Clicking and Popping Hips and Pain

author : AMSSM
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Member Question

Pretty much since I was a young kid, my hips will let out a big "pop" when I get up from sitting down or bending over. It is sometimes loud enough for people around me to gasp! 

Anyway, I've never really experienced hip pain until after my long run (16 miles) two days ago. The pain feels deep in my right hip and extends down the side of my right calf and up the right side of my lower back when I try and walk. Yesterday and today I've only been able to sleep and sit at home. 

Please help! 

Answer from Dr. Rebecca Gurney, MD
Member AMSSM 

The hip popping sounds like snapping hip syndrome. Snapping hip syndrome is a condition described by a snapping sensation felt when the hip is flexed and extended. This is usually caused by a tendon (the iliotibial band or the iliopsoas) moving over a part of the pelvic bone. This may be accompanied by an audible snapping or popping noise and pain or discomfort. It usually decreases with diminished activity and rest and is often also treated with anti-inflammatory medications and physical therapy. 

However, it can be caused by a more serious problem deep in the hip such as a labral tear.  Labral tears are reported in sports that require frequent hip rotation. Runners with a labral tear typically complain of pain in the anterior hip or groin. They may have mechanical symptoms, including clicking, locking, catching, or giving way.  The diagnosis of a labral tear is often complicated and sometimes delayed due to misdiagnosis. An MRI may show a tear, but an MR arthrogram (an MRI with dye injected into the hip joint) is a better and more reliable test. Labral tears are complex and often frustrating to treat. Physical therapy has mixed results. Arthroscopic surgery is often helpful, but the recovery can be prolonged. 

The pain you are describing could also be a number of other things including sciatica or a stress fracture. Sciatica symptoms include low back pain, buttock pain, and pain, numbness or weakness in various parts of the leg and foot. It is a result of the the sciatic nerve being irritated at some level. This is often treated with rest, medications, and physical therapy. With running long distances, there is always a risk of a stress fractures.  Stress fractures in runners occur most often in the tibia, but can develop in any bone of the lower extremity, including the metatarsals, navicular, and femoral neck. Usually a stress fracture has more of an insidious onset of localized pain. The pain is initially related to activity and increases in severity with increased activity. Eventually the pain is present during less strenuous activity and ultimately during rest. A stress fracture in the femur can potentially be harder to heal due to its location. This type of fracture does not always show up an x-rays and may need an MRI or bone scan to diagnose it. A stress fracture is treated with rest and evaluation of fracture risk factors. 

In order to prevent injuries such as these, make sure you are wearing well fit running shoes. If you are going to be running significant distance, it is recommended to go to a running store and be fit in a pair of running shoes. Also, make sure your shoes are not too old, running shoes should be changed out at least every six months if you are running distance. Be careful not to increase your distance too quickly as this also puts you at risk for injury. 

In general, if your pain does not resolve with a few days of rest, ice and anti-inflammatory medications, evaluation by a physician would be recommended. 

Dr. Rebecca Gurney, MD

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date: September 20, 2013

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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