Author: Dr. J. Pieter Hommen
From the professional athlete to the weekend warrior, hip pain is bringing athletes of all types in for treatment to my office. Certain conditions, when left un-treated, can lead to permanent disability and may prevent a full return to sports.
Do you avoid certain hip positions such as tying your shoes with your legs crossed? Do you feel that you have lost hip motion? Do you have difficulty laying on the side of your hip at night? You may be experiencing one of the following types of hip pain.
Hip Impingement (Femoroacetabulum Impingement or FAI)
A potentially painful hip condition caused by the squeezing together of two bones in the hip, resulting in potential cartilage injuries of the hip. Several sports are notorious for impingement including soccer, gymnastics, football, baseball catchers, hockey, golf, yoga, as well as power-lifting. You may find that your hip has pain and difficulty with hip rotation and flexion activities such as tying your shoes.
If left untreated, the hip cartilage may become brittle and peel off the bone leading to eventual osteoarthritis – a condition of severe cartilage wear that may require future hip replacement surgery. Patients who come to see me are usually in their early twenties to early fifties. Generally, I will first start a course of physical therapy as well as recommend that you alter your sports activities. If hip arthroscopy is recommended, it can help restore the normal labrum and cartilage structures of the hip in patients who present early the course of FAI.
Hip Labrum Tear
The labrum is a cartilage ring that lines the hip socket (acetabulum). It prevents dislocation of the hip joint through a suction-seal effect while maintaining appropriate hip motion and contact between the femur and acetabulum. A tear of the labrum can lead to abnormal hip motion and increased stress on the cartilage lining of the femoral head and acetabulum and eventual cracking and loss of the cartilage. Labrum tears are often seen in combination with hip impingement (or FAI) – see above.
A labrum tear can result in a painful loss of hip motion, clicking, and inability to resume athletic activity. Treatments usually start with physical therapy to restore hip motion and function, however hip arthroscopy may be advised to repair the tear and treat the potential cause of the tear such as impingement (FAI).
Peritrochanteric Pain Syndrome
Do you feel pain at night time sleeping on the side of your hip? Do you have a painful snapping at the outer side of your hip? Do you have hip weakness while standing on one leg? You may have one of the following common hip problems:
Iliotibial Band Tendonitis
A painful tightness of the (iliotibial) IT band at the outer side of the hip - common in runners. Pain at night when laying on the side of the hip.
A painful popping or clicking at the outer side of the hip that feels like the hip is dislocating. Common in young female athletes involved in dance, gymnastics, cheerleading.
Present with pain at the outer side of the hip with possible weakness with activities.
Gluteus Tendon Tear
Present with pain at the outer side of the hip with possible weakness on single leg activities or hip abductor work-outs.
Pain at the outer aspect of the hip commonly from a tight IT Band. Pain often worsened at night time when laying on the side of the hip.
Treatment of the hip usually involved a course of diligent therapy, however may require an arthroscopic release of the IT Band and a removal of the inflamed bursal tissue. The gluteal tendon tear can also be repaired with arthroscopic techniques
A condition often seen in younger women involved in sport activities where flexibility is advantageous – such as gymnastics, cheerleading, and dance. They often present at a much earlier age (adolescence) with pain during rotation and end-range of the hip joint. They may have no notable or very subtle labrum or cartilage abnormalities on MRI scan. Treatment may require an arthroscopic tightening of the capsule of the hip joint.
As an orthopedic surgeon with advanced fellowship-trained in sports medicine and arthroscopic procedures, I specialize in hip sports-related injuries. My goal is to heal your hip and get you back to sports activities.
About The Author:
J. Pieter Hommen, MD
Dr. Hommen is board certified and fellowship trained in sports medicine and advanced arthroscopy of the shoulder, elbow, hip, knee, and ankle. He specializes in injuries and arthritis of the shoulder and knee and non-arthritic injuries of the hip. Through social media, Dr. Hommen’s goal is to provide accurate reviews of peer-reviewed and evidence-based medical data to improve your understanding of what can often be complex medical topics. This allows you to better share in the medical decision-making process as a more educated patient.