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Pelvis, Hip, and Thigh Injuries

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Essential Sports Medicine

Abstract

The pelvic, hip, and thigh regions are commonly injured during sport-related activities. Acute injuries can occur due to contact or non-contact mechanisms. Common acute injuries include quadriceps, hamstrings, and adductor muscles’ strains or tears; bony or muscle contusions. While overuse injuries occur after repetitive stress, tissue overload, and faulty mechanics. These include femoral neck stress fractures, femoroacetabular impingement, athletic pubalgia, greater trochanteric pain syndrome, snapping hip syndrome. Early diagnosis leads to proper treatment interventions that can include oral or topical medications, rehabilitation, injections, and surgery when indicated. Finally, the return to sport decision is made after a successful rehabilitation process to ensure the safety and health of the individual.

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References

  1. Fuller CW, Ekstrand J, Junge A, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Clin J Sport Med. 2006;16(2):97–106.

    Article  PubMed  Google Scholar 

  2. Tonnis D, Heinecke A. Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am. 1999;81(12):1747–70.

    Article  CAS  PubMed  Google Scholar 

  3. Freckleton G, Pizzari T. Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. Br J Sports Med. 2013;47(6):351–8.

    Article  PubMed  Google Scholar 

  4. Askling CM, Tengvar M, Saartok T, et al. Proximal hamstring strains of stretching type in different sports: injury situations, clinical and magnetic resonance imaging characteristics, and return to sport. Am J Sports Med. 2008;36(9):1799–804.

    Article  PubMed  Google Scholar 

  5. Askling CM, Tengvar M, Saartok T, et al. Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings. Am J Sports Med. 2007;35(2):197–206.

    Article  PubMed  Google Scholar 

  6. Bengtzen RR, Ma OJ, Herzka A. Point-of-care ultrasound diagnosis of proximal hamstring rupture. J Emerg Med. 2018;54(2):225–8.

    Article  PubMed  Google Scholar 

  7. Bleakley C, Glasgow P, MacAuley D. PRICE needs updating, should we call the POLICE? Br J Sports Med. 2012;46(4):220–1.

    Article  CAS  PubMed  Google Scholar 

  8. Brukner P. Hamstring injuries: prevention and treatment—an update. Br J Sports Med. 2015;49(19):1241–4.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Erickson LN, Sherry M. Rehabilitation and return to sport after hamstring strain injury. J Sport Health Sci. 2017;6(3):262–70.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Reurink G, Goudswaard GJ, Moen MH, et al. Platelet-rich plasma injections in acute muscle injury. N Engl J Med. 2014;370(26):2546–7.

    Article  CAS  PubMed  Google Scholar 

  11. Grassi A, Napoli F, Romandini I, et al. Is platelet-rich plasma (PRP) effective in the treatment of acute muscle injuries? A systematic review and meta-analysis. Sports Med. 2018;48(4):971–89.

    Article  PubMed  Google Scholar 

  12. Subbu R, Benjamin-Laing H, Haddad F. Timing of surgery for complete proximal hamstring avulsion injuries: successful clinical outcomes at 6 weeks, 6 months, and after 6 months of injury. Am J Sports Med. 2015;43(2):385–91.

    Article  PubMed  Google Scholar 

  13. Jacobsen P, Witvrouw E, Muxart P, et al. A combination of initial and follow-up physiotherapist examination predicts physician-determined time to return to play after hamstring injury, with no added value of MRI. Br J Sports Med. 2016;50(7):431–9.

    Article  PubMed  Google Scholar 

  14. King J. Post-traumatic ectopic calcification in the muscles of athletes: a review. Br J Sports Med. 1998;32(4):287.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Mendiguchia J, Alentorn-Geli E, Idoate F, et al. Rectus femoris muscle injuries in football: a clinically relevant review of mechanisms of injury, risk factors and preventive strategies. Br J Sports Med. 2013;47(6):359–66.

