- Psoas tendon tightness
- Iliotibial band (ITB) tightness
As part of your physical examination, the doctor will attempt to elicit any snapping from around your hip. A deep clunk in the front of the hip may frequently be related to a labral tear. A soft tissue click, especially if related to a tender and tight psoas may initially respond to specific physiotherapy stretching exercises. Occasionally the doctor will arrange for you to have a psoas sheath injection of local anaesthetic and cortisone. Together with physiotherapy, this frequently settles. Occasionally, despite these treatments, the psoas tendon may be released arthroscopically.
A tight ITB is initially treated with physiotherapy with work on ITB stretches and deep tissue massage. Core stability and abductor retraining is also important. Sometimes an injection of local anaesthetic and cortisone to the side of the hip at the site of snapping helps settle the problem. ITB release can be performed arthroscopically if the above non-operative treatment fails.