The hip joint is made of the femur and the pelvis. Along the outside of the hip joint is a muscle called the tensor fascia latae (TFL) that has a thick band of fascia attached to it called the iliotibial band (ITB). This band runs from the TFL to just below the outside of the knee. When the ITB becomes inflamed, there can be a generalized click or snap over the outside of the hip with hip flexion, extension, or rotation. There can also be the same symptoms over the lateral aspect of the knee. This is termed ITB Syndrome. A detailed history as well as a clinical exam are key in the diagnosis of snapping hip. X-rays can be used to look for associated or predisposing factors. MRI can be used to help confirm the diagnosis.
What are the signs and symptoms of ITB Syndrome?
- Pain, clicking or snapping over the outside of the hip or knee
- Pain with activity or aching following activity
- Tenderness to palpation to the outside of the hip or knee
What causes ITB Syndrome?
- Continual rubbing of the ITB on the lateral knee combined with repeated knee flexion and extension
- Overuse of the lower extremity
- Decreased lower extremity flexibility or muscle imbalances
- Frequent hill running
How is ITB syndrome treated?
Typical treatment of ITB syndrome is rest from all aggravating activities along with physical therapy to regain motion and strength. Strengthening of the core, hip rotators, glutes, and lower extremities is key. With rest and physical therapy, most all people begin to feel much better and will begin a slow return to activity. In cases where rest and PT are not effective in eliminating the pain, surgical intervention to lengthen the ITB may be warranted.