A snapping hip is also known as iliotibial bundle friction syndrome. Another type of snapping hip is caused by congenital dislocation of the hip joint or laxity of the joint capsule, resulting in snapping when the hip joint is over-extended and externally rotated. There are two types of snapping hips: intra-articular and peri-articular. The broad fascia is located on the anterolateral aspect of the upper thigh and is the thickest fascia in the body. The lateral part of the broad fascia is especially thickened by the tendon fibers of the tensor fasciae latae muscle (which is located in the upper middle third of the lateral femur) and is called the tibial fascia, which ends at the lateral epicondyle of the tibia. Hypertrophy or tightness of the bundle for some reason, or over-protrusion of the greater trochanter, or bursitis, can cause the two to rub against each other and produce a snapping sound when the hip joint moves. Snapping Hip – Symptoms Snapping hip is an audible or felt rattling of the hip joint during active extension and flexion activities and walking. Extra-articular snapping is more common. The main reason is the thickening of the posterior border of the iliotibial bundle or the anterior border of the gluteus maximus tendon. When the hip joint is flexed, retracted or rotated, the thickened tissues slide back and forth in the greater trochanter and give out a rattling sound, and at the same time, a thick and tight fibrous band can be seen and felt sliding over the greater trochanter. This phenomenon is not present during passive movement, and is most common in young adults, often bilateral. This popping tends to occur spontaneously and can progress to the severity of a popping sound with each step. However, it is usually painless, and if pain is present, it is often the result of concomitant bursitis of the greater trochanter. Thickening of the anterior border of the iliotibial bundle or gluteus maximus tendon is associated with trauma or strain, and congestion and edema and aseptic inflammatory reaction of the affected tissues after trauma or strain lead to a series of pathological changes such as fibrous tissue proliferation. Sometimes the enlarged upper edge of the greater trochanter hooks onto the posterior part of the iliotibial bundle and produces snapping; sometimes hip snapping is caused by the iliopsoas tendon slipping on the iliopubic tubercle and/or the anterior inferior iliac spine; sometimes it is caused by the lower edge of the gluteus maximus muscle rubbing against the sciatic bone during hip flexion; osteochondroma of the greater trochanter can also cause hip snapping. Patients with snapping hip often have hip inversion. As the angle of the femoral neck becomes smaller, the force arms of the gluteus medius and gluteus minimus become shorter, and the abduction function is affected, which will increase the tension of the upper part of the iliotibial bundle, causing snapping and dysfunction. Diagnosis of snapping hip The diagnosis of snapping hip is not difficult, during the examination, the patient is asked to do the extension and flexion, adduction or internal rotation of the affected side of the hip joint, and snapping sound is heard in the greater trochanter, and at the same time, a cord is felt or seen to be sliding in the greater trochanter, then the diagnosis can be confirmed. However, it should be differentiated from intra-articular snapping. Clinical manifestations of snapping hip 1, extra-articular snapping, discomfort Whenever the medullary joint is doing flexion-extension, adduction, or internal rotation, snapping occurs due to the posterior border of the iliotibial bundle or the thickened tissue of the anterior border of the gluteus maximus tendon slipping over the protrusion of the greater trochanter. At the same time, a thick, tight fiber can be palpated (or even seen on the surface of the body in thin individuals) sliding back and forth over the greater trochanter. It is usually painless, but the patient is always conscious of discomfort in the medulla. If accompanied by secondary bursitis, there can be localized pain. 2.Chronic lower back pain due to the increase of lumbosacral angle, lumbar gravity line from the anterior part of the vertebral body moved backward to the articular eminence, which is prone to cause chronic injury to the lumbosacral posterior joints. 3.Positive iliotibial come contracture test. Snapping hip treatment When snapping hip is not accompanied by pain, it usually does not need treatment. When accompanied by pain or mental burden on snapping, rest, physical therapy, braking and corticosteroid drugs local sealing treatment can be used. 1, the principle of treatment to relieve spasm, slippery joints. 2, commonly used acupoints and parts of the residence, ring jump, wind city, Yangling, commission and other points, and the lower lumbar, buttock, lateral femoral part. 3, commonly used techniques palm root kneading method, plucking method, holding method, rubbing method, and hot compresses. 4.Operating method: The patient takes the prone position, the doctor stands on the affected side, and first applies palm root pressure and kneading method to the sacrospinal muscles on both sides of the lumbosacral segment, focusing on the affected side and gradually transitioning to the affected side of the buttocks. From the lumbosacral to the buttocks up and down for about 3-5 minutes, and press and knead the middle point of the committee for 1 minute. With the patient lying on the side and the affected side on top, start from the buttocks, go through the lateral part of the broad fascia, the iliotibial bundle and down to the lateral side of the knee joint with palmar root pressure and kneading, up and down round trip for about 5-8 minutes, with passive movement of hip flexion and extension. Then make round-trip flicking method from top to bottom along the iliotibial bundle. Press the points of Jusi, Huanjiao, Fengshi and Yanglingquan. The patient takes the supine position, from the anterior superior iliac spine, the beginning of the broad fascia tensor muscle downward, through the proximal anterior femur, the lateral femur to the lateral knee joint with the root of the palm pressing and kneading method, up and down back and forth for 5-8 minutes, and with the passive movement of the hip joint internal and external rotation. Then flick the broad fascia tensor muscle of the anterior superior iliac spine and the tense fascia at the greater trochanter. Finally, rubbing method is applied to the patient’s area to the extent of heat. Hot compresses can also be applied to the greater trochanter.