Hip injuries & trauma

Hip injuries happen in various ways, with each impacting different parts of the hip joint. Some of the most common hip injuries include:

• Hip flexor injury: Involves damage to the muscles in the front of your hip, which are responsible for lifting your knee toward your body and bending at the waist. These injuries can occur due to overstretching, overuse or sudden movements.
• Hip fractures: Common in older adults, these breaks happen in the upper part of your thigh bone (femur) and are usually caused by falls or direct trauma.
• Hip labral tear: This involves a tear in the ring of cartilage (labrum) that follows the outside rim of your hip joint socket.
• Hip bursitis: Inflammation of the bursae, the small fluid-filled sacs that cushion your hip joints, often due to repetitive motions or prolonged pressure.
• Hip dislocation: Occurs when the head of the femur slips out of its socket, often due to a high-impact injury such as a car accident.
• Hip osteoarthritis: This degenerative joint disease leads to the breakdown of cartilage in the hip, causing pain and stiffness.

Risk factors for hip injuries

Certain factors increase your risk of sustaining hip injuries. For example, older adults are more prone to hip fractures and osteoarthritis due to low bone density, muscle deterioration and joint wear and tear.

Other causes of hip injuries include:

• Activity level: Athletes and individuals with physically demanding jobs are at higher risk for hip injuries, including hip flexor injuries and other strains.
• Previous injuries: Past hip injuries could increase your chances of being reinjured.
• Muscle loss: At around age 40, you begin to lose muscle mass. If you have weak muscles around the hip, you are at a higher risk for hip injuries, especially hip flexor injuries.
• Bone density: Conditions like osteoporosis weaken bones, making them more susceptible to fractures or injuries.
• Obesity: Extra weight puts additional stress on your joints, including your hip joint, and may contribute to conditions like osteoarthritis and bursitis.

Signs of a hip injury

Most signs of a hip injury are noticeable. Swelling and tenderness or pain are usually the first signs you will notice. Other common signs include:

• Stiffness
• Bruising
• Limping
• Popping or clicking sounds

Diagnosing hip injuries

Your doctor will use a combination of a physical exam and utilize imaging tests to confirm a hip injury and determine the type. During the physical exam, your doctor will assess your hip's range of motion, strength and tenderness.

To further investigate, they may order imaging tests such as a X-ray, MRI and CT scan. These tests provide detailed images of your hip's bones and soft tissues, helping to identify fractures, tears and strains.

The Thomas test for hip flexor injuries

If your doctor suspects you have a hip flexor injury, they may confirm diagnosis with the Thomas test, which helps identify tightness or hardening in the hip flexor muscles. It's commonly utilized to check the flexibility and function of the hip flexors, particularly the iliopsoas muscle.

During the Thomas test, you will lie on your back with your legs hanging off the edge of the table. Your doctor will have you pull one knee in toward your chest and watch the position of the opposite leg, which remains extended and hangs off the edge of the table. If the extended leg remains flat on the table with the knee slightly bent, it indicates normal flexibility of the hip flexors.

Can hip injuries heal on their own?

Minor hip injuries often heal on their own with proper care and rest. However, more severe injuries require medical attention to ensure proper healing and prevent complications.

• Hip flexor injury: Mild to moderate hip flexor injuries usually heal with proper care. Severe cases might need physical therapy or even surgery.
• Hip fractures and dislocations: These are serious injuries and need immediate medical attention to realign bones and stabilize the joint, often requiring surgery.
• Labral tears and osteoarthritis: These conditions typically do not heal on their own. Treatment is usually focused on managing pain and could include physical therapy or surgery.

Ignoring hip injuries can lead to chronic pain and long-term mobility issues. Early medical attention and appropriate treatment are vital for a successful recovery.

Common hip injury treatments and therapies

Treatment for hip injuries depends on the type and how severe the injury is. Rest is one of the more effective treatments for hip injuries, including a hip flexor injury. Reducing or avoiding activities that aggravate the injury allows the hip to heal.

Other treatments may include:

• Physical therapy: Strengthening and stretching exercises improve flexibility, support and range of motion. It's particularly beneficial for hip flexor injuries.
• Medications: Over-the-counter pain relievers and anti-inflammatory drugs may help manage pain and reduce swelling.
• Ice and heat therapy: Applying ice packs can reduce inflammation and pain, while heat therapy relaxes and loosens tissues. Heat therapy is often beneficial for hip flexor injuries or muscle strains.
• Injections: Corticosteroid injections can provide relief for severe inflammation and pain in cases like bursitis or arthritis.
• Surgery: For serious conditions such as hip fractures, labral tears or severe osteoarthritis, surgical intervention, including hip replacement surgery, may be necessary to repair or replace damaged structures.