The hip joint is one of the most important joints for athletes, it is used in movements such as running, jumping, changing in direction, and kicking. In high impact sports, the chance of injuring the hip increases. For example, this can range from minor muscle strains to major structural pathologies, including fractures. Even with the best preventative strategies, hip injuries do occur in sports either from overuse or acute trauma. However, athletes can get back to full recovery and performance if the injury is diagnosed early and managed appropriately.

Types of Hip Injuries

Muscle Strains

First, the most common type of injury are muscle strains. A strain involves tearing of the muscle fibers due to overstretching, sudden changes in direction, speed, or sudden twisting movement. The most frequently affected muscles are:
• Hip flexors – injured in sprinting and kicking sports
• Groin/inner thighs – normally injured in soccer and hockey
• Hamstrings – pulled in sports including quick starting/stopping and kicking
• Glutes – might get injured during jumping activities 

Bursitis (Trochanteric or Iliopsoas Bursitis)

Bursae are small, fluid-filled sacs that decrease friction between bones and soft tissues. Overuse, repetitive motion, or direct injury can result in inflammation of these bursae, thus causing pain and stiffness. The most common hip bursitis’ are:
• Trochanteric bursitis – pain and tenderness on the outer side of the hip, common in runners
• Iliopsoas bursitis – pain and tenderness in the front part of the hip

Hip Fractures and Stress Fractures

Fractures are not as common in young populations but can be happen with traumatic accidents, such as a fall or during a full contact sport. Stress fractures can also be seen from repetitive impacts, such as running or jumping.

Hip Dislocations

With some high impact sports, the head of the femur can come out from the socket with a fall, a tackle/check or any direct blow to the hip. It can lead to severe injuries to the surrounding musculoskeletal tissues and immediate medical attention is necessary. 

Sports Hernias

In sports hernias, also known as “Athletic Pubalgia”, there is injury to soft tissue in the groin and lower abdominal area. Unlike a traditional hernia, where there is bulging in the abdominal wall, a sports hernia is simply a tear/strain of the soft tissue. Usually, this pain increases with activity, especially sports that involve twisting movements or sudden changes in direction.

Labral Tears

Labral tears are an injury to the cartilage around the hip socket. Normally, the labrum is an important structure for stability and movement without dislocation of the hip joint. It can get injured with repetitive movement or high impact activities. 

What are common symptoms of a hip sports injury?

• Pain around the hip joint, including radiation to the groin, front of the thigh or glutes
• Swelling
• Tenderness to the touch around the joint
• Decreased range of motion in the hip
• Clicking during hip movements
• Weakness at the hip
• Pain with weightbearing activity or movement 
• Instability, locking or giving out feeling at the hip 

How is a hip sports injury diagnosed?

To diagnose the accurate condition your Physiotherapist and/or doctor will use a combination of physical examinations and diagnostic testing.

Clinical Examination

For the examination, they will ask a series of questions to create a subjective history which includes the mechanism of injury, current symptoms and complaints, pre-existing or previous injuries, and relevant medical history. Next, they will conduct physical/objective testing for the range of motion, strength, and function of the hip. They will perform some special tests to try to reproduce your pain and rule in and rule out certain conditions. 

Imaging Tests

If further detail is required, then imaging may be necessary. Then, your doctor might request that you go for an x-ray, ultrasound, MRI or CT scan, depending on the structures involved. 

How does Physiotherapy rehabilitate a hip sports injury?

Initial phase

The focus of this stage is to reduce the pain, inflammation and swelling around the area, and preventany further damage.
• Rest – Stop activities that stress the hip or make the pain significantly worse
• Ice – Icing the injury 15-20 minutes 3-4 times a day helps with swelling and pain
• Compression – Elastic bandages may help manage pain and swelling
• Elevation – Keep the foot and knee elevated, if possible, to reduce swelling from travelling down the leg

Sub-acute and recovery stage: 

In this stage the focus shifts towards improving range and strength for the patient. Using the combination of:

• Stretching and range of motion exercises – To maintain flexibility and prevent stiffness

• Strengthening – Focused on core and hip stability

• Balance and proprioception training – Restore coordination and balance in the affected side

• Sport-specific drills – Gradual return to sport-specific, quick, and high impact movements

• Return to sport – Finally, returning the athlete back to their sport safely, and giving them strategies to prevent future injuries

• Surgery: In some cases where conservative management fails, or in big traumatic accidents with extensive injuries, surgical procedures may be necesasry.

Need help with a hip pain?

If you are experiencing these symptoms or pain around your hip, look for PhysioNow! We have many expert Physiotherapists that can support your recovery. Book with PhysioNow today for your first assessment and treatment. With 10 clinics across the GTA from Burlington, Oakville, Mississauga, to Etobicoke, you can get help quickly!