We’ve previously written about a condition called “femoroacetabular impingement”, commonly referred to as “FAI”. The hip is a ball-and-socket type of joint. FAI is a condition where the femoral head (the ball), acetabulum (the socket), or both do not fit normally in place due to an alteration in the shape of the femoral head or rim of the acetabulum. The result is increased contact (impingement) as the hip is placed through a range of motion.
A review of our results from FAI surgery across all age groups showed that 95% of athletes (all levels – including recreational, high school, college, and professional / Olympic) successfully returned to sports with excellent pain relief, function, and performance. The physical therapist or performