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Injuries of the Hip and Groin

Your Name Here

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The HipStrongest 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

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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

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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

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Hip Sprain and Strain Causes

Strength and flexibility imbalances

Often confused with hip subluxation

Often presents as a hip sprain or strain

If left untreated, can result in hip dislocation

Hip subluxation more serious injury

Bone pops out then back in place

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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

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Hip Sprain and Strain Care

X-rays to rule out stress fractureDecreased ROM until hip is pain free

Crutches and limited weight bearingModerate stretching exercises for strength and flexibility

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Dislocated Hip Joint Causes

A force transferred along the long axis of the femur

Falling on one’s side

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Dislocated Hip Joint Causes

Common in…

Contact sports

Athletes with cerebral palsy

Skiing accidents

Posterior dislocation more common than anterior dislocation

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Dislocated Hip Joint Signs

In posterior dislocation thigh isFlexed, adducted, and internally rotated

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Dislocated Hip Joint Signs

Anterior dislocationAbducted and externally rotated Thigh may be flexed or extended

The femur head is posterior to the acetabulum

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Dislocated Hip Joint Signs

May result in a lack of circulation

Atrophic necrosis

Death of tissue due to lack of circulation

Damage to sciatic nerve may also occur

A fracture is common with this injury

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Dislocated Hip JointCare

If accompanied with a fractureSurgical procedure may be needed

Bed rest for two weeks following injury

Without accompanied fractureCrutches and partial weight bearing for up to eight weeks

Gradual ROM and strengthening following partial recovery

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Groin StrainCauses

Overextension of the groin musculature

Running

Jumping

Twisting

External rotation

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Groin StrainCauses

Poor strength and flexibility in groin musculature

High percent of body fat

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Groin StrainSigns

Feeling of tearing during movement

Pain, weakness, or internal bleeding

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Groin StrainCare

Ice, pressure, and rest for 2-3 days

Protective spica bandage applied to area

Commercial restraints to decrease ROM

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Groin Strain Study2002 – “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

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Groin Strain StudyIncidence

Many injuries go unreported because the athlete plays through the pain

Most common in ice hockey and soccer players

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Groin Strain StudyPrevention

Therapeutic intervention to strengthen adductor muscle groupAdduction strength at least 80% of abduction strength

Warm-up–Bike–Adductor stretching–Sumo squats and

side lunges

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Groin Strain StudyPrevention

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

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Groin Strain StudyRehabilitation

Passive physical therapy treatment is ineffective

Massage and stretching

8-12 week strengthening program is most effective

Resistance training, balance training, and abdominal strengthening

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ImplicationsHip 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

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Sources

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

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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

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SourcesGroin Strain Pictures

www.sportsmed.buffalo.edu/info/groin.gifwww.med.umich.edu/1libr/sma/groinstr.gifwww.theoaklandpress.com/.../7288_512.jpgwww.thinknatural.com/.../prod/800056_la.jpghttp://www.seethetrainermidwest.com/stcat/images/thumb/279900- Large.jpghttp://www.newyorkrangers.com/pressbox/images/primages/Jagr_0 304PHI-LeClair-150pr.jpghttp://www.sportinglife.com/pictures/general/allsporttimcahilleverton .jpgwww.bmaps.net/fixed/gstrain2.jpg