Des Moines Orthopaedic Surgeons Hip Pain in Athletes

By Matthew DeWall, MD, Des Moines

Although less common than other areas such as the knee and shoulder, hip pain can be a significant problem for athletes. The first important thing to determine in the treatment of hip pain is where the discomfort is coming from. There are many potential causes of pain around the “hip”. Pain in this area may indeed come from the hip joint, but more commonly in the young athlete, it is from another cause such as a musculotendinous problem.

Important information in determining cause can come from the location, pattern and severity of the pain. The hip joint is located near the groin, much more central in position than most people think. Pain coming from within the groin region can certainly be from the hip joint. Sudden onset of significant pain in this area should prompt evaluation, especially in the young athlete. In children and adolescents, a problem with the growth plate can occur. This usually presents with sudden onset of pain which makes it difficult to bear weight or walk on the affected leg. Other potential causes of pain originating in or around the hip joint include less common, overuse injuries such as stress fractures or an injury to the tissue lining the rim of the hip socket, called the labrum.

Significant injury can also occur to muscles around the hip. Posteriorly, the hamstring muscles originate from the pelvis. Injury to these muscles can cause significant pain and weakness in this area. Injury to hip flexor muscles can also occur, causing pain in the front or anterior side of the hip. Occasionally in the young athlete, one of the hip flexors may tear away with a small piece of bone. This most commonly occurs with kicking activities, and is called an avulsion fracture. Although quite painful, it will heal with simple treatments.

A hip pointer is a contusion to the iliac crest, or pelvic bone, just above the hip joint. Typically occurring with contact sports, the injury can result in significant bleeding into the surrounding muscles. Often this will cause feeling s of pain and weakness that may take several weeks to resolve. Again, with simple treatments of rest, ice and stretching, the symptoms will gradually improve.

Bursitis is another cause of hip pain, resulting in pain located laterally over the bony prominence of the femur or thigh bone. A bursa is a layer of tissue occurring in many areas of the body, and when inflamed, can cause significant discomfort. This may rarely occur due to trauma, but more often is a type of improper use or over use type injury. Treatments to reduce inflammation such as ice, medication, and occasionally injections can often alleviate the pain.

Finally, due to the many muscles which are found around the hip region, hip pain can often be related to muscle or tendon causes. Much as lower back pain, over use or muscle strains can occur around the hip region. Inflammation of tendons, or tendonitis may also be a problem. These are likely the most common causes of pain around the hip region, and with a period of rest and anti-inflammatories will often resolve on their own.

Overall less common than other injuries, “hip” pain can still be a problem. Most often it not related to the hip joint directly, and with a few serious exceptions, will usually improve with simple treatments.

To reach Dr. DeWall or to schedule an appointment please call 515-224-5223. Dr. DeWall specializes in all aspects of knee and hip surgery, including joint replacement, sports injuries and arthroscopic surgery.