According to the Journal of the American Academy of Orthopaedic Surgeons, athletic hip injuries account for some 6 percent of all sports injuries and their prevalence is increasing. These injuries are serious business and may require treatment depending on the type and severity. John Christoforetti, M.D., an orthopedic surgeon and sports medicine specialist on the medical staff at Texas Health Orthopedic Specialists, a Texas Health Physicians Group practice, provided some important insights and information for any athlete, whether a weekend warrior or serious competitor.
To get started, we wanted to know how hip injuries occur in athletes. According to Christoforetti, they can occur as a result of collisions, falls or other trauma with the field, other players or structures of the sport like hockey rink boards, the road or even the ocean floor. Perhaps surprisingly, these traumas are less common than injuries that happen slowly through sports training or repetitive motion associated with a particular sport.
Why is that? Christoforetti explains it this way: “Soft tissue irritations or partial tears of tendons connecting muscles of the hip to the bones of the hip, injury to the cushion cartilage of the hip joint itself or — most commonly — injury to the rim cartilage, can become sources of very limiting pain and disability. Sometimes the injury can even prevent the athlete from participating in the sport. What I typically see is a bone structure of the hip and spine that limits the range of athletic motion — or fails to provide enough bone stability for sports training or performance. And over time, this conflict between the bone structure and the physical demands can lead to wearing out, irritation or destruction of the surrounding soft tissues.”
Susceptibility to an Athletic Hip Injury
Weekend warriors are just as susceptible to hip injuries and Christoforetti explains that, in particular, those who participate in endurance athletics or high-impact training activities can overload the hip and surrounding structures. Here’s why: Working all week can decondition the skeletal support (core muscles) and lead to even greater forces crossing the hip during weekend activities. He cites a database of thousands of cases of arthroscopic hip surgery collected across the United States, showing that the vast majority of patients are active, but not professional, athletes.
Christoforetti also broke down what types of activities may be more likely to lead to an athletic hip injury based on his practice’s patient data. The answer depends on the athlete’s gender. For women, the most common activities were running, soccer, yoga, fitness or gym activities. Injured men tended to participate in rotational, pivoting sports like hockey, baseball and soccer — as well as the activities associated with female injuries. The common thread: repetitively training or playing a sport that forces the hip joint into an over-tight or unstable position.
We also wanted to know if diet, family history, age and other factors may contribute to athletic hip injuries. According to the doctor, certain hip conditions may have been passed down from parent to child, but most forms of hip arthritis result from excessive demands created by life, work or sports over time — and are unique to each patient. Excessive body weight and overtraining beyond the body’s recovery limits or through pain, can also create a vulnerability to injury. Christoforetti stresses the importance of baseline fitness through maintenance of life balance.
Treatment for Athletic Hip Injuries
Sometimes a simple home exercise program coupled with outpatient physical therapy, can reduce patient symptoms and improve patient-reported outcomes. This conservative approach to treatment can also be supplemented by injectable medicines like cortisone or investigational products called biologics (platelet-rich plasma or stem cells) to reduce inflammation pain and facilitate recovery. Often, a short period of activity modification may also benefit the patient.
In rare cases, hip bone structure and athletic participation leads to damage that must be surgically repaired. In the past decade, the medical community has made great strides in minimally invasive and traditional surgical procedures that can repair damaged tissues, but also correct bone structures that led to the damage in the first place. In fact, there’s hope that these interventions may someday prevent the need for hip joint replacements.
According to Christoforetti, many patients go weeks — or even years — enduring unnecessary hip or groin pain, while others spend years on treatment before they’re accurately diagnosed. He advises patients to seek treatment at the onset of symptoms — at a modern diagnostic center. Seeking timely treatment will lead to better patient outcomes.
Hip pain giving you grief? Visit TexasHealth.org/SportsMedicine for more information about Texas Health Sports Medicine or to find a sports medicine physician near you.