    Article  PubMed  Google Scholar 

  16. Kary JM. Diagnosis and management of quadriceps strains and contusions. Curr Rev Musculoskelet Med. 2010;3(1–4):26–31.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lee J, Mitchell A, Healy JC. Imaging of muscle injury in the elite athlete. Br J Radiol. 2012;85(1016):1173–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Aronen JG, Garrick JG, Chronister RD, McDevitt ER. Quadriceps contusions: clinical results of immediate immobilization in 120 degrees of knee flexion. Clin J Sport Med. 2006;16(5):383–7.

    Article  PubMed  Google Scholar 

  19. Riede U, Schmid M, Romero J. Conservative treatment of an acute compartment syndrome of the thigh. Arch Orthop Trauma Surg. 2007;127(4):269–75.

    Article  CAS  PubMed  Google Scholar 

  20. Tammareddi K, Morelli V, Reyes M. The athlete’s hip and groin. Prim Care. 2013;40(2):313–33.

    Article  PubMed  Google Scholar 

  21. Whittaker JL, Small C, Maffey L, Emery CA. Risk factors for groin injury in sport: an updated systematic review. Br J Sports Med. 2015;49(12):803–9.

    Article  PubMed  Google Scholar 

  22. Tyler TF, Nicholas SJ, Campbell RJ, Donellan S, McHugh MP. The effectiveness of a preseason exercise program to prevent adductor muscle strains in professional ice hockey players. Am J Sports Med. 2002;30(5):680–3.

    Article  PubMed  Google Scholar 

  23. Hall M, Anderson J. Hip pointers. Clin Sports Med. 2013;32(2):325–30.

    Article  PubMed  Google Scholar 

  24. Anderson K, Strickland SM, Warren R. Hip and groin injuries in athletes. Am J Sports Med. 2001;29(4):521–33.

    Article  CAS  PubMed  Google Scholar 

  25. Orchard JW, Steet E, Massey A, Dan S, Gardiner B, Ibrahim A. Long-term safety of using local anesthetic injections in professional rugby league. Am J Sports Med. 2010;38(11):2259–66.

    Article  PubMed  Google Scholar 

  26. Wright AA, Taylor JB, Ford KR, et al. Risk factors associated with lower extremity stress fractures in runners: a systematic review with meta-analysis. Br J Sports Med. 2015;49(23):1517–23.

    Article  PubMed  Google Scholar 

  27. DeFranco MJ, Recht M, Schils J, Parker RD. Stress fractures of the femur in athletes. Clin Sports Med. 2006;25(1):89–103.

    Article  PubMed  Google Scholar 

  28. Wright AA, Hegedus EJ, Lenchik L, et al. Diagnostic accuracy of various imaging modalities for suspected lower extremity stress fractures: a systematic review with evidence-based recommendations for clinical practice. Am J Sports Med. 2016;44(1):255–63.

    Article  PubMed  Google Scholar 

  29. Sankar WN, Matheney TH, Zaltz I. Femoroacetabular impingement: current concepts and controversies. Orthop Clin North Am. 2013;44(4):575–89.

    Article  PubMed  Google Scholar 

  30. Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;(417):112–20.

    Google Scholar 

  31. Samora JB, Ng VY, Ellis TJ. Femoroacetabular impingement: a common cause of hip pain in young adults. Clin J Sport Med. 2011;21(1):51–6.

    Article  PubMed  Google Scholar 

  32. Clohisy JC, Carlisle JC, Beaule PE, et al. A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008;90 Suppl 4:47–66.

    Article  PubMed  Google Scholar 

  33. Byrd JW. Femoroacetabular impingement in athletes: current concepts. Am J Sports Med. 2014;42(3):737–51.

    Article  PubMed  Google Scholar 

  34. Casartelli NC, Leunig M, Maffiuletti NA, et al. Return to sport after hip surgery for femoroacetabular impingement: a systematic review. Br J Sports Med. 2015;49(12):819–24.

