THE CLINIC: A Click in One Hip

Thu, 13 Sept. 2012 - 12:56 a.m. MT
Credit: ARA Staff - American Running Association

QUESTION:
I am a 61-year-old male and I have been running, skiing, and hiking for over 30 years. I have recently developed a click—which I cannot feel, but merely hear—in one hip. It occurs when walking slowly on level floors. It does not happen when walking fast or going up or down stairs. It has not hindered my exercise. Should I have someone look at it?
 
Dale Gregory
Denver, CO 
 
ANSWER:
The hip click, in my experience, is most commonly caused by the snapping of the iliopsoas tendon as it moves forward. The second most common cause is the tensor fascia lata snapping laterally over the hip bone. Both of these should not cause worry. However, there are other causes of clicking, such as limbus injury or a loose body. These should be treated to prevent subsequent degenerative changes. Certain tumors about the hip joint, such as an osteochondroma, might also require treatment. Consequently, because you are active and most likely hope to continue to be active for many more years, I would suggest that you get it checked out with a sports medicine doctor to be sure that the clicking is truly benign.
 
Michael Clarke, MD, FACS
Springfield, MO
 
ANSEWR:
Yes, a painless click is not something to worry about. If it is a frequent nuisance, it may merit an examination by a physician well-versed in clicks and their various causes. These are sorted into intraarticular and extraarticular causes, meaning inside the joint and outside of it, respectively. The iliotibial band (ITB) may be rubbing on the outer bony prominence of the hip. The hip flexor muscle (iliopsoas) may be rubbing over the pelvic wall. A labral (cartilage) tear may be causing a snapping of the hip as well.
 
Rob Meislin, MD

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(RUNNING & FITNEWS® September/October 2006 • Volume 24, Number 3)




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