I've Got the Hip PopsQ: I have increased my walking speed and strength training by adding hill and track work recently and have noticed my hip often pops when I'm sitting and I move my knees together or apart from each other. I can also make it pop when I stand on one leg and make small circles with the other leg. It also happens when I do sit ups. There isn't any pain, but I'm concerned I'm damaging whatever is making the noise. Is the popping normal?
A: I frequently see patients in my practice with this question. Some have it with pain associated and most without any pain at all but mostly concerned it is something wrong. It is not isolated to walkers and is common for dancers, martial artists, runners, skiers, weight lifters, people doing Pilates, and athletes of all types. It also happens to those who spend most of their day sitting. So, what's going on?
The muscle commonly responsible for this issue is the psoas. You have two psoas muscles, each originating on the right and left sides of your lower spine. The belly of the muscle travels on the front of the spine, and its lower tendon inserts on the top of your femur or upper leg bone. It goes right over the front of your hip joint just before attaching to the femur. This is the location which the pop can best be felt with fingertip pressure applied.
The psoas is the primary muscle involved in lifting your knee upwards as in walking, running, climbing stairs,and kicking. Other muscles assist in this motion but rarely cause a "pop" like the psoas. In the clinic, I find the patient usually re-creates the symptoms while performing an abdominal sit-up or leg-lift exercise, identifying the psoas as the culprit.
As you train with greater intensity, all the muscles you use become tighter, and the psoas gets tighter along with all the other skeletal muscles in your body. Sitting for long periods of time will place the psoas in its shortened position, allowing the muscle to become tighter. As you stand up, the natural stretch force is placed on the front of the hip. The muscle tension results in the tendon gliding a little, creating a pop noise and clunk-like sensation. I often describe it as similar to plucking a guitar string.
What to do about this? Stretching and reviewing your abdominal/core program on your own or with a trained professional if you are not seeing results. The psoas can be stretched by lunging positions with extension of the low back. In yoga, the Cobra Pose often will stretch it.
A well-trained body worker should be able to assess your level of muscle tension and ability to stretch and teach the necessary corrections, should you need them. Healthcare providers utilizing hands-on myofascial release techniques are also helpful when stretching alone isn't effective.
I hope you enjoy the stepped up intensity and keep moving, keep stretching. Enjoy all it offers.—Greg Lekas