Hip pops – sounds of trouble?
How do you know when hip popping and snapping is something to be concerned about? A general rule of thumb is if you have pain in the joint along with popping sounds you want to see a qualified health practitioner.
There are three areas where snapping or popping may be felt and heard. The most common area is at the outside of the hip at the greater trochanter of the femur. Snapping hip syndrome is named for the clunking sound that occurs at the greater trochanter when the dancer stands and shifts their weight onto the leg, which creates the snapping sensation and clunking sound. Extremely tight lateral hip muscles create this clunk as they snap over the greater trochanter. This is not a desirable action as it’s an easy way to develop bursitis or tendonitis in the greater trochanter area over time due to the constant irritation. The solution is to stretch the lateral hip muscles. You can do this by standing on one leg and letting the hip move sideways as the upper body.
The second area of popping is around the front of the hip. This pop is often heard during a kick or battement. For some dancers their hip pops every time they lift their leg, and for others once they ‘pop’ their hip by standing on one leg tipping the pelvis forward as they lean to the side, it won’t pop for a while. This type of popping is generally related to the iliopsoas tendon. Sometimes the iliopsoas tendon snaps over the bony ridge of the pelvis or femur. There is always a bursa that acts like a pillow between the joint and a tendon and when the iliopsoas bursa gets irritated and inflamed you will also feel pain in the front of the hip besides hearing and feeling the pop. If you feel a popping sensation in the front of the hip try stretching out the iliopsoas by frequently doing a runner’s lunge stretch. This stretch can be done standing with your foot up on a surface, sitting (as shown) or on the floor in the more traditional stretch. If stretching the iliopsoas muscle helps decrease the popping, then briefly stretch before or after battements, and periodically during class between combinations and at the end of class. As with all tight muscles when you first begin to stretch, the muscle acts like a yo-yo. You stretch it out and then it wants to go back to its original shape. It takes time and commitment to truly change the flexibility of a muscle.
The third area where pops may be felt is within the joint. Labral tears are often the cause. What is a labral tear? Let’s start by remembering that the hip joint is a ball and socket joint. The head of the thigh bone is the ball, and the acetabulum is the socket. In latin ‘labrum’ means lip. So the acetabular labrum is the ring of cartilage that is attached to the edge of the acetabulum and acts to deepen the bowl shape where the head (or ball) of the femur rests.
Injuries to the labrum can occur from chronic trauma, such as a dancer working to turnout their leg through sheer muscular determination and force, and also acute trauma, such as a fall or violent motion at the joint.
Signs and symptoms that accompany a labral tear may be pain with certain movements, (usually in the groin area), loss of strength, decreased range of motion, and a ‘catching sensation’ in the hip.
I checked in with sports physician, Vernon Patterson, DO, and asked him about labral tears at the hips. He reported that the majority of patients with labral tears have a history of acute injury while weight bearing that resulted in a sudden onset of groin pain and a period of pain and disability. The initial injury may have been earlier in their career, but memorable. If the dancer did not have any significant injury history to the area then he would be concerned about structural problems that could make them highly susceptible to other joint problems, including labral tears.
While the majority of hip popping is benign and won’t cause painful problems, they are a signal that the muscle balance around the hip needs to be evaluated. But if there is pain with the popping sensation see a physician. Your hips will thank you for listening!
January 15th, 2010 at 4:44 pm
Your blog on hip pops is perfectly timed. I have rheumatoid arthritis, which I’ve had since I was 12 (or at least first diagnosed then). For the most part, it has stayed in remission. Dance classes and figure skating, etc, (exercise in general) has really helped. But, unfortunately I have some lasting joint damage — mostly in my wrists and hips.
I have a gynecological related surgery scheduled for later this year (presently scheduled for September). The lack of flexibility in my hips, however, could complicate surgery or at least make it longer and more difficult. My doctor wants me to work on increasing hip flexibility as much as possible between now and then.
In dance terms, it’s my 2nd position that suffers the most. I have a very narrow 2nd position and it’s even worse in plié. My grand-plié isn’t even a good demi-plié. My turnout itself, without overstretching in the knee or something, is only about 45 degrees. And my 2nd on l’aire is barely 45 degrees.
There is some joint pain and occasional popping (though usually not at the same time). Most of the time, the pain is a dull lack of flexibility type pain instead of a sharp shooting pain.
I’m 39 and have been dancing for 5-6 years now. My dance instructor is currently working on coming up with some exercises to help, but I would like your input as well.
What exercises do you recommend to improve my hip flexibility and increase the width of my 2nd position and deepen my 2nd plié?? The doctor suggested yoga and additional dance stretches and such, but she didn’t give any specific exercises to focus on.
Your help would be greatly appreciated. Thanks!
Donna
January 16th, 2010 at 5:03 am
Hi Deborah.
First off I want to say how helpful I find the blog and look forward to each edition.
I have some students who complain about a clicking/popping sensation when they are doing a developpe devant. I was once told that tjis is due to a lack of use of the abdominal muscles. Is this true or was my information wrong.
Many Thanks,
Paul
January 16th, 2010 at 7:06 am
Paul, the role of the abdominals is to flex the spine and to stabilize the pelvis in an upright position on the legs. It is possible that due to your pelvic alignment that you are getting the tendon of the psoas to pop over a bony piece of the pelvis – but generally, I think that statement sends the wrong message. For the pops in the developpe devant or battement devant, I would focus on iliopsoas flexibility and secondly iliopsoas strengthening.
January 16th, 2010 at 7:10 am
Donna, for the second position flexibility I would focus on adductor flexibility. Try putting your leg on a low stool. Gently press your heel in to the chair – this will turn on the adductors – keep them turned on while you barely stretch side and then to the front by flexing at your hips. This will help stretch not only the adductors but the fascia of the inner leg. This type of stretching is what my new dvd on effective stretching practices is all about. I have found this way of stretching very helpful for those who have struggled with flexibility. Let me know how you do!
January 16th, 2010 at 1:14 pm
Thank you so much for resonding so quickly
Paul
January 27th, 2010 at 5:32 pm
Hi Deborah!
I just want to clarify the stretch you explained for the first type of popping, at the outside of the hip. Are you saying that I should stand, for example, on the right leg and, if pressing my weight into the right hip laterally, lean the upper body to the left?
January 28th, 2010 at 11:50 am
Yes, that is correct. You’ll feel a slight pull, not a big one, at the outside of the hip. You can also get into this area by doing the psoas lunge stretch in the runners position, and then shift your facing to the front leg so your hip drops and you feel it more on the outside of the hip. Frankly, one of the fastest ways to make a shift is by using the pinkie ball and releasing the tension in this self-massage way.