Are you hip to the hip strain?
hen people think of sports injuries, the discussion usually circulates around knee and ankle sprains, or lately, concussions. But as a certified athletic trainer working at one of the local high schools here in the East Bay; I am seeing more athletes with complaints of hip pain. It could possibly be a muscle strain (pulled muscle), a bruise or something else entirely. Sports place a high demand on our bodies. When it comes to the hip area, injuries can come from sprinting, kicking a ball, or any type of activity that involves trunk rotation (like twisting for instance). This may cause a sudden onset of pain or gradually build up to what we call an overuse injury. The three main type of injuries that athletes, coaches and parents should be aware of are muscle strain, hip labral tear and apophysitis. A muscle strain is an indirect injury caused by excessive stress or force on the muscle rather than direct trauma to the muscle. There are typically three degrees that a strain can fall under: 1st degree — Is considered mild. There is little tissue disruption with no loss of strength or motion. 2nd degree — Has some tissue damage and strength and motion are compromised. 3rd degree — Complete disruption of the muscle with visible damage (bruising, swelling), loss of function and motion A hip labral tear involves the ring of soft tissue that follows the outside rim of the socket of your hip joint. Athletes who participate in sports such as soccer, football, golf and ballet are at a higher risk of developing a hip labral tear. Signs and symptoms: hip pain, locking, clicking, catching sensation, stiffness and limited range of motion. Causes: Repetitive motions such as sudden twisting or pivoting are common in golf and softball and can lead to wear and tear; degenerative changes can increase friction inside the hip joint (osteoarthritis); structural abnormalities — some people are born with hip problems that can accelerate wear and tear of their joint; injury to or dislocation of the hip joint which can occur during car accidents or from playing contact sports such as hockey. Apophysitis is an injury to the growth plates of the bones in your hip. These growth plates are where tendons attach to the bones. It does not affect how tall you are. During growth spurts, bones usually grow first followed by ligaments and tendons. This may cause pain because of decreased flexibility. This injury usually occurs as a result of repetitive back or hip movements; otherwise known as an overuse injury. However, it can also be caused by a sudden twisting or cutting movement. Symptoms: pain over hip, more pain during or after playing a sport, pain is generally relieved by the activity, typically there is no swelling in the hip area, may cause immediate pain and limping where it is hard to put your full weight down as you try to walk. With any of these injuries you may need to consult your family physician who may refer you to a doctor who special-
izes in sports medicine or hip disorders. At this point, the physician will perform a physical exam, look at your history and possibly order an x-ray or an MRI to help determine exactly what is going on inside your hip joint region. It is usually necessary to rest or decrease your activity so that you are not having pain. Stretching and doing specific strengthening exercises for your abdominals (core) are very important. Prevention is a key element especially for muscle strains. Several factors include proper warm up, dynamic and passive stretching, muscle strength, getting enough rest, staying hydrated and eating healthy meals.
Last but certainly not least, one of the missing pieces in injury prevention is fatigue. Fatigue alters proper movement patterns, decreases sound technique and increases the risk of injury. ✪ Kelli Adams is a physical therapist assistant for the staff of Sports Medicine For Young Athletes, a division of Children’s Hospital Oakland with a facility in also in Walnut Creek. If you have questions or comments regarding the “Health Watch” column, write the Sports Medicine For Young Athletes staff at Health@SportStarsMag.com. To view Kelli’s references for this article, view it online at www.SportStarsMag.com.
Health Watch Kelli Adams
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January 13, 2011