Q. My son is 17 and over the last year he has had snapping in his hips. His right hip snaps more than the left. Sometimes it hurts when it snaps and sometimes it feels better after it snaps. We mentioned it to our pediatrician, who ordered X-rays, which he said looked normal. He said my son may have a labral cartilage tear of his hip and suggested that he see an orthopedic surgeon. My son says it does not hurt that much and he does not want to have surgery. We wondered what other suggestions you might have.
A. There are many reasons for a snapping or catching sensation in the hip. This could be related to a lack of flexibility such as a form of iliotibial band syndrome, which is snapping of the muscle on the outside part of the hip.
Other possible causes of hip snapping could be a tendon that rubs and snaps on occasion with certain motions, particularly on flexing and rotating the hip inwards. The hip labrum is a cartilage that helps to stabilize the ball part within the hip socket. If this is torn, it can result in catching or locking as well. A loose body, which is a piece of bone or cartilage that is loose in the hip joint itself, can also cause catching.
The fact that both hips are involved makes a diagnosis of a loose body or labral cartilage tear less likely and the more likely diagnosis would be a tendon or muscle that is catching. Many times these can be treated with a stretching and flexibility program, anti-inflammatory medication and occasionally a diagnostic or therapeutic injection.
The anatomy of the hip may result in a bony impingement, which can result in painful motion or catching as well. I recommend that your son see an orthopedic surgeon for evaluation of his hip to determine the reason for the snapping. You can then determine whether this is a serious or significant problem or something that can be easily rehabilitated.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net