Hip injuries are a great source of disability in an athlete. These injuries cause pain, mechanical symptoms (catching and clicking) and a decline in athletic performance.
Athletes also may complain of tightness and reduced range of motion. Hip injuries in athletes are often misdiagnosed as muscle strains or soft tissue contusions. However, within the past decade, various disorders within the hip joint have been identified and treated arthroscopically.
In addition to the ball and socket shape, soft tissue plays an important role in hip stability. The joint capsule and the ligaments provide a thick sleeve surrounding the hip. The ligamentum teres, which supplies the bone with blood and nutrients, contributes to joint stability. Injuries to the ligamentum teres have been a documented source of intractable hip pain and instability in athletes. Another important structure, the psoas tendon, protects the anterior intermediate portion of the joint capsule. Because of its location, it is often subjected to increased load in athletes.
Depending on the sport, an athlete’s hip may be subjected to increased forces that are capable of causing acute or chronic injury. In golf, labral tears and capsular looseness are common. Similar to the movements of ballet, figure skating and martial arts, the golf swing forces the hip joint into external rotation.
Increased force may cause cartilage and labral tears and result in instability and pain. Football players subject their hips to high-impact traumatic injuries, as well as injuries related to axial loading with rotation. Chondral defects are frequent arthroscopic findings in football players.
Hockey players are subjected to high-impact traumatic injuries like football players, but also suffer injuries related to significant abduction and external rotation movements. Strains of the iliofemoral ligament, femoroacetabular impingement and labral injuries are common findings. Ballet dancers subject their hips to the extremes of motion, particularly rotation. This movement can lead to instability secondary to capsular stretching and instability of the hip.
The goal for most injured athletes is to return to their sport. With the development of hip arthroscopy, many athletes have been relieved of pain and are promptly resuming high levels of activity.
The Steadman Hawkins Clinic, headquartered in Vail, specializes in sports medicine. For more information, go to www.steadman-hawkins.com.
