Abstract
Background
Injuries of the hip in the adolescent and young adult athlete are receiving more attention with advances in the understanding of femoroacetabular impingement (FAI), labral pathology, and hip arthroscopy. Labral tears have not been well characterized in rowers.
Questions/purposes
The purposes of this study were (1) to describe the clinical presentation of labral pathology in rowers; (2) to describe the MRI and radiographic findings of labral pathology in rowers; and (3) to determine the likelihood that a rower with labral injury, treated arthroscopically, will return to sport.
Methods
We conducted a review from August 2003 to August 2010 to identify all rowers with MRI-confirmed intraarticular pathology of the hip presenting to our institution. Baseline demographics, symptoms and physical findings, and location of the labral tear with associated pathology, management, and early followup were recorded. The review yielded a total of 21 hips (18 rowers, three with bilateral labral pathology) with a mean patient age of 18.5 years (range, 14–23 years). Most of the rowers (85%) were female and the series included prep school (44%) and collegiate rowers (56%). Eighteen of the 21 hips (85%) eventually underwent arthroscopic surgery at our institution.
Results
A large majority of patients had isolated groin pain (71%) and physical findings consistent with impingement (81%). There was no single, dominant location for the labral tears on MRI. Among the 18 patients who had surgery, 10 (56%) returned to rowing, six (33%) never returned, and return data were not available for two (11%) at a mean of 8 months (range, 3–25 months) after surgery.
Conclusions
The repetitive motions of the hip required for rowing may be a factor leading to intraarticular labral injuries in the athletes. Underlying anatomic abnormalities of the hip such as FAI may predispose certain patients to these injuries. However, many patients treated arthroscopically did not return to sport at a mean of 8 months after surgery.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Similar content being viewed by others
References
Brosh S, Jenner JR. Injuries to rowers. Br J Sports Med. 1988;22:169.
Byrd JW. Hip arthroscopy in athletes. Instr Course Lect. 2003;52:701–709.
Byrd JW, Jones KS. Prospective analysis of hip arthroscopy with 10-year followup. Clin Orthop Relat Res. 2010;468:741–746.
Dragoni S, Giombini A, Di Cesare A, Ripani M, Magliani G. Stress fractures of the ribs in elite competitive rowers: a report of nine cases. Skeletal Radiol. 2007;36:951–954.
Feeley BT, Powell JW, Muller MS, Barnes RP, Warren RF, Kelly BT. Hip injuries and labral tears in the national football league. Am J Sports Med. 2008;36:2187–2195.
Hickey GJ, Fricker PA, McDonald WA. Injuries to elite rowers over a 10-yr period. Med Sci Sports Exerc. 1997;29:1567–1572.
Kocher MS, Tucker R. Pediatric athlete hip disorders. Clin Sports Med. 2006;25:241–253, viii.
Ng L, Campbell A, Burnett A, O’Sullivan P. Gender differences in trunk and pelvic kinematics during prolonged ergometer rowing in adolescents. J Appl Biomech. 2012 Jul 6 [Epub ahead of print].
O’Kane JW, Teitz CC, Lind BK. Effect of preexisting back pain on the incidence and severity of back pain in intercollegiate rowers. Am J Sports Med. 2003;31:80–82.
Philippon M, Schenker M, Briggs K, Kuppersmith D. Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscopic decompression. Knee Surg Sports Traumatol Arthrosc. 2007;15:908–914.
Philippon MJ. The role of arthroscopic thermal capsulorrhaphy in the hip. Clin Sports Med. 2001;20:817–829.
Philippon MJ, Yen YM, Briggs KK, Kuppersmith DA, Maxwell RB. Early outcomes after hip arthroscopy for femoroacetabular impingement in the athletic adolescent patient: a preliminary report. J Pediatr Orthop. 2008;28:705–710.
Siparsky PN, Kocher MS. Current concepts in pediatric and adolescent arthroscopy. Arthroscopy. 2009;25:1453–1469.
Smith C, Masouros S, Hill A, Amis A, Bull AM. A biomechanical basis for tears of the human acetabular labrum? Br J Sports Med. 2009;43:574–578.
Smoljanovic T, Bojanic I, Hannafin JA, Hren D, Delimar D, Pecina M. Traumatic and overuse injuries among international elite junior rowers. Am J Sports Med. 2009;37:1193–1199.
Wenger DE, Kendell KR, Miner MR, Trousdale RT. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res. 2004;426:145–150.
Wilson F, Gissane C, Gormley J, Simms C. A 12-month prospective cohort study of injury in international rowers. Br J Sports Med. 2010;44:207–214.
Winzen M, Voigt HF, Hinrichs T, Platen P. [Injuries of the musculoskeletal system in German elite rowers] [in German]. Sportverletz Sportschaden. 2011;25:153–158.
Author information
Authors and Affiliations
Corresponding author
Additional information
Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This work was performed at Boston Children’s Hospital, Boston, MA, USA.
About this article
Cite this article
Boykin, R.E., McFeely, E.D., Ackerman, K.E. et al. Labral Injuries of the Hip in Rowers. Clin Orthop Relat Res 471, 2517–2522 (2013). https://doi.org/10.1007/s11999-013-3109-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11999-013-3109-1