Hip pain in sportsmen and women often occurs in conjunction with or is related to chronic groin pain. Here we explain the common causes of hip pain in sports.
Select the location of your hip pain:
Front of the hip (anterior hip pain)
Outside of the hip (lateral hip pain)
Hip pain in children should always be examined by a doctor to rule out Perthes’ disease.
Pain at the front of the hip
A labral tear of the hip is a tear to the cartilage lining of the joint, called the acetabulum. Symptoms of a labral tear include:
- Pain in the hip and/or groin.
- A clicking or locking of your joint may occur.
- You may have stiffness and/or restricted mobility in your hip joint.
- Symptoms may come on suddenly following an impact or trauma. But can also develop gradually if your joint progressively degenerates.
- More on labral tears
Synovitis of the hip
Synovitis often occurs in sports people alongside another hip joint injury. Symptoms include:
- Difficulty walking.
- Pain in your hip joint at night, which sometimes radiates further down your leg.
- This condition can also affect young children and be linked to the presence of a virus.
- Diagnosing and treating the original cause or co-existing condition is the key to recovering from hip synovitis.
- More on Hip synovitis
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Osteoarthritis of the hip
Osteoarthritis is ‘wear and tear’ (degeneration) of the hip joint. The hard cartilage on the ends of the bone wears away and eventually, the bone starts to wear away also. Symptoms include:
- Hip pain
- Reduced joint mobility
- Joint inflammation. Your hip joint will feel hot and inflamed.
It is common in older people over the age of 50, especially women. Although there is no cure, osteoarthritis can be managed with various treatment options.
- More on Osteoarthritis
Ligament teres tear
The ligamentum teres is a ligament that joins the acetabulum (pelvis) to the head of the femur (thigh bone). Symptoms are similar to a number of other hip injuries:
- Deep aching pain in the hip joint
- Reduced range of motion
- Hip pain at night
- Pain may radiate into the groin.
There are no specific tests or imaging methods to help diagnose a Ligamentum teres tear. They are usually picked up during arthroscopic surgery. A complete rupture of the ligament can be serious as this stops the blood supply to the head of the femur causing necrosis.
Rectus femoris tendon injury
The rectus femoris is one of the powerful quadriceps muscles at the front of the thigh. A strain or tear in the tendon can occur at its origin at the front of the hip. Symptoms include:
- A sudden sharp pain at the front of the hip or groin.
- Pain usually occurs whilst doing an explosive-type activity such as sprinting or jumping.
- Swelling and bruising may occur with pain when lifting the knee up against resistance.
- Tenderness will be felt when pressing in where the muscle attaches at the front of the hip.
- More on Rectus femoris tendon injury
A hip pointer occurs following a direct impact or trauma to the front of your hip. It is common in contact sports like rugby or American football. There will often be bruising and pain at the point of impact which can be eased by ice and compression.
- Symptoms of a hip pointer include pain and tenderness over the front of your hip.
- Pressing in on the point of injury will be painful.
- There is usually some obvious bruising or swelling.
- A full assessment should be undertaken to rule out the possibility of damage to intra-abdominal organs.
- More on Hip pointer
Pelvic stress fracture
A pelvic stress fracture is a hairline-type fracture in the large pelvis bone. This is due to repetitive impacts or forces, rather than one sudden impact or accident. They are more common in women and normally occur in the pubic rami, where the hamstring and groin muscles attach. Symptoms include:
- Tenderness over the inferior pubic ramus at the bottom of the pelvis.
- Pain is felt in the groin or hip which increases with exercise but eases or gets better with rest.
- You will experience reduced strength and movement in the pelvic area.
- More on Pelvic stress fracture
Traction apophysitis/ilium apophysitis
Ilium apophysitis is an overuse injury that occurs in children and adolescents at the front of the pelvis. An apophysis is an area of growth of a bone that also acts as a point for muscles to attach to. This injury can particularly affect those who participate in sports and those with tight hip muscles. The hip pain usually intensifies with activity.
Symptoms: Apophysitis of the Ilium typically results in dull pain at the front of the hip. There will be tenderness at a specific point on the front of the hip. The pain usually gets worse with activity and there may be some mild swelling.
- More on Ilium apophysitis
Slipped capital femoral epiphysis
This injury occurs when there is a fracture at the neck or top of the thigh bone. The injury happens to the epiphysis which is where the bone grows as children grow older. It is more common in boys aged 11 to 16 years old and occurs gradually over a period of time. Hip pain and groin pain are major symptoms that can cause the injured person to walk with a limp.
Symptoms of a slipped capital femoral epiphysis include pain in the hip and groin which can radiate into the knee. The patient may walk with a limp. When examined they may find one leg is shorter than the other and rotated outwards slightly. Moving the leg out to the side known as abduction and rotating the hip outwards is often limited compared to the uninjured side.
Pain on the outside of the hip
The following are common causes of pain on the outside of the hip:
Trochanteric bursitis/Hip bursitis
Hip bursitis, also known as Trochanteric bursitis is inflammation of a bursa or small sack of fluid between the tendon and bone. A bursa prevents friction and helps movement in the joint so when it becomes inflamed, it causes hip pain. Most cases of hip bursitis are caused by overuse and poor biomechanics, although a direct impact like a fall could also cause it. Read more on the causes, symptoms, and treatment of this condition.
- More on hip bursitis
Important do not miss:
- Avascular necrosis of the head of the femur
- Slipped capital epiphysis
- Perthes’ disease
- Fracture of the neck of femur
- Nerve root compression
Hip pain in children
Hip pain in children is often put down simply as ‘growing pains’. It is important to seek professional medical advice if children have pain in the hip.
Perthes’ disease affects children, most commonly boys aged between four and ten years old, but can also occasionally occur in younger children and teenagers.
- Tiredness and groin pain are two common symptoms, and they may have a noticeable limp.
- Medical help is needed to diagnose this condition as early as possible to try to prevent and limit any future problems.
- More on Perthes’ disease
When should I see a doctor?
- Severe pain in or around the hip or groin area, especially during walking.
- A “giving way” feeling in the hip during walking or going up/downstairs.
- Altered sensation in the leg – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia).
- Unable to complete your normal daily activities after the initial 72 hours.
Further medical assistance can be sought through either your local GP or a private clinician such as a physiotherapist, sports therapist, osteopath, or chiropractor.
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In the first instance, if you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment. Another warning sign is if your hip “gives way” whilst walking and once again, you should consult your doctor or visit A&E.
Secondly, if you have applied for P.R.I.C.E. principles and still have a weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your knee, you are highly recommended to seek advice from a specialist expert – such as a physiotherapist, sports therapist, osteopath, or chiropractor – who can provide you with advice and an appropriate and effective recovery and rehabilitation program.