Hip pain in an athlete can be a devastating occurrence. Whether due to an injury or to chronic overuse, the pain can often sideline an athlete from competitive activity.
Localizing the pain can often be difficult. True pain emanating from the hip joint typically involves the groin area, but some people also have pain referred to the outer hip area or buttock. The pain may radiate down the thigh or into the lower back. There may be associated clicking, or even a loud pop may be present. Usually, a careful exam can detect he source of pain, which can usually be treated with activity modification, stretching, and exercise or physical therapy. But what can be done when those modalities don’t help?
First, a detailed history and exam can help detect the source of the pain. Overall limb alignment can reveal problems with pelvic imbalance, over-rotation of the hips, and flatfoot deformities. Training histories can help detect stress fractures. Loss of rotation in the hip suggests a problem stems from the joint space. X-rays may show avulsion fractures, calcium deposits, stress fractures, congenital deformities, or arthritis. An MRI may be necessary, and can show cartilage injuries, labral tears (the rim of the socket), loose bone fragments, or torn tendons.
Depending on the diagnosis, most hip pain can be treated conservatively. Occasionally, a cortisone injection can help stop inflammation. Diagnostic injections in the joint can differentiate pain from within and outside the joint. Surgery may entail an arthroscopy to repair a labral tear or shave down a spur, drilling holes in bone to stimulate blood flow, or releasing a tendon to relieve pain.
If your symptoms persist despite modifying your routine and allowing for rest, an examination by a specialist may be needed. Often a complete evaluation, including x-rays and occasionally an MRI, may be necessary to rule out a more serious injury.
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