COMMON ACUTE AND

OVERUSE INJURIES OF HIP

JOINT
ARAVINDH D
MPT- SPORTS PHYSIOTHERAPY
ANNAMALAI UNIVERSITY
 ANATOMY OVERVIEW
• The hip joint is a ball and
socket type of synovial joint that
connects the pelvic girdle to the
lower limb. In this joint, the head
of the femur articulates with
the acetabulum of the pelvic (hip)
bone.
• The hip joint is a multiaxial
joint and permits a wide range of
motion; flexion, extension,
abduction, adduction, external
rotation, internal rotation and
circumduction.
 Leading Causes of Hip Injuries
From accidental falls to certain medical conditions, hip injuries can
happen fast and unexpectedly, or gradually over time.
The most common causes of hip injuries include:

• Falls: Falls are one of the leading causes of hip injuries among
older adults, often resulting in hip fractures. Conditions that
affect balance or coordination, such as Parkinson’s disease or
peripheral neuropathy, can also increase the risk of falls.
• Trauma: Motor vehicle accidents, sports injuries or any direct
blow to the hip area can lead to a variety of hip injuries, including
hip dislocation, fracture or labral tear.
• Overuse: Repetitive activities or movements — particularly in
sports or physically demanding jobs — can lead to injuries such
as stress fractures, tendinitis or bursitis.
• Poor biomechanics: Incorrect technique during
exercise, sports or physical work can place excessive
stress on the hip joint and lead to injuries. This includes
improper lifting techniques or poor running form.
• Degenerative conditions: Age-related conditions such
as osteoarthritis and osteoporosis weaken the hip joint
and bones, making them more susceptible to injuries.
• Muscle weakness or imbalance: Weak or imbalanced
muscles around the hip can fail to support the joint
properly, leading to increased risk of injury. This
includes conditions such as hip dysplasia or muscle
imbalances caused by improper training or lack of
conditioning.
 Common Hip Injury Symptoms
Hip injuries can present a variety of symptoms depending on the type and severity of
the injury.

The most common hip injury symptoms include:

