Question
Years ago, I fell on my right hip when I lost my balance while kicking a ball. Landed sideways on my right glute. No pain or problem immediately afterward. That night, when I assumed my usual 'frog leg' position on my back to sleep, I realized I couldn't abduct my right hip past 45 degrees with my knee flexed (it usually went all the down to the bed, I am very flexible). This resolved a few days later. I subsequently noticed that my right hip would pop during extension if I did 'bicycle' exercises on my back. If I exercise by walking on a treadmill, I occasionally get some pain in my right buttock and thigh. Maneuvers to test for tightness of the rectoris femoris and piriformis are negative. Am I injuring the hip? Can I do any exercises to improve this? I am 55 years old and have no medical problems, normal weight.

Answer
Donna,

You most likely strained the hip and pelvic joint system with that fall, and caused it to malfunction.   The popping is most likely the iliopsoas (or just psoas) tendon snapping over the boney knob it attaches to on the inside of the femur.   If the popping comes from the outside or lateral hip, and not from the inside/medial hip, then it could be snapping of the iliotibial band over the boney prominence called the greater trochanter of the femur.  You can google all these anatomic parts to see them.   Usually, IT Band snapping is irritating and will cause lateral hip and thigh pain whereas psoas snapping is often painless but annoying.  Theoretically, the malfunction causes stress to the tendons and connective tissues.  This leads to thickening and/or fibrotic scar tissue changes to the tissues, causing tightness, rubbing, popping, etc.   The third possibility is that you tore the soft cartilage rim that lines the inner socket of your hip.  This is called the acetabular labrum.  If you have a labral tear, it will usually click (more so than pop) and it will sometimes cause your hip to catch or lock-up with walking or other weightbearing movements.  Your best bet would be to get evaluated by a chiropractor or orthopedist to determine which anatomic site is the source of the popping, and also which tissues are irritated.  A well-skilled chiropractor can thoroughly evaluate this.  Assuming you don't have a labral tear, and thus don't need an MRI-arthrogram of your hip, obtain the combination of chiropractic joint manipulation to the pelvis and hip along with various myofascial release techniques to the target tissues.  You can see some of this stuff on my web site (www.drgillman.com products/services tab).   You likely will not affect the condition with stretching, but you may have to do some strengthening of the hip/buttock muscles.  If all goes well, the popping will stop after a few weeks of treatment and strengthening exercises.   Interestingly, there is very little written about this condition.     

'Hope this was helpful,

Dr G