Hip Sprain

Definition:

The hip is one of the most anatomically stable joints, but it is susceptible to injury when it is in the flexed position. Thus, hip sprains are uncommon sports injuries, accounting for less than 4% of all sprains. These injuries usually occur as a result of severe twisting or traumatic impact to the hip, such as what may occur during a fall or with direct and forceful contact. Hip sprains can also result from overuse and overstretching of the hip, especially among individuals who do not warm up sufficiently before activity.

Anatomy:

The hip joint has a capsule that is comprised of multiple circular and longitudinal ligaments, including the transverse ligament, the iliofemoral ligament, the pubocapsular ligament, and the ischiocapsular ligament. A ligament is a band of tissue that connects bones together. Because the bones of the hip anchor muscles that travel down the leg, across the abdomen, and into the buttocks, a sprain in the hip area may radiate pain to any of these sites.

Symptoms:

- Pain that is felt directly over the injured ligament and that increases with activity

- Swelling and bruising (in severe cases)

- Stiffness and muscle spasm

- The partial or full loss of joint flexibility

- Discomfort or pain with walking

Diagnosis:

The physician will examine the affected area and apply pressure to the areas of suspected injury to identify points of maximum tenderness. Patients may be asked to perform certain movements to determine the range of motion, the stability of the joint, and muscle strength. Radiographs should be taken to rule out fracture, dislocation, and subluxation. Magnetic resonance imaging is used to look for labral tears, which can be confused with joint sprain.

Treatment:

- Ice the injured area

- Maintain relative rest and use crutches with no or partial weight bearing until walking is no longer painful.

- Progress to rehabilitation of the muscles, range-of-motion exercises, and proprioception activities around the joint. Progressive chiropractic adjustments may address concomitant joint dysfunction.

Prognosis:

The prognosis for this condition depends on the severity of the strain. With conservative treatment, mild to moderate sprains will usually heal on their own within a few weeks to a couple of months. Severe injuries may require surgery followed by a physical therapy rehabilitation program. It is important to allow the injury to heal completely before resuming physical activity to avoid the risk of reinjury. Special medical athletic wear (e.g., Bio Skin compression shorts) helps to increase proprioception and control muscle movements to improve recovery time after injury.