11 Common Hip Pain and Injuries in Athletes

Hip pain is a common cause of discomfort in athletes and can be a frustrating problem to treat. In the past, just about any hip pain symptom was attributed to a "muscle strain"-type injury. While this can be a very common cause of hip pain in athletes, there are many other conditions that can sideline a player as well.

Man clutching his hip
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Muscle Strain

Muscle strain, or pulled muscle, occurs when a muscle is overstretched or torn. In athletes, this type of injury is common in the hip and groin area due to fatigue, overuse, or the improper use of a muscle. The failure to warm up before exercise also contributes to the problem.

Muscles around the hip joint are especially prone to strain because of the tremendous force they can generate. Groin pulls and hamstring strains are two examples of this.

Strains can also affect the lower back, triggering pain around the buttock and hips without structural problems in the hip itself. These often occur as a result of extreme rotational movements during sports.

Muscle strains are generally treated with RICE (rest, ice application, compression, and elevation), while pain can be alleviated with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs).

Contusion (Hip Pointer)

A contusion, simply known as a bruise, is a region of injured tissue in which blood capillaries have ruptured. When a contusion is caused by blunt force impact, swelling and pain will accompany the characteristic black-and-blue discoloration of the skin.

A direct blow to the outside of the hip can injure the ilium, the largest bone of the hip. In athletes, this type of injury is commonly referred to as a hip pointer. Treatment of a hip pointer typically involves RICE and NSAIDs. It can often take a week or two before the hip is pain-free with movement.

Osteitis Pubis

Osteitis pubis is the inflammation of the pubic symphysis, the joint of the two major pelvic bones at the front of the pelvis. Osteitis pubis is thought to be due to the repetitive pull of muscles over the front of the hip joint. The condition is often seen in long-distance runners, soccer players, and hockey players who take long strides over prolonged periods of time.

RICE, NSAIDs, and physical therapy are usually considered appropriate for the treatment of osteitis pubis. Steroid injections may be suggested to reduce pain and inflammation. Walking aids may be necessary.

Hip Bursitis

Bursitis is the inflammation of the fluid-filled sacs throughout the body, called bursae, that help reduce friction between bone, muscles, and tendons.

Inflammation of the bursa over the outside of the hip joint, called trochanteric bursitis, can cause pain with hip movement. Without the cushioning effect of the bursa, any movement of the hip joint can be painful.

Trochanteric bursitis is common in football players, soccer players, and hockey players who place prolonged and extreme pressure on the hip joint during sports, frequently changing directions or suddenly stopping.

While hip bursitis can be effectively treated with ice, NSAIDs, steroid injections, and physical therapy, the condition has a tendency of coming back and becoming chronic.

Snapping Hip Syndrome

Snapping hip syndrome is a term used to describe a cluster of symptoms that can develop when one of three possible scenarios occur:

  • When the iliotibial (IT) band that runs along the outside of your leg from the hip to the knee and shinbone snaps over the outside of the thigh
  • When the deep hip flexor muscle that forms part of the quadriceps snaps over the front of the hip joint
  • When there are tears of the cartilage or labrum around the hip socket

Snapping hip syndrome is typically treated with rest, NSAIDs, and physical therapy. Special stretches and exercises can often get the displaced muscles or tissues back into their proper position.

Hip Labral Tear

The labrum of the hip is a cuff of thick tissue that surrounds the hip socket which helps support the hip joint. When a labral tear of the hip occurs, a piece of this tissue can become pinched in the joint, causing pain and "catching" sensations with movement.

Hip labral tears can often be treated conservatively with RICE, NSAIDs, physical therapy, and steroid injections.

Larger labral tears (or smaller tears that do not respond to conservative treatment) may require hip arthroscopy to surgically repair the injury. Depending on the extent of the tear, recovery can take anywhere from 6 to 12 weeks.

Femoroacetabular Impingement

Femoroacetablar impingement (FAI) is a condition where a bone spur forms along the edge of the ball-and-socket hip joint. This can cause the loss of mobility of the joint and damage to surrounding soft tissues, including the labrum. FAI is thought by many surgeons to be a precursor to arthritis of the hip joint.

FAI is typically treated non-surgically with RICE, NSAIDs, and physical therapy. For those who fail to respond to conservative measures, hip arthroscopy may be recommended. While the surgery can improve symptoms, it has not been proven if it can do anything to prevent hip arthritis.

Stress Fracture

Stress fractures of the hip typically occur in the upper neck of the femur (thigh bone). These are often seen in long-distance runners who place repetitive stress on the hip, causing compression and the development of microfractures. These injuries are especially common in athletes with nutritional deficiencies or eating disorders.

Doctors will most often recommend non-surgical treatment of compression-type stress fractures. Athletes will be instructed to stay off the affected leg for at least 4 to 6 weeks, using crutches if necessary. Pain can be treated with hot and cold treatments and NSAIDs.

If needed, arthroscopic surgery will focus on supporting the area of fracture with internal fixation hardware such as metal plates and screws.

Sports Hernia

Sports hernias, also known as athletic pubalgia, is a painful soft tissue injury that occurs in the groin area. It is a problem commonly seen in hockey players but can occur in other sports that require repetitive twisting and turning at high speeds. The problem is thought to be due to an imbalance of the strong muscles of the thigh and the relatively weaker muscles of the abdomen.

RICE and NSAIDs are generally recommended for the first 7 to 10 days of treatment, after which physical therapy may bring the athlete back to sports readiness within 4 to 6 weeks. If the condition is severe, surgery may be needed, performed either as an open surgery or laparoscopically.

Hip Arthritis

Arthritis of the hips is increasingly seen in older athletes who may have already endured injuries during their sports career. The type most commonly seen in older athletes is osteoarthritis, also known as wear-and-tear arthritis.

Hip arthritis in athletes is treated the same as anyone else. In most cases, the condition is treated non-surgically with activity modification, NSAIDs, physical therapy, and possibly steroid injections.

Severe cases may require surgery, including hip arthroscopy, hip osteotomy, hip resurfacing, arthrodesis (joint fusion), or hip replacement.

A return to high-impact sports is not recommended for athletes with a hip replacement due to the risk of joint failure or dislocation. If you undergo hip replacement, speak with your orthopedic surgeon about which sports are right for you.

Traumatic Subluxation and Dislocation

Complete dislocation of the hip joint is a very rare hip injury; most commonly seen in high-speed car crashes. However, hip subluxations, an injury where the ball of the ball-and-socket hip joint is pushed part of the way out of the joint, are being recognized as a possible cause of hip pain in athletes.

These are seen more commonly in football players or soccer players who are frequently tackled or hit with blunt force.

Hip subluxation and dislocation are considered serious injuries. Treatment involves closed reduction (in which the joint is put back into its correct position), followed by prolonged rest, pain medications, traction (if necessary), and physical therapy. Surgery is typically recommended if there is recurrence or if nearby nerves, blood vessels, or ligaments are damaged.

A Word From Verywell

Hip pain is a common complaint of athletes in many different sports. Finding the best way to alleviate symptoms usually involves the input of an orthopedic surgeon, especially if there has been an injury. Recovery often requires time, rehabilitation, and most importantly patience to get you back to sport readiness.

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18 Sources
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