Its all in the hips!

It's all in the Hips.

By Daniel Rocha LMT CPT CNS 


You know you have to squat for more giant legs, but the pain is not just a nuisance; it’s hindering your workouts. Let’s look at some severe injuries that can occur within the hip. 

Hip Fractures

The hip is a ball and socket joint in the femur that helps control and stabilizes the legs. The hip joint is responsible for lower limb mechanics, such as walking and climbing stairs. A hip fracture is a break in the upper quarter of the femur. Hip injuries often occur in the elderly, where fractures are associated with falling. Statistics show hospital admissions for hip fractures in people 65 years old or older, and the numbers rise with age in women and patients with osteoporosis. A hip fracture is a disruption to the proximal femoral shaft or femoral neck. A femoral fracture occurs in the area of the zone of weakness. Two common fractures in the elderly are intertrochanteric and femoral neck, which occur between the greater and lesser trochanters of the proximal femur. 



Trauma, such as automobile accidents or sports activity, where a direct blow to the side of the hip causes a hip fracture. Most hip fractures in the elderly are due to falls because the bones are weakened by cancer or advanced osteoporosis, where a break can occur just by a patient standing. Symptoms of a hip fracture include pain and aching around the person's groin or thigh, where the movement of the leg or rotation of the hip makes the pain more extreme. A hip fracture is easily diagnosed in patients who have fallen, are older, and have osteoporosis. A physician can discover signs of the fracture with an x-ray of the patient's hip and femur. Still, some fractures are tiny or isolated and only viewed with magnetic resonance imaging (MRI).


On the field: 

Field and court-based sports such as basketball, football, hockey, and soccer, among others, require explosive multi-planar movement in a single stance and high-speed change of direction, so any hip and groin injury (HAGI) is a significant time loss for an elite athlete. Situations where sub-optimal pre-season training has occurred, or the vigor of in-season competition minimizes physiological recovery periods between bouts of physical activity, magnifying risk factors and increasing injury risk. Identifying and managing HAGI are challenging due to numerous structures within the region being the cause of pain and injury. Physicians and manual therapists must consider the likelihood of concurrent pathology and injury re-occurrence, focusing on prevention strategies. The historical and current state of HAGI focuses on applying evidence and clinical experience to develop future risk reduction strategies.


Identifying injuries with high incidence and preponderance within the sport is a widespread practice and leads to prevention investigation and risk reduction. In the case of HAGI, practitioners rely on generalized risk factors and special populations to provide the current best methods. Athletes across sports possess inherent characteristics which require a diverse set of risk-modifying interventions to increase the odds of improved health and sports participation. For these programs to improve, clinical questions and tests on the athletes are performed to advance the practical evidence-based that will improve athlete health. This requires establishing integrated institutions and avenues within all levels (youth, collegiate, semi-professional, professional) and geographical locations (including the United States) of sporting populations. This program begins by proactively implementing current evidence-informed interventions, such as global exercise programs with injury-specific construct modifications, within diverse sporting populations. Assessing the residual outcomes and amending programs accordingly could increase HAGI in understudied populations. Still, for now, recommendations and practice rely on clinical experience and liberal interpretations of courses across sports.  

Overall, if the nagging pain continues, it would be advised to see your primary care physician and get some imaging done. 


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Rossi, M. D., Waun, J. E., & Odle, T. G. (2021). Hip Fractures. In B. Narins (Ed.), The Gale Encyclopedia of Senior Health: A Guide for Seniors and Their Caregivers (3rd ed., Vol. 3, pp. 1216-1218). Gale.


Short, S. M., MacDonald, C. W., & Strack, D. (2021, February 1). Hip and groin injury prevention in elite athletes and team sport – current challenges and opportunities: Published in International Journal of Sports Physical therapy. International Journal of Sports Physical Therapy. Retrieved November 22, 2021, from 

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