot be reabsorbed by the sarcoplasmic reticulum. If the calcium is not reabsorbed, there will continue to be ATP sent to the muscle so it is constantly contracted. So basically, the muscles are never in a state of relaxation. The contraction of the muscles pulls on the tendons, causing them to rub over the bones and bursa in the hip. The repeated rubbing distresses the cells that make up the tendon or bursa which will then send signals to the white blood cells to destroy what is causing the pain. Since there is no foreign body to destroy, the cells continue to stay and keep the tendon/bursa inflamed and continuing the rubbing.

This disruption is an example of negative feedback. The cells in the bursa or tendon become stressed and send signals for white blood cells to come and destroy whatever is damaging the cell. Since the damage is being caused by rubbing within the hip, the white blood cells will continue to be sent until the problem is corrected.

The immune response to the constant rubbing of the tendon/bursa is an example of positive feedback. As long as the rubbing continues, the flow of white blood cells will continue until the inflammation is treated in other ways.

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Disruptions of Homeostasis, Level of Structural Organization

Subcellular: Sarcomeres are at a constant state of contraction, H band is closed and myosin and actin are constantly using calcium to pull towards each other

Cellular: Cells are constantly being pulled towards each other, causes stress on the cells. Nerve cells (neurons) are sending signals telling the muscle cells to contract without allowing for the necessary relaxation period

Tissue: Muscle tissue becomes weak due to constant contraction of the sarcomeres and muscular cells

Organ: Since muscles are made of muscle tissue, the muscle become weak and are unable to perform their normal functions

Organ System: Other muscles have to compensate for the weak muscle and become more prone to injury due to overuse.

Organism: The person has weak muscles so they cannot do everything they may want to do. They can also be in a lot of pain because of the constant inflammation and rubbing of the tendons and muscles.

Systems Involved

Muscular System

Nervous System

Immune System (