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Hip and Groin Injuries in Athletes- A New Frontier in Sports Medicine

Growing body of Knowledge

There is increasing optimism for athletes and everyday athletes with hip and groin pain due to a growing body of knowledge and recent advances.  There is a better understanding about the anatomy and function of the hip.  For accurate diagnoses, a proper biomechanical exam is imperative.  Hip experts are coming together to collaborate on the best available tests to examine the hip joint to rule in and rule out conditions more precisely.  There also have been improvements in imaging, such as MRI’s.  There have been advancements in fitness and prevention, physical therapy, and arthroscopic surgery.

Prevention is Always the Best Medicine

Fitness and physical therapy professionals can identify early warning signs of movement disorders and imbalances that may lead to injuries before they become injuries.  There is a screen called the Functional Movement Screen which will identify faulty movement patterns and imbalances of the body including the hip.  A score below a 14 has been found to correlate with a higher risk of injury.  Once there is an established injury or pain, doctors of physical therapy and sports medicine physicians can apply evidence-based treatment approaches.

Some of the structures and problems inside the hip joint (intra-articular) include:

Labral tears, loose bodies, femoracetabular impingement, capsular laxity, ligamentum teres rupture, chondral damage.

Some of the structures and problems outside the hip joint (extra-articular) include:

Iliopsoas tendonitis, iliotibial band, gluteus medius or minimus, greater trochanteric bursitis, stress fracture, adductor strain, Piriformis syndrome, sacroiliac joint pathology.

Mimickers of hip problems:

Athletic pubalgia, sports hernia, osteitis pubis


Once the anatomical problem and the imbalances of the body are identified, evidence-based treatment can be delivered. Evidence-based treatment incorporates the latest research, clinical expertise, and patients’ goals.  For many of the above problems, Physical Therapy and conservative treatment is the most evidence-based initial treatment plan.

Sports Medicine Advancements

In orthopedic surgery, knowledge and advancements have been rapid recently. There are now sports medicine physicians who are specializing in the hip. Dr. John Salvo, sports medicine fellowship trained physician and double board certified orthopedic surgeon at the Rothman Institute, is one of the region’s leaders in hip arthroscopy, especially in athletes. Dr. Salvo states, “Our knowledge of common hip conditions that cause pain in the athletics and pre-arthritis population has increased with better understanding of biomechanics of the hip. Better imaging such as high resolution MRI has allowed us to accurately identify the pathological structures and this guides our treatment.”  “Advances in technology have allowed us to treat these conditions arthroscopically with excellent results. With all of this, we can guide patients through their recovery and ultimately get them back to normal activities.”

Have It Looked at Early

If you have hip pain or a problem, or would like to prevent injury, you can consult physical therapists who work together with fitness professionals, or a sports physician.

Dr. Lance Knaub PT, DPT, OCS, CSCS

Doctor of Physical Therapy/Owner