Sports Medicine Center
Hip & Thigh Injuries
The hip joint is one of the most used and most important joints in the body. It allows us to walk, run, and jump. It bears the body’s weight and the force of the strong muscles of the pelvis and leg. It can also one of the most flexible joints in the body.
The surgeons at Summit Orthopedic Specialists are at the forefront of many innovative surgical treatments to get you back to the activities you love as quickly as possible.
Hip Anatomy and Function
The hip is a ball-and-socket joint. The round head of the femur (thigh bone) glides and rotates within a socket, called the acetabulum. The acetabulum is a stable joint surrounded by ligaments and muscles.
The motion and the support of the hip are controlled by muscles of the pelvis, abdomen,thighs and lower back.
Common Symptoms of Hip Injury
While the hip joint is one of the sturdier areas of the body, sports-related injuries and problems do occur in the hip area. Symptoms may include:
- Pain with movement
- Catching or clicking
- Loss of strength
- Reduced range of motion
- Swelling and stiffness
- Warmth and redness
Hamstring Muscle Strain
Hamstring muscle injuries are common in athletes, especially those who participate in sports that require sprinting, such as track, soccer, and basketball. These can also occur in recreational athletes. A pulled or torn hamstring is an injury to one or more of the muscles at the back of the thigh.
Patients will usually notice a sudden, sharp pain in the back of the thigh while running. Additional symptoms that may follow include swelling, bruising, or hamstring weakness. Most hamstring injuries respond well to nonsurgical treatment.
Hip Impingement (FAI)
Normally, the ball (femoral head) and the socket (acetabulum) fit together perfectly for a good range of motion and stability in the hip. In patients with femoral acetabular impingement (FAI), the bones of the hip are abnormally shaped, causing them to rub against each other and cause damage the joint.
Over time, this can cause tearing of the labrum (the ring of soft tissue around the hip socket) and osteoarthritis. This can cause pain in the groin area or sometimes toward the outside of the hip.
If activity modification, anti-inflammatory medication, and physical therapy aren’t successful, arthroscopic surgery to remove the bone spur and repair or clean out damage to the labrum and articular cartilage can be successful.
Muscle strains frequently occur in the hip area when a stretched muscle is forced to contract suddenly. A fall or direct blow to the muscle, overstretching, and overuse can tear muscle fibers, resulting in a strain. Symptoms include pain over the injured muscle, swelling, and loss of strength in the muscle. Abductor strains and tears can occur with trauma or overtime. This area is considered the “rotator cuff of the hip”. This can cause pain on the outer portion of the hip an may cause one to limp.
In general, treatment and rehabilitation are designed to relieve pain, restore range of motion, and restore strength. The prescribed treatment is usually rest and ice, as well as an anti-inflammatory medication to reduce swelling and ease the pain.
Hip Labral Tears
Hip labral tear involves the ring of soft cartilage tissue, called the labrum, that follows the outside socket of the hip joint. Certain activities or injuries can result in a tear of the labrum. Structural abnormalities of the hip can also lead to a labral tear. Symptoms include hip pain or a “catching” sensation in the hip joint. Using arthroscopic surgery techniques, surgeons can remove loose fragments from within the joint and trim or repair the hip labral tear.
Muscle Strains in the Thigh
The thigh has three sets of strong muscles: the hamstring muscles in the back of the thigh, the quadriceps muscles in the front, and the adductor muscles on the inside. Muscle strains are common, especially among athletes, and usually occur when a muscle is stretched beyond its limit, tearing the muscle fibers.
When a muscle strain occurs, pain is sudden and may be severe. The area around the injury may be tender to the touch, with visible bruising if blood vessels are also broken. Treatment involves rest, ice, compression, and elevation. Anti-inflammatories and physical therapy may also be prescribed.
Pediatric Avulsion Fracture About the Hip
Growing teens, especially those involved in sports, are one group of patients at risk for a particular type of fracture. Many “pulled muscles” may actually be undetected avulsion fractures of the pelvis, which usually occur with sudden muscle contractions.
A small piece of bone from the ischium where the hamstring muscles attach is torn away by these muscles. A broken pelvis is often painful, swollen, and bruised. Avulsion fractures experienced by athletes normally heal without surgery but will require the use of a walker or crutches while the bones are healing.
There are two types of snapping around the hip. External snapping is often visible and occurs when a tight fascial band (iliotibial or IT band) snaps over the outside of the hip bone. Internal snapping occurs deep in the hip and causes an audible “pop.”. It is caused by the snapping of the iliopsoas over the front of the pelvis. They are both usually treated with physical therapy and anti-inflammatories if they are painful. Surgery is rarely needed except in severe or chronic cases.
A sports hernia is a painful, soft tissue injury that occurs in the groin area. It most often occurs during sports that require sudden changes of direction or intense twisting movements. Rest, ice and anti-inflammatory medication may resolve the pain and allow an athlete to return to their sport. If the pain comes back after you resume activities, you may need surgery to repair the torn tissues.
Direct Anterior Approach
When a hip replacement is called for we offer the direct anterior approach. The direct anterior approach for hip replacement is a less painful alternative to the traditional lateral or posterior approach. It is less invasive, which leaves only a 3 to 4-inch incision on the anterior side of the hip to access and replace the joint during surgery.
The surgeon does not have to detach tendons from the hip but can move the muscles to the side in direct anterior hip surgery. This approach leads to faster recovery, minimal pain, and more normal activity of the patient after surgical hip replacement.
Due to the absence of any cut or detachment of hip tendons or tissues in the surgical process, hip replacement recovery precautions are easy to follow. The direct anterior approach enables patients to resume their daily activities soon after surgery with a decreased risk of hip dislocation or replacement failure.