Hips that Click: What May Be Causing It & Tips to Help

How changing your movement can help hips that click

A click or clunk in the hip during certain movements can be unsettling, especially when you don't know why it's happening. As a physiotherapist and Pilates teacher, this can actually be more common than you think.

If your hip (or your client's hip, if you're a movement professional) snaps or clicks during certain movements, particularly when moving from flexion into extension (the leg travelling from a forward/lifted position to swinging back behind you), it may be one of three types of Snapping Hip Syndrome (SHS).

First, a few general facts about SHS:

• It's a common complaint.

• It's sometimes painful, but is mostly a discomfort or nuisance.

• It's not typically serious.

  
  

Let's look at the three types of SHS, and how Pilates/modifying your movement may help alleviate symptoms.

1. External SHS

• A snap on the outside of the hip, caused by the iliotibial band (ITB) sliding forward and back over the greater trochanter during hip flexion and extension.

• Lateral knee pain can also be associated with ITB syndrome.

• Common in runners.

  
  

2. Internal SHS

• The iliopsoas tendon snapping over a bony prominence at the front of the pelvis, or the femoral head.

• Some people experience a deep ache in the anterior hip or groin during or after activity.

• Common in dancers, or with repetitive external rotation of the thigh. May present with reduced hip extension and lower back pain.

  
  

3. Intra-articular SHS

• Less common than external or internal SHS.

• "Intra-articular" means the snapping is occurring within the joint itself.

• Possible causes include a labral tear, loose bodies, or internal ligament tears - which would need to be diagnosed via further investigation and a scan. Clearance from a doctor or physiotherapist is recommended before commencing Pilates/exercise.

  
  

How Pilates and Exercise Can Help

As a Pilates teacher, my aim is to ensure the body is working in harmony. Through certain exercises, you may notice a difference between the left and right hip, or you feel the legs may both be working well, yet you still feel or hear a click.

Here are some of the things I think about when this comes up:

• Does placing the legs in parallel over external rotation help? Or vice versa!

• Are you gripping through your hip flexors?

• Does it improve if they can access their "seat" (ie: glutes and hamstrings) more?

• Does altering the range of motion help?

• What happens when you add a prop, such as a resistance band or magic circle, for them to push into?

  
  

Adding a prop can help in two ways: 1) it provides support 2) it can help the client access the correct muscles more effectively. In this case, their posterior chain: mostly the glutes & hamstrings.

If any of the above stops or reduces the clicking, it gives you a direction to work with. You can begin exploring exercise options with those modifications which can be key to resolving the click and allowing any irritation to subside.

This might mean continuing with supported or modified work for a few weeks or even months, until the body can create this engagement independently. It may mean ongoing support or modification for a longer period.

Work through the points above to see what you can achieve without the clunk or click. Let me know in the comments below what works for you!

Please note: it's always best practice to seek a professional assessment. If there is pain associated with your click or clunk, please make an appointment with your doctor or physiotherapist. This blog is not a substitute for an individualised assessment by your medical professional.

Looking for more personalised advice?

You can schedule an Initial Assessment session with me for an in-depth assessment, personalised advice, and exercises you can start after your first session. You can book directly on my website or contact me if you cannot see a time that suits you on pilatesphysio.sa@gmail.com

About Sonia

Sonia is a Comprehensively Trained Pilates Instructor in both Classical and Contemporary Pilates. With 17+ years' experience as a Musculoskeletal Physiotherapist, she brings a unique perspective to her Pilates teaching to support clients through their movement journey - whether they are returning to sport or navigating day-to-day life.