For dancers, injuries involving the lower extremities are typically the most common. The exact areas of injury can vary slightly depending on the genre of dance but hip injuries are shown to be the 3rd or 4th most common for ballet dancers. Dancers may complain of pain in the front of the hip, side of the hip, or back of the hip. The location of the pain as well as what specific dance movement provokes the pain provides a lot of information as to what the cause may be.
A fairly common complaint from dancers who are having pain in the front of the hip is “my hip pinches when I perform passé and developpé to the front or side” or “I feel a pop when I lower my leg from developpé devant or a la seconde”. It may be so common that dancers may have a tendency to ignore it thinking it will go away with time. That may be the case for some, but there are some things to consider. Although, there may be different causes to this pinch or pop in the front of the hip, here are some common causes:
Snapping Hip Syndrome/Hip Flexor Tendinopathy: The hip flexor, namely the iliopsoas muscle, is the muscle in the front of the hip that moves the hip into flexion and external rotation-- for example with developpé, passé, and grand battement. With hip snapping syndrome, the hip flexor muscle is “snapping” over part of the bony structure of the skeleton and creating a noise or “pop” when lowering the leg. For some, this may just be a bizarre party trick with no pain or discomfort at all. It is important to note that even if it starts out pain free, it can become painful over-time since the underlying cause may be due to repetitive overuse of the hip flexor muscle and weakness or underactivity of the deep core and glut muscles. It may be tempting to stretch the hip flexors thinking this will help loosen up the area that feels tight and resolve the issue, but depending on the individual presentation, it may make it worse or more irritated. Whenever something begins to hurt, it can be helpful to take note of what makes your pain better and what makes your pain worse as this will often help pinpoint exactly what the cause is as well as provide a pathway to get out of pain.
Hip Impingement: When body movement occurs that involves the hips, the joint surfaces that make up the hip (the ball and the socket) move as well. This relatively small motion inside the joint is what allows for the big movement of our legs. Hip impingement occurs when these joint surfaces come too close together during movement or positions and pinch some of the surrounding tissues. This can commonly occur during developpé, passé, or attitude devant to name a few. The dancer may also experience a catching or locking sensation.
Hip labral tear: The hip labrum is a ring of soft tissue along the outside rim of the hip socket that serves to deepen the hip socket. It also plays a role in hip stability to help guide the ball of the hip joint within the socket when movement occurs. The motion of turnout for dance naturally puts stress into the portion of the labrum in the front of the hip. This DOES NOT mean that just because you do ballet, you are destined to having a hip labral tear. There are a variety of causes for hip labral tears but some most pertinent to dance include: repetitive microtrauma, hip impingement (discussed above), hypermobility, or hip dysplasia (born with bony abnormality of the structure of the hip socket).
There is good news here…
Just because you are experiencing any of these complaints, doesn’t mean you are doomed. There are many options to conservatively treat pinching, popping, snapping, and any other hip discomfort. Just like any other complaint in different parts of the body, the best course of action is to get it checked out sooner rather than later by a practitioner who understands dance. This can be a Medical Doctor, a Physical Therapist, an Athletic Trainer, an Osteopath--the options are numerous but it’s important to go to someone who is well versed in the demands of dance to help you sort and get you back on track.
By taking action relatively quickly vs waiting it out, this will help to avoid additional movement compensations your body may develop over time in efforts to avoid painful movements.
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*This is meant for informational purposes only and not to diagnose. This information should not replace individual medical or health advice. See your local healthcare provider to understand your hip pain.*