Athletic Hip Injuries: A Guide to Getting Back in the Game

Hip pain in athletes is often misunderstood. It can start as a vague ache in the groin, a sharp pull during sprinting, or deep discomfort after a match. Because the hip is both a ball-and-socket joint and a hub for powerful muscle groups, injuries here can be complex. The good news is that most athletic hip conditions are treatable, and many athletes return to full performance with the right diagnosis and plan.

At Cincinnati SportsMedicine and Orthopedics, Dr. Almasri focuses on hip preservation and orthopedic sports medicine. This series covers one athletic hip topic each week. Here is the overview.

Why the athletic hip hurts

The hip must bear weight and generate power at the same time. Sports that load the hip at end range — soccer, football, hockey, dance, track and field, gymnastics — place especially high demand on the joint, labrum, cartilage and surrounding tendons. Pain may come from inside the joint, the soft tissues around it, or both.

• The labrum: a ring of cartilage that deepens the socket and helps stability.
• The articular cartilage: the smooth surface cushioning the ball and socket.
• The femoral head and acetabulum: the ball-and-socket bones of the hip.
• The surrounding tendons and muscles: gluteal tendons, hamstring origin, iliopsoas, rectus femoris and core muscles.

What this weekly series covers

• Hip impingement (FAI) — the most common structural cause of groin pain in athletes.
• Hip labral tears — clicking, catching and deep groin pain.
• Hip instability and dysplasia — from microinstability to socket coverage.
• Proximal rectus femoris and hip flexor injuries — kicking and sprinting sports.
• Hamstring strains and proximal tears — sit-bone pain and weakness.
• Core muscle injury / sports hernia — groin pain without a bulge.
• Gluteal tendinopathy and abductor tears — lateral hip pain in athletes over 40.
• Cartilage preservation in the active hip.
• Return to sport and the international Delphi consensus study.

When to see a hip specialist

• Groin, side, or front-of-hip pain lasting more than a few weeks
• Pain that limits sport, training or daily activity
• Clicking, catching, instability, or a sense of the hip giving way
• A sudden injury with weakness or difficulty bearing weight

Early evaluation can prevent a small problem from becoming a career-limiting one.