Hip Pain and Athletes: Ask the Expert
by Dr. Allston Stubbs, MD
Assistant Professor of Orthopaedics
Wake Forest Baptist Health
From Yankee slugger Alex Rodriguez to the high school hockey star next door, hip pain is bringing athletes to sports medicine specialists in increasing numbers. It's important to pay attention to hip pain when it begins in order to prevent a chronic condition from developing.
What are some of the most common types of hip injuries among athletes?
Hip overuse injuries such as bursitis and tendonitis occur commonly in active individuals. Inflammation of the cushion (bursa) between the muscle and the hip bone can cause bursitis. The main symptom is pain at the point of the hip. This can be seen in contact sports such as football and ice hockey. Tendonitis can occur in any of the tendons that surround the hip joint. The most frequently encountered hip tendonitis is iliotibial (IT) band tendonitis, which can cause pain in both the knee and hip. It most frequently affects endurance athletes such as long-distance runners.
Hip pointer injuries are caused by direct impact with the top of the hip bone (iliac crest). The bone and overlying muscle are often bruised, and the pain can be intense.
Osteoarthritis is one of the most common causes of chronic hip pain for older athletes. It is the wearing out of the cartilage that protects the bones in the joints. As we age, this protective cartilage slowly erodes until the underlying bone is exposed, resulting in pain when the joint moves and bears weight.
Hip labral tears caused by injury to the hip labrum, which functions as a bumper around the hip socket. They often cause pain in the groin and a catching sensation in the hip.
Hip impingement is a condition often detected in young and middle aged athletes in which the bones of the hip are abnormally shaped and do not fit together perfectly. The bones rub against one another and damage the joint.
Stress fractures, which are caused by repetitive trauma to the hip bone over time, are most often seen in long-distance runners.
Avascular necrosis can be defined as the death of bone due to a lack of adequate blood flow. When this occurs in the hip it is usually in the ball of the joint, called the femoral head. It causes a dull ache or throbbing in the hip, groin or buttock and pain when walking or moving the hips from side to side.
If I injure my hip, what should I do?
Many minor hip injuries can be treated safely at home. Get off your feet, rest and apply ice for 10-20 minutes every two to four hours. For pain, try over-the-counter pain relievers such as acetaminophen, aspirin, ibuprofen, etc.
Seek immediate medical attention if your hip pain is caused by an injury and is accompanied by:
- A joint that appears deformed
- Inability to move your leg or hip
- Inability to bear weight on the affected leg
- Intense pain
- Sudden swelling
Any pain that limits your ability to walk or run normally should be evaluated by a sports medicine physician.
Will treatment take me out of my game?
Not necessarily. Many patients respond to conservative treatment options such as medication and physical therapy. If these measures fail to restore your pre-injury condition, surgery may be considered.
Fortunately advanced diagnostic imaging makes it possible to more precisely determine the best treatment for you. That, combined with recent developments in less invasive surgical procedures, has resulted in more options to get you quickly back to your active self.
Hip arthroscopy is a minimally invasive procedure performed through tiny incisions, using a small camera inside the joint to visualize the damaged structures. A variety of instruments repair torn tissue, remove bone spurs, re-shape abnormal bones and treat injured cartilage.
Wake Forest Baptist is the first hospital in the Triad to offer a new type of hip surgery as an alternative to total hip replacement. Developed in England, the Birmingham Hip Resurfacing System removes less of the patient's bone than traditional hip replacement surgery.
Partial or total hip replacement surgical techniques and devices are constantly improving to enhance the lives of those with hip injuries.
How can I prevent hip injuries?
Strengthening or resistance exercises, such as using weight machines, swimming or walking on hills or climbing stairs, can make the muscles and tendons of your hip area stronger.
An ounce of prevention can head off hip pain before it becomes a major problem. If you are starting to have hip pain, don't push through the pain. Allow the area to calm down for a few days before getting back into your training regimen, and if the pain persists and does not go away with rest, visit a sports medicine specialist.
Request an appointment online or call 336-716-WAKE (toll-free 888-716-WAKE) or visit Orthopaedics: Knees & Hips.