Athletic and Active? Watch Out for Hip Injuries

With greater awareness and outpatient treatment, it's easier than ever to treat hip problems.

When people think of hip problems, they usually think they’re limited to older people with frail bones or joints. But even young athletes and weekend warriors can fall prey to hip injuries, says Bob Yin, MD, an orthopedic surgeon with St. Jude Heritage Medical Group.

“These injuries are more recognized now because of improved technology--we have better MRI scans and minimally invasive surgical techniques," Dr. Yin says. "In the past we had a limited ability to diagnose and easily treat these injuries because the hip is a large joint that’s not as accessible as the knees.”

Who’s at risk for hip injuries?

Athletes who participate in a range of sports can be susceptible to hip injuries, says Dr. Yin. “We see it a lot in young hockey players,” he says. “Softball and baseball players can also have hip injuries, especially catchers who are squatting repetitively. Gymnastics, cheerleading—basically any sport that requires an extreme range of motion of the hip on a regular basis—can pose problems.”

What are the most common hip problems?

The hip is a ball-and-socket joint that relies on a cartilage ring called the labrum to act as a gasket sealing the thigh and pelvic bones together in the joint. “It’s common to see labral tears when the hip is used excessively or an athlete falls and injures himself, and that can affect the stability of the hip,” Dr. Yin says. “The other common issue is called impingement. That’s when the bones in the hip don’t fit properly and make abnormal contact in the joint, which can be debilitating. People can be born with it, or it can develop over time.”

What are the signs of hip injury?

“There will be pain and the inability to do the usual athletic activity,” Dr. Yin says. “An athlete may be unable to even do exercises such as squats, lunges, leg presses or go on a treadmill because of the pain.”

Parents of teen athletes should watch their children for an unwillingness to participate in their usual activities—and that goes beyond gym class. “If the child goes to school with hip pain or discomfort, it can affect the ability to sit in class, so parents have to watch for difficulty in academic performance,” Dr. Yin says. “Someone can also feel symptomatic during a long car ride in a fixed position. That can extend into pain and discomfort during daily living, even just sitting and walking.”

How can hip injuries be treated?

Dr. Yin stresses that hip pain should be checked by a physician. “If it goes unchecked, it could develop into progressive degeneration of the joint,” Dr. Yin says. “We also recognize that some people with hip pain and its symptoms won’t require surgery, so it’s best to seek a physician’s advice.”

Dr. Yin starts with more conservative treatment options, which can include modifying or stopping the activity that is causing the hip problems; physical therapy to change the mechanics of the hip; or cortisone or pain medication injections into the joint if it’s inflamed, rather than a labral tear.

If the hip injury is more severe, the minimally invasive surgical option is called hip arthroscopy. “This uses three or four small incisions to access the hip joint with a small camera and surgical instruments, compared to one larger incision with traditional hip surgery,” Dr. Yin says. “This is an outpatient procedure, and most patients are back to work after one to two weeks and back to their recreational activities after three months. I had a patient in his 50s who was a golfer who developed hip pain from a tear that was affecting his swing. He went back to golf after three months and the last time I saw him he had a lower handicap than before.”

The goal with hip arthroscopy is “hip preservation,” Dr. Yin adds. “What we can do is intervene early in degenerative problems to delay or prevent hip replacement later on.”

Can the hips be helped in other ways?

When it comes to hip problems, Dr. Yin says prevention is better than curing. “One preventive measure is proper stretching before and after exercise. The focus should be on stretching the lower back and hamstring muscles, as well as the core. Stretching should also be done with a purpose—don’t stretch to pass the time, but do it with the same thoughtfulness that would be part of any athletic training regimen or workout.”

Dr. Yin adds that anyone who lifts weights during training should focus on using proper form with each move, rather than just how heavy the weight is. “And core strength and stability is important. Don’t think only about the extremities during weightlifting. Core strength helps with hip durability, which can prevent injury.”

Does your doctor recommend you see a specialist for a painful sports injury? Find an orthopedic surgeon near you.