Are you a dancer with pain in the front of your hips (anterior hip pain)? Have you been told that you have ‘snapping hip syndrome?’ You are not alone! Anterior hip pain and snapping hip syndrome are very common in dancers.
What is snapping hip syndrome?
There are two kinds of snapping hip syndrome.
The first is when the iliotibial band (IT band) snaps over the outer hip bone, known as the greater trochanter as shown below.
2. The more common type seen in dancers is when the iliopsoas tendon snaps over bony prominences in the front of the hip joint as shown below. It is usually caused by overuse, tightness, and dysfunctional muscle firing of the hip flexors - muscles you use every time you lift your leg to the front or side (think fondues, developpes, and grand battements). Due to dysfunctional muscle firing patterns, the head of the femur (thigh bone) is pulled forward in the hip socket. The snapping then occurs when the tight hip flexor muscle/tendon of the iliopsoas snaps over the head of the femur.
How is it treated?
Snapping hip syndrome and other anterior hip pain can be treated conservatively with physical therapy. Treatment will likely include:
Neuromuscular reeducation to restore proper coordination of the hip muscles
Lumbopelvic stabilization exercises
Hip joint mobilization to restore proper mechanics as needed
Muscle energy and release techniques
Targeted stretching
Most importantly, dancers need dance-specific exercises in order to improve muscle firing patterns while dancing. Typically a physical therapist (PT) will begin by training your deep core muscles to improve lumbopelvic stabilization. You may then work on training the iliopsoas (the deep hip flexor muscle) to fire before the rectus femoris and tensor fascia latae (TFL) (the superficial hip flexors), when lifting the leg. Your PT may have you perform low developpes to the front and side, focusing on your muscle firing pattern and technique (such as not hiking the hip, turning out from the deep hip external rotators, etc). You will also likely do hip extension strengthening exercises, specifically focusing on your gluteus maximus in order to help normalize hip joint mechanics. Often dancers will also need soft tissue mobilization to the TFL and rectus femoris, and possibly the iliopsoas. They then need to be taught how to properly release and stretch these muscles on their own. Stretching is not always the answer!
Dancers love to stretch when something hurts. But depending on how you are stretching, you could be causing more harm than good, especially with anterior hip pain. To stretch the front of the hips, dancers typically like to hang out in deep lunges. But what most dancers don’t know is that in this deep lunge position, you are stretching your hip joint capsule more than your hip flexors, which could be contributing to your anterior hip pain. If you have a snapping hip, stretching in a deep lunge is particularly a bad idea, as it sends the head of your femur even further forward than it already is. Instead, make an appointment to be evaluated by a dance medicine physical therapist so that you can be properly treated and return to dancing pain free! If you’d like to make an appointment to be evaluated by one of our skilled Dance Medicine Physical Therapists, please call (212) 353-8693 or email schedule@zionpt.com.
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