    Article  PubMed  Google Scholar 

  35. Griffin DR, Dickenson EJ, Wall PDH, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome: a multicentrerandomised controlled trial. Lancet. 2018;391(10136):2225–35.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Segal NA, Felson DT, Torner JC, Zhu Y, Curtis JR, Niu J, et al. Greater trochanteric pain syndrome: epidemiology and associated factors. Arch Phys Med Rehabil. 2007;88(8):988–92.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Reiman MP, Goode AP, Hegedus EJ, et al. Diagnostic accuracy of clinical tests of the hip: a systematic review with meta-analysis. Br J Sports Med. 2013;47(14):893–902.

    Article  PubMed  Google Scholar 

  38. Dean BJ, Franklin SL, Murphy RJ, Javaid MK, Carr AJ. Glucocorticoids induce specific ion-channel-mediated toxicity in human rotator cuff tendon: a mechanism underpinning the ultimately deleterious effect of steroid injection in tendinopathy? Br J Sports Med. 2014;48(22):1620–6.

    Article  PubMed  Google Scholar 

  39. Nissen MJ, Brulhart L, Faundez A, et al. Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clin Rheumatol. 2019;38(3):647–55.

    Article  PubMed  Google Scholar 

  40. Fitzpatrick J, Bulsara MK, O’Donnell J, et al. The effectiveness of platelet-rich plasma injections in gluteal tendinopathy: a randomized, double-blind controlled trial comparing a single platelet-rich plasma injection with a single corticosteroid injection. Am J Sports Med. 2018;46(4):933–9.

    Article  PubMed  Google Scholar 

  41. Litwin DE, Sneider EB, McEnaney PM, Busconi BD. Athletic pubalgia (sports hernia). Clin Sports Med. 2011;30(2):417–34.

    Article  PubMed  Google Scholar 

  42. Birmingham PM, Kelly BT, Jacobs R, et al. The effect of dynamic femoroacetabular impingement on pubic symphysis motion: a cadaveric study. Am J Sports Med. 2012;40(5):1113–8.

    Article  PubMed  Google Scholar 

  43. Agten CA, Sutter R, Buck FM, Pfirrmann CW. Hip imaging in athletes: sports imaging series. Radiology. 2016;280(2):351–69.

    Article  PubMed  Google Scholar 

  44. Vasileff WK, Nekhline M, Kolowich PA, et al. Inguinal hernia in athletes: role of dynamic ultrasound. Sports Health. 2017;9(5):414–21.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Drew MK, Osmotherly PG, Chiarelli PE. Imaging and clinical tests for the diagnosis of long-standing groin pain in athletes. A systematic review. Phys Ther Sport. 2014;15(2):124–9.

    Article  PubMed  Google Scholar 

  46. Larson CM. Sports hernia/athletic pubalgia: evaluation and management. Sports Health. 2014;6(2):139–44.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Bureau NJ. Sonographic evaluation of snapping hip syndrome. J Ultrasound Med. 2013;32(6):895–900.

    Article  PubMed  Google Scholar 

  48. Byrd JW. Disorders of the peritrochnateric and deep gluteal space: new frontiers for arthroscopy. Sports Med Arthrosc Rev. 2015;23(4):221–31.

    Article  PubMed  Google Scholar 

  49. Blankenbaker DG, De Smet AA, Keene JS. Sonography of the iliopsoas tendon and injection of the iliopsoas bursa for diagnosis and management of the painful snapping hip. Skelet Radiol. 2006;35(8):565–71.

    Article  Google Scholar 

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Vázquez-Galliano, J., Miranda-Comas, G. (2021). Pelvis, Hip, and Thigh Injuries. In: Miranda-Comas, G., Cooper, G., Herrera, J., Curtis, S. (eds) Essential Sports Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-64316-4_15

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  • DOI: https://doi.org/10.1007/978-3-030-64316-4_15

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