• Pain: This is the most common symptom of a hip injury. The pain can be sharp and
sudden, or it can be a dull ache that worsens over time. It might be localized in the
hip area or radiate to the groin, thigh or knee.
• Swelling or inflammation: These are common responses to injury. Swelling around
the hip joint may indicate an injury like a fracture, dislocation, bursitis or tendinitis.
• Difficulty walking or moving: If you find it hard to walk or move your leg, it may be
due to a hip injury. This could manifest as a decreased range of motion, limping or
the inability to bear weight on the affected leg.
• Stiffness: This can be an indicator of arthritis or other degenerative conditions
affecting the hip. It can also occur after a period of immobility following an acute
hip injury.
• Clicking or popping noise: A clicking or popping sound or sensation in your hip
during movement can indicate conditions like snapping hip syndrome or a labral
tear.
 1. Hip Fracture
• A hip fracture is a serious injury that involves a break in the
upper part of the femur (thighbone) near where it meets the
pelvis at the hip joint.
• Research has shown that in 98% of cases, hip fractures are
caused by falls — particularly in elderly people with
weakened bones.
• Stress injuries such as long-distance running or high-impact
traumas such as car accidents can also result in hip fractures.
The most often symptom of a hip fracture is severe pain in the
hip or groin area. The pain is usually exacerbated by any
attempt to move or put weight on the leg on the side of the
fractured hip.
 Hip Dislocations
• A hip dislocation occurs when the head of the femur
(thighbone) is forced out of its socket in the hip bone.
• This can happen due to severe trauma or impact, such
as a car accident or a fall from a significant height. In
some cases, a dislocation can also occur due to a
sports injury or from a severe twist or bend at the hip
joint.
• The most common symptoms of a dislocated hip
include severe pain, immobility or limited mobility and
visible deformity.
 LABRAL TEAR
• A labral tear involves damage to the labrum — a ring of
cartilage that surrounds the socket of the hip joint. The
labrum helps to stabilize the hip joint and acts as a shock
absorber.
• Labral tears can result from acute trauma, such as a fall or a
direct blow to the hip, but they are often a result of
repetitive stress from certain sports or activities that involve
a lot of twisting and pivoting, like golf, ballet or soccer.
• The most common symptoms of a labral tear include hip
pain, reduced range of motion, a sense of grinding or
popping and stiffness in the hip area.
 HIP BURSITIS
• Hip bursitis, also known as trochanteric bursitis,
is inflammation of the bursa in the hip. The bursa is a small,
fluid-filled sac that acts as a cushion between bones and soft
tissues, reducing friction and allowing smooth movement.
• Bursitis often results from overuse or repetitive stress on the
hip, but it can also occur due to direct trauma, certain
systemic diseases like rheumatoid arthritis or lupus, or
following surgery or infection.
• Typically, pain in the hip is the most common symptom,
while swelling and pain that worsens with movement or
pressure can also be signs of hip bursitis.
 HIP TENDONITIS
• Hip tendonitis is inflammation or irritation of the
tendons in the hip — thick bands of tissue that connect
muscles to bones.
• This condition can result from overuse or repetitive
strain, often due to activities that involve a lot of
running, jumping or other high-impact movements. Age
and certain health conditions like rheumatoid arthritis
and diabetes can also increase the risk of tendinitis.
• Pain and tenderness are the most common symptoms
— typically felt at the point where a tendon attaches to
a bone.
 HIP SYNOVITIS
• Hip synovitis, also known as transient synovitis, is
an inflammation of the synovial membrane that lines
the hip joint. This condition is most common in children
between the ages of 3 and 10, but it can also occur in
adults.
• While the exact cause is often unknown, it may be
associated with viral infections, allergies or trauma to
the hip.
• The most common symptoms include hip pain, limping,
restricted hip movement and in some cases a mild fever.
 HIP IMPINGMENT
• Hip impingement, also known as femoroacetabular
impingement (FAI), is a condition where there is abnormal
and wearing contact between the ball and socket of the hip
joint.
• This can occur because of variations in the shapes of the hip
bones, leading to abnormal contact during hip movements.
Although FAI is often caused by physical activity, age or
previous hip injuries, it is also caused by defects at birth
where the hip bones are abnormally shaped.
• FAI symptoms often include hip pain, stiffness or locking
sensations and can lead to damage to the hip joint over time.
 SNAPPING HIP SYNDROME
• Snapping hip syndrome is characterized by a feeling of snapping
or the presence of a popping sound in the hip during activities,
including walking, getting up from a sitting posture, or
maneuvering your leg. This may be caused by a tendon or muscle
sliding over a bony part of the hip.
• Although it can be felt by anyone, it’s most common in athletes,
dancers and people who engage in activities that require repeated
bending at the hip.
• As the name of the conditions suggests, the most common
symptom is a snapping sensation or sound of snapping. The
condition itself is often harmless and more of an annoyance than
a cause for concern, but in some cases, it can lead to pain or
injury.
 MUSCLE STRAINS
• A hip flexor strain involves an injury or tearing of the
muscles at the front of the hip, known as hip flexors.
These muscles help bend the hip and lift the knee.
• Hip flexor strains often occur as a result of sudden
movements, such as sprinting, kicking or changing
direction quickly, which makes them especially common
in athletes.
• The most common symptom of a hip flexor strain is
sharp pain in the front of the hip, although it can also
extend to the groin area. The area affected might also
become swollen and tender to the touch.
Cont…
• A hip adductor strain, often referred to as a pulled groin, is
an injury to the muscles on the inner side of your thigh,
which are responsible for pulling the legs together and
stabilizing the hip and pelvic region.
• Hip adductor strains are similar to hip flexor strains and they
often occur as a result of poor flexibility or sudden
movements, such as sprinting, kicking or changing direction
quickly, which makes them especially common in athletes.
• The most common symptom is pain, which can range from
mild to severe depending on the extent of the strain and can
increase when you bring your legs together or move your
hip.
• Not sure what’s causing your pain?
 HIP POINTER
• The hip pointer can arise from both direct contusion causing
impact and indirect strain injuries of the hip, primarily in
contact sports. Forced extension of the hip, by for example a
tackle from behind in rugby, may result in a sprain or
avulsion of the Sartorius muscle at its iliac crest attachment.
• Pain may be felt when walking, laughing, coughing, or even
deep breathing. Direct contusions to the anterior superior
iliac crest may also involve the attachment of the Sartorius
muscle.
• Hip pointers are common in contact sports such as rugby and
judo and proper protective equipment is essential.
Additionally, developing appropriate skills and techniques
may help avoid a hip pointer. . Ultimately, however, there is
not much an athlete can do to prepare for such an impact.
 SLIPPED CAPITAL FEMORAL EPIPHYSIS
• A slipped capital femoral epiphysis may occur in older children,
particularly between 12 and 15 years. This is similar to a Salter-
Harris type I fracture. It occurs typically in overweight boys who
tend to be late maturers.
• The slip may occur suddenly or, more commonly, as a gradual
process. There is sometimes associated pain, frequently in the
knee, but the most common presenting symptom is a limp.
• Examination reveals shortening and external rotation of the
affected leg. Hip abduction and internal rotation are reduced. -
During flexion the hip moves into abduction and external
rotation.
• Radiographs show widening of the growth plate and a line
continued from the superior surface of the neck of the femur
does not intersect the growth plate.
 Treatment of Hip Sports Injuries
• Rest: Avoid painful activities until recovery.
• Ice/Heat Therapy: Ice for acute pain; heat for
tight muscles.
• Physical Therapy: Strengthening, stretching,
and balance exercises.
• Manual Therapy: Massage and joint
mobilization.
 Prevention of Hip Sports Injuries
• Warm-up/Cool-down: Dynamic warm-ups and post-
exercise stretches.
• Strength & Flexibility: Squats, bridges, and hip
stretches.
• Gradual Progression: Increase training intensity
slowly.
• Proper Technique: Ensure correct form in sports.
• Footwear: Wear supportive shoes.
• Listen to the Body: Stop if pain occurs and seek early
treatment.