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J Athl Train. 1999 Oct-Dec; 34(4): 382–385.
PMCID: PMC1323352

Snapping Iliopsoas Tendon in a Recreational Athlete: A Case Report

Douglas R. Keskula, PhD, PT, ATC, Jason Lott, PT, CSCS, and Jewell B. Duncan, MD

Abstract

Objective:

To describe the evaluation, diagnosis, and conservative treatment of a 31-year-old female recreational athlete with a snapping iliopsoas tendon.

Background:

The iliopsoas tendon has been implicated as an inflamed structure in this unique form of snapping hip. Hip pain, limitation of motion, or both may severely restrict vocational and recreational function and activities of daily living.

Differential Diagnosis:

Left snapping hip syndrome secondary to the iliopsoas tendon or the iliotibial band.

Treatment:

The treatment goal was to restore the athlete's pain-free, functional abilities. The primary focus of the treatment program was stretching of the left hip flexors. The patient demonstrated reduced pain and improved function following a 4-week stretching program and was fully functional and symptom free at 6 months.

Uniqueness:

Snapping hip syndrome is a clinical entity that may be described as hip pain associated with an audible snap of the hip during motion. The most common and well-known cause of this syndrome involves the snapping of the iliotibial band over the greater trochanter. A less common cause is the snapping of the iliopsoas tendon over the iliopectineal eminence.

Conclusions:

Understanding the anatomy and function of the iliopsoas tendon and related structures provides a basis for evaluation and treatment of this unique problem.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Jacobson T, Allen WC. Surgical correction of the snapping iliopsoas tendon. Am J Sports Med. 1990 Sep-Oct;18(5):470–474. [PubMed]
  • Schaberg JE, Harper MC, Allen WC. The snapping hip syndrome. Am J Sports Med. 1984 Sep-Oct;12(5):361–365. [PubMed]
  • Zoltan DJ, Clancy WG, Jr, Keene JS. A new operative approach to snapping hip and refractory trochanteric bursitis in athletes. Am J Sports Med. 1986 May-Jun;14(3):201–204. [PubMed]
  • Lyons JC, Peterson LF. The snapping iliopsoas tendon. Mayo Clin Proc. 1984 May;59(5):327–329. [PubMed]
  • Rotini R, Spinozzi C, Ferrari A. Snapping hip: a rare form with internal etiology. Ital J Orthop Traumatol. 1991 Jun;17(2):283–288. [PubMed]
  • Brignall CG, Brown RM, Stainsby GD. Fibrosis of the gluteus maximus as a cause of snapping hip. A case report. J Bone Joint Surg Am. 1993 Jun;75(6):909–910. [PubMed]
  • Harper MC, Schaberg JE, Allen WC. Primary iliopsoas bursography in the diagnosis of disorders of the hip. Clin Orthop Relat Res. 1987 Aug;(221):238–241. [PubMed]
  • Vaccaro JP, Sauser DD, Beals RK. Iliopsoas bursa imaging: efficacy in depicting abnormal iliopsoas tendon motion in patients with internal snapping hip syndrome. Radiology. 1995 Dec;197(3):853–856. [PubMed]

Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association