Child Orthopedics

Frequently Asked Questions

My 13-year old daughter has what's called a snapping hip syndrome. She's on a soccer team and the pain is starting to affect her participation. What can be done about this? Will she outgrow it?

Snapping hip syndrome is occasionally reported by dancers and other athletes such as long distance runners and soccer players. The condition is caused by a thick portion of the iliotibial band (ITB) flipping back and forth over the hipbone. The iliotibial band is a long band of fascia or connective tissue that goes from the side of the hip down to the side of the knee.

Girls and women are affected more often than boys and men. This is probably because of differences in the hip shape and contour of most females versus males.

Treatment is usually conservative with antiinflammatory drugs, stretching, and physical therapy. Steroid injections may help. Sometimes only one injection is needed. In other cases, the symptoms respond after a series of injections. The number must be limited due to local effects of the steroids.

If treatment fails, then surgery may be considered. The surgeon can make a Z-shaped incision to release or lengthen the ITB. Some surgeons cut out a diamond-shape portion of the ITB. This is done right over the greater trochanter, the place on the bone where the ITB is rubbing.

The surgery can be done with an arthroscope and a very small incision. This type of operation is called minimally invasive. It's still surgery with potential complications, so nonsurgical treatment is always suggested first.

Victor M. Ilizaliturri, Jr., MD, et al. Endoscopic Iliotibial Band Release for External Snapping Hip Syndrome. In The Journal of Arthroscopic and Related Surgery. May 2006. Vol. 22. No. 5. Pp. 505-510.

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