A common concern that I hear from patients is their hip makes noise. Sounds such as a clicking, grinding, or snapping during certain movements can be unnerving especially when associated with pain.
There are a few reasons a hip can make noise, but most causes can be managed or improved through treatment and exercise. A proper assessment can determine the source of noise and start treatment. Below are a few common hip issues that can create pain or noise in the hip.
- FAI (Femoroacetabular Impingement): Our hip is a ball and socket joint where the femur and acetabulum in the pelvic meet. We can experience bony abnormalities that leads to early contact between the rim of acetabulum and femur such as increased size around the rim or part of femur. However, image studies show that these morphologies or bony changes, are actually fairly common in the general population and not always associated with pain. Other contributing factors to clicking and pain with FAI can be muscular weakness leading to increased gliding of femur or repetitive load in specific movements. This can lead to a catching sensation at front of hip.
- Arthritic changes: The hip is one of the largest weight-bearing joints in body and is commonly affected by arthritis. Typically, it presents in individuals over 55 with hip pain, morning stiffness, and weakness. Patients occasionally report grinding or locking sounds and pain as their symptoms progress. Strengthening the muscles and increased joint mobility can help alleviate these symptoms.
- ALT (Acetabular labral tear) can also occur with FAI. Patients with this concern often present with anterior hip and groin pain depending on area of the tear. Audible noises such as clicking, locking or popping is associated with ALT as well as discomfort and pain with running, twisting and long periods of sitting. Learning to strengthen the hip stabilizer muscles and core can help patients conservatively manage their hip pain.
- Snapping hip: There are three types of snapping hip syndrome: external, internal, and intra-articular. Extra articular involves the posterior ITB band or posterior aspect of gluts as they move over their femur during hip flexion, extension or rotation. This is commonly associated with a snap or clunk noise. Internal snapping hip is the iliopsas snapping over the inside of femoral head and commonly occurs when the hip is flexing. Lastly, is the intra-articular snapping hip which includes labral tear, ligamentum tear, and loose bodies in the hip socket. Targeted exercises that focus on hip stability and control over the pelvis can impact pain and discomfort with this movement.
All of these hip issues can be managed and improved with specific exercises and treatment prescribed by your Physiotherapist. A noisy or clicking joint does not necessarily mean damage or cause for alarm. A Physio assessment can be hugely beneficial in long term treatment and hip health!
