Common Hip, Groin, and Thigh Injuries

Thigh, Groin, and Hip Conditions

Hip Dysplasia

Abnormal articulation between the femoral head and acetabulum. Often associated with an irregularly developed pelvis; coxa vara/valga. Can cause pain leading to hip subluxation or dislocation. May be congenital or developmental (DDH).

Risk factors:

• Being female
• Firstborn
• Born breech
• Family history of hip dysplasia
• Swaddling

Quad Contusion

Mechanism of Injury (MOI): Direct blow to thigh musculature.

• Grade 1: Superficial intramuscular bruise that produces mild hemorrhage.
• Grade 2: Deeper intramuscular bruise.
• Grade 3: Moderate intramuscular bruise.
• Grade 4: Deep intramuscular bruise that may split the fascia latae, allowing the muscle to protrude (muscle herniation).

Potential complication: Myositis ossificans.

Muscle Strain

A stretch or tear in one or more of the muscles or tendons; typically caused by sudden forceful contraction or stretch.

Most commonly injured: Hamstrings, rectus femoris, medial gastrocnemius, adductors.

Acute Femoral Fracture

Occurs most often in the shaft (middle third) but can also occur near the neck.

Femoral Neck Stress Fracture

Prevalent in endurance athletes. Often caused by excessive downhill or mountain running or a lot of jumping activities.

Hip Pointer

Contusion of the iliac crest and abdominal musculature.

Hip Sprain

Onset of hip pain with circumduction.

Hip Dislocation

Traumatic force directed along the long axis of the femur, usually from a car accident or other trauma with large forces.

Femoral Acetabular Impingement (FAI)

Bony lesions on the femoral head or rim of the acetabulum.

• Cam: Growth on the femoral head (potentially from overuse during the growth period in adolescence).
• Pincer: Growth on the acetabulum.

Decreased smoothness of articulation can lead to tearing of the labrum and articular cartilage.

Hip Labral Tear

A tear of the acetabular labrum. Can result from overuse or acute MOIs. Repetitive movements such as running or pivoting can lead to degeneration of the labrum; hip subluxation or dislocation can also cause tears.

Athletic Pubalgia ("Sports Hernia")

Result of increased muscular loads on the pubic bone or pubis. May not be an actual hernia. Most common locations: Abdominals and adductors (at their origin/insertion on the pubis).

Inguinal Hernia

Protrusion of the abdominal cavity lining or intestine through the abdominal musculature. More common in males.

Osteitis Pubis

Inflammatory condition of the pubic symphysis and attachments at that site.

Signs and Symptoms:

• Localized pain over the pubic symphysis.
• Potentially radiates outward.
• May start in the distal abdominal or proximal adductor muscles.
• Clicking or popping upon rising from a seated position.