Acute Hip & Groin Injuries

Acute hip and groin pain is usually caused by a sudden injury or trauma rather than being of gradual onset or a chronic long term injury.

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Below we outline the more common acute hip and groin injuries, some of the less common injuries as well is important conditions to consider that should not be missed.

Some long term or chronic injuries can appear as acute injuries from time to time if they are very painful.

Common acute hip and groin injuries

Groin strain is a tear or strain in one of the adductor muscles of the groin. Symptoms of a groin strain vary depending on how bad the injury from very mild to a complete rupture requiring immediate medical assistance. A sudden sharp pain in the groin usually when sprinting or turning sharply is felt with immediate swelling and possibly bruising.

Groin inflammation is inflammation of one or more of the adductor muscle tendons in the groin. Symptoms include pain in the groin at the very top of the muscle which can radiate down the leg. This is a gradual onset injury rather than an acute going injury, however if it can appear as an acute injury if painful and severe.

Hip synovitis is inflammation of the synovial membrane or sheath which surrounds the joint. It is a common complication of most hip injuries but transient hip synovitis commonly affects children between the ages of 2 and 9 years old. Symptoms include pain when moving the hip joint and difficulty walking. A fever may also be present.

Labral tear of the hip is damage to the lining of the socket that makes up the hip joint called the labrum. It is caused by trauma such as collisions or falling onto the hip or twisting suddenly with body weight going through the joint. Symptoms are pain, stiffness and restricted movement in the hip joint. The patient may experience a clicking or locking of the hip.

Less common acute hip and groin injuries

Iliopsoas strain is a tear or strain of the powerful iliopsoas muscle which lifts the knee up. Symptoms include a sudden sharp pain at the front of the hip. There may be tenderness, swelling and bruising in severe cases however the iliopsoas muscle is very deep and not easily felt.

Hip bursitis or Trochantic bursitis is inflammation of a small bursa or sack of fluid which sits between a tendon and the bone on the outside of the hip. Symptoms of hip bursitis include pain on the outside of the hip which is worse during activities such as running, climbing stairs or getting out of a car. The pain will gradually get worse and the area on the outside of the hip is tender when pressing in. Pain may also radiate down the outside of the thigh.

Snapping hip is often seen in dancers. Symptoms of a snapping noise and feeling around the hip joint are experienced either at the front of the hip or on the outside of the hip. It is not likely to be particularly painful although if pain is present it is more likely with snapping at the front of the hip.

Rec fem muscle strain is a tear of the tendon of the rectus femoris quadricep muscle where it inserts at the hip. It is caused through overuse or a sudden sharp explosive load on the tendon. Symptoms of a sudden sharp pain at the front of the hip with swelling and bruising may occur.

Avulsion of the AIIS or anterior inferior iliac spine is where the tendon of the rectus femoris muscle comes away from the bone at the front of the hip, often taking a small piece of bone with it. It is common in children and adolescents. Symptoms include a sudden sharp pain at the time of injury with tenderness over the point where the tendon inserts at the anterior inferior iliac spine with swelling and bruising. Avulsion fractures can also occur on the bony bit at the front of the the hip called the anterior superior iliac spine or ASIS for short.

Referred pain is where a problem or injury elsewhere in the body causes pain to be referred into the hip and groin. Lower back problems such as sciatica or slippled disc can cause pressure on the sciatic nerve causing pain to radiate into the hip, groin and further down the leg depending on where the nerve is restricted. Sacroiliac joint disorders can also cause pain to be radiated into the hip, groin and buttocks.

Stress fractures can occur to the neck of the femur, pubic ramus and the acetabulum. A stress fracture of the neck of the femur is a stress fracture to the top of the femur or thigh bone. It is a gradual onset groin injury, however symptoms can appear acute if pain is severe enough. Generally there are not many signs and symptoms of a stress fracture of the neck of the femur other than pain at the extreme movements of the hip joint. It is not likely to show up on an X-ray until healing is underway.

Stress fractures of the pubic ramus at the bottom of the pelvis occur occasionally in long distance runners. Symptoms may be similar to groin inflammation with local tenderness, however pain is not made worse with passively abducting the hip out to the side or resisting the groin muscles pulling it back in again. Treatment is active rest avoiding running and other aggravating activities until local tenderness has gone and other factors such as nutrition should be considered especially in females.

Important do not miss

Slipped femoral epiphysis occurs when there is a fracture at the top of the thigh bone. The fracture usually occurs gradually over a period of time and the two parts of the bone then slip apart, with the head of the Femur moving backwards.

Abdominal and medical conditions such as Appendicitis, Prostatitis, Urinary tract infections and Gynacolocical conditions should all be considered by the medical practitioner in cases of undiagnosed and long standing acute hip and groin pain.