Sports Medicine: Hip overuse injuries/snapping hip syndrome/stress fractures/osteitis pubis
Overuse hip injuries occur when there are repetitive stresses and trauma caused to a specific area of the hip. These injuries will often times go unnoticed by the athlete, for an extended amount of time before eventually becoming debilitating. Some examples of overuse hip injuries are described below:
Snapping Hip Syndrome
What is snapping hip syndrome?
This is a condition most often seen in hurdlers, runners, dancers and gymnasts. All of these activities require a great amount of hip motion and repetitive movements that can lead to muscular imbalances. The repetitive movements and muscular imbalances can lead to a snapping in the hip that can be both audible and painful.
What causes snapping hip syndrome?
Snapping hip syndrome results from muscles snapping over the bones around the periphery of the hip outside the hip joint.. This is usually felt when moving the hip up towards the chest and back to its normal position.
What are the symptoms of snapping hip syndrome?
Initially the athlete will complain an audible “snap” with certain hip movements. Over time, that snapping can be followed by pain and swelling. A decrease in flexibility or a loss in hip movement may also be noticed.
How is snapping hip syndrome diagnosed?
A thorough history and physical exam are often used to diagnose snapping hip syndrome. X-rays or an MRI may be used to rule out any other causes of the hip pain.
What is the treatment for snapping hip syndrome?
Rest and ice are used initially to treat snapping hip syndrome. A physician may prescribe anti-inflammatory medications or set the athlete up with a physical therapist for rehabilitation. Rehabilitation will consist of education of proper technique and progression of stretches and exercises designed to return to athletic activity. In extreme cases, surgery can be done to release a portion the muscles if all other treatment options have failed.
What is the long-term outlook for snapping hip syndrome?
With proper management, return to full activity is expected. It is important to continue to perform hip flexibility and strengthening exercises to maintain muscular balance and to avoid a recurring injury.
Osteitis pubis
What is osteitis pubis?
Osteitis pubis is an inflammation where the pubic bones come together in the front of the pelvis. It is a condition that is most often seen in football, soccer, distance running and wrestling.
What causes osteitis pubis?
Osteitis pubis is caused by repetitive stress at the symphysis pubis articulation and the connecting bony structures. The pull of tight groin and hip muscles on the bones of the pelvis can cause inflammation.
What are the symptoms of osteitis pubis?
Athletes complain of pain deep within the groin region and have pain while running, doing sit-ups and squatting. The athlete may also experience discomfort from the pressure of riding a bike.
How is osteitis pubis diagnosed?
A thorough history and physical exam are used to diagnose osteitis pubis. Athletes may be tender over the front of their pelvis. It is common for a physician to order x-rays and even a bone scan to determine the severity of the injury and to determine treatment options.
What is the treatment for osteitis pubis?
Treatment for osteitis pubis usually consists of rest and oral pain medication. Depending on the age of the athlete and severity of the injury, a physician might also order a corticosteroid injection directly into the affected area.
What is the long term outlook for osteitis pubis?
If the athlete adheres to the treatment plan, a full return to activity is expected. The rehabilitation process is generally slow and requires that the athlete be patient. The rest period is followed by a gradual increase in activity and ultimately a complete return to sports.
Femoral neck stress fractures
What is a femoral neck stress fracture?
A femoral neck stress fracture is an overuse injury to the top part of the thigh bone that leads to the ball portion of the hip joint. Unlike other fractures, these injuries occur gradually over time. Femoral neck stress fractures are often seen in distance runners or athletes that begin intense training after a long period of inactivity.
What causes femoral neck stress fractures?
Femoral neck stress fractures can be caused by many different factors, including:
- Internal Factors
- Nutrition
- Muscle Imbalance
- Foot Mechanics
- Flexibility
- External Factors
- Increasing training to quickly
- Hard Running Surface
- Steep Incline
- Excessive training
What are the symptoms of femoral neck stress fractures?
The symptoms of a femoral neck stress fracture generally start out as vague groin pain that increases over time. The pain will begin to increase with activity. Eventually, the pain may focus more onto specific point, hurt at night and cause increased discomfort when the hip is flexed forward.
How is a femoral neck stress fracture diagnosed?
A physician will use a thorough history and physical exam to diagnose a femoral neck stress fracture. If the physician suspects a femoral neck stress fracture they will often order x-rays, an MRI and/or bone scan to determine the severity of the injury.
What is the treatment for a femoral neck stress fracture?
In the treatment of femoral neck stress fractures, rest is the key. If they are caught early, rest and physical therapy to work on strength and flexibility can be used to treat them. However, if the stress fracture is more severe, the athlete may be placed on crutches and instructed not to put any weight on the injured leg. In the most severe cases surgery is required to repair the fracture.
What is the long term outlook for femoral neck stress fractures?
With the proper rest and treatment, athletes can return to full activity after overcoming a femoral neck stress fracture. It is important for the athlete to understand what factors may have led to their injury and to avoid them.
