Recognizing Anterior Hip Pain/Snapping Hip Syndrome in Dancers
This anterior hip pain article was written by Dr. Katie Sun Worrall at Zion Physical Therapy
Are you a dancer experiencing pain in the front of your hips (anterior hip pain)? Have you been told that you may have snapping hip syndrome? You are not alone! Anterior hip pain and snapping hip syndrome are very commonly experienced by dancers.
What is snapping hip syndrome?
There are two kinds of snapping hip syndrome that you should recognize.
The first is when the iliotibial band (IT band) snaps over the outer hip bone, or greater trochanter (see image 1 above).
The more common second type seen in dancers is when the iliopsoas tendon snaps over bony prominences in the front of the hip joint (see image 2 below).
Causes for this condition include:
- 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, 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 via physical therapy often includes neuromuscular reeducation for the hip muscles, lumbopelvic stabilization exercises, hip mobilization as needed, muscle energy and release techniques, and targeted stretching.
In addition, dancers will need dance-specific exercises in order to improve muscle firing patterns during future dancing. The video link below gives an example of this.
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, 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 (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 as the injury heals. Often, dancers will also need soft tissue mobilization to the TFL and rectus femoris, and possibly the iliopsoas, too. They then need to be taught how to properly release and stretch these muscles on their own to ensure continued progress
Stretching is not always the answer, though. Dancers love to stretch when something hurts, but depending on how you are stretching, you could be causing more damage than help, 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, and likely contributing to your anterior hip pain.
If you have snapping hip syndrome, 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 like those at Zion Physical Therapy.
You can find a clinic in your area and within your insurance network by using the BetterPT physical therapy clinic locator, as it will put you into contact with a physical therapy clinic that can truly help improve your health, fitness, and pain. If you’re on the go, choosing to download the BetterPT app is a great alternative, putting the information about these individuals in the palm of your hand. Don’t let your hip pain stop you from dancing and being your best!
Dr. Katie Worrall got her start in the physical therapy field based on her prior experience as a professional dancer in New York City. Her interest in the field stemmed from her own personal experiences with dance, injury and physical therapy based recovery, and motivated her to make it possible for her to help others in the way that she previously was. Not only is Dr. Worrall a Doctorate of Physical Therapy graduate from Columbia University she has also completed clinical dance medicine and orthopedics rotations at the Harkness Center for Dance Injuries, and hosts injury prevention workshops for current dancers.