What are Hip and Groin Disorders?

Hip and groin disorders are more common in athletes. They are caused by rapid acceleration and deceleration motion.

The rehabilitation time for hip and groin injuries is longer than most other injuries, therefore, early and accurate diagnosis is essential. The management of hip and groin injuries is complex due to the presence of multiple anatomic structures in that region. Moreover, the signs and symptoms of most hip and groin disorders are similar, making the diagnosis difficult.

Based on the onset of the disorder (acute or insidious), hip and groin disorders are categorized as:

Those with an acute onset. These include:

• Muscle strains
• Contusions (hip pointer)
• Avulsions and apophyseal injuries
• Hip dislocations and subluxations
• Acetabular labral tears and loose bodies
• Proximal femur fractures

Those with insidious onset. These include:

• Sports hernias and athletic pubalgia
• Osteitis pubis
• Bursitis
• Snapping hip syndrome
• Stress syndrome
• Osteoarthritis

The common sports activities that result in hip and groin injuries are those that require regular bending, kicking, and turning movements as in soccer, ice hockey, basketball, football, and tennis. In addition, sports that involve running can also produce hip and groin disorders.

Causes of Hip and Groin Disorders

The common causes responsible for hip and groin disorders are as follows:

• Trauma
• Overuse
• Muscle strength and limb length abnormalities
• Incoordination around the lumbo-pelvic region (lower back and pelvis region)
• Decreased abdominal stability
• Inguinal wall (groin) weakness
• Increased shear forces around the hemipelvis (one half of the pelvis) region

Symptoms of Hip and Groin Disorders

Hip pain, one of the common symptoms, may not always be felt precisely over the hip joint. Pain may be felt in and around the hip joint and the cause for pain may be multifactorial. The exact position of your hip pain suggests the probable cause or underlying condition causing pain. Pain felt inside the hip joint or your groin area is more likely to be because of problems within the hip joint. Likewise, pain felt on the outer side of your hip, upper thigh, or buttocks may be a result of problems of the muscles, ligaments, tendons, and soft tissues surrounding the hip joint. However, certain disease conditions affecting other parts of your body such as lower back or knees can also cause hip pain.

Diagnosis of Hip and Groin Disorders

The diagnosis of hip and groin disorders involves the following steps:

• Subjective examination that includes complete medical history, past treatment, nature of injury, etc.
• Physical examination
  • Observational evaluation while sitting and standing, gait patterns from frontal and sagittal plane (front and side), muscle wasting, rotational difference between both legs, and leg length variances
  • Range of motion tests
  • Palpation
  • Ligament stress tests
• Muscle testing
• Neural tests

Treatments for Hip and Groin Disorders

The treatment of hip and groin disorders includes physical therapy or exercise therapy, which includes different rehabilitation programs such as warm-up, strengthening programs, and sport-specific training. Along with exercises, medications may also be prescribed. Self-care and pain relieving anti-inflammatory medications offer symptomatic relief. However, the exact cause for the pain needs to be addressed.

Practicing certain measures can avoid aggravation of pain and improve the quality of life. Avoiding physical activities that may worsen the pain, stretching the quadriceps and hamstring muscles, and performing warm-up exercises before your actual exercise regimen help to improve the condition. Applying ice packs over the region of pain for about 15 minutes, three to four times daily reduces both pain and swelling.

Surgery is considered if conservative line of management fails.