Injuries of the Hip and Groin

Injuries of the Hip and Groin Your Name Here

The Hip • Strongest and best-protected joint in the body • Rarely injured in sport • Due to numerous supporting ligaments and muscles • Any movements outside the normal ROM can be harmful

Hip Sprain and Strain • Sprain • Partial or complete tearing of a ligament • connects bone to bone • Strain • Stretch or rip in muscle fiber or its tendon

Hip Sprain and Strain Causes • Impact with another participant or a stationary object • Violent twist where feet are firmly planted and trunk is forced in opposite direction

Hip Sprain and Strain Causes • Strength and flexibility imbalances • Often confused with hip subluxation • Hip subluxation more serious injury • Bone pops out then back in place • Often presents as a hip sprain or strain • If left untreated, can result in hip dislocation

Hip Sprain and Strain Signs • Inability to circumduct the thigh • Significant pain in the hip region • Particularly during hip rotation • Symptoms similar to a stress fracture • Constant pain in the area

Hip Sprain and Strain Care • X-rays to rule out stress fracture • Decreased ROM until hip is pain free • Crutches and limited weight bearing • Moderate stretching exercises for strength and flexibility

Dislocated Hip Joint Causes • A force transferred along the long axis of the femur • Falling on one’s side

Dislocated Hip Joint Causes • Common in… • Contact sports • Athletes with cerebral palsy • Skiing accidents • Posterior dislocation more common than anterior dislocation

Dislocated Hip Joint Signs • In posterior dislocation thigh is • Flexed, adducted, and internally rotated

Dislocated Hip Joint Signs • Anterior dislocation • Abducted and externally rotated • Thigh may be flexed or extended • The femur head is posterior to the acetabulum

Dislocated Hip Joint Signs • A fracture is common with this injury • May result in a lack of circulation • Atrophic necrosis • Death of tissue due to lack of circulation • Damage to sciatic nerve may also occur

Dislocated Hip JointCare • If accompanied with a fracture • Surgical procedure may be needed • Bed rest for two weeks following injury • Without accompanied fracture • Crutches and partial weight bearing for up to eight weeks • Gradual ROM and strengthening following partial recovery

Groin StrainCauses • Overextension of the groin musculature • Running • Jumping • Twisting • External rotation

Groin StrainCauses • Poor strength and flexibility in groin musculature • High percent of body fat

Groin StrainSigns • Feeling of tearing during movement • Pain, weakness, or internal bleeding

Groin StrainCare • Ice, pressure, and rest for 2-3 days • Protective spica bandage applied to area • Commercial restraints to decrease ROM

Groin Strain Study • 2002 – “Adductor Muscle Strains in Sport” • Musculature • Adductor muscle group includes: • Pectineus, adductor longus, adductor brevis, adductor magnus, gracilis, and obturator externus • Adductor longus is most commonly injured due to lack of mechanical advantage

Groin Strain Study • Incidence • Many injuries go unreported because the athlete plays through the pain • Most common in ice hockey and soccer players

Groin Strain Study • Prevention • Therapeutic intervention to strengthen adductor muscle group • Adduction strength at least 80% of abduction strength • Warm-up • Bike • Adductor stretching • Sumo squats and side lunges

Groin Strain Study • Prevention • Strengthening • Ball squeezes • Seated adduction machine • Unilateral lunges with reciprocal arm movements • Sports-specific • On ice: kneeling adductor pulls • Standing: cable resisted stride lengths • To simulate skating • Slide skating • Cable column crossover pulls

Groin Strain Study • Rehabilitation • Passive physical therapy treatment is ineffective • Massage and stretching • 8-12 week strengthening program is most effective • Resistance training, balance training, and abdominal strengthening

Implications • Hip injuries are rare in sports • Can be very serious and career threatening • Understand causes, signs, and care of injuries • Ensures… • The safety of the athlete • Promotes a quick and effective rehabilitation plan

Sources Hip Sprain and Strain Pictures www.rad.washington.edu www.amberdragon.ca/.../0503/0301pelvis.gifnorthonline.sccd.ctc.edu/.../images/exer06.gifhttp://www.sportsinjuryclinic.net/gallery/hip/hip_flexor_stretch.jpg

Sources Dislocated Hip Joint Pictures familydoctor.org/Images/444_f1.jpg www.criduchat.co.uk/gifs/CDH.gif www.ispub.com/.../ijem/vol1n2/hip-fig1.jpg

Sources Groin Strain Pictures www.sportsmed.buffalo.edu/info/groin.gif www.med.umich.edu/1libr/sma/groinstr.gif www.theoaklandpress.com/.../7288_512.jpg www.thinknatural.com/.../prod/800056_la.jpg http://www.seethetrainermidwest.com/stcat/images/thumb/279900-Large.jpg http://www.newyorkrangers.com/pressbox/images/primages/Jagr_0304PHI-LeClair-150pr.jpg http://www.sportinglife.com/pictures/general/allsporttimcahilleverton.jpg www.bmaps.net/fixed/gstrain2.jpg

Injuries of the Hip and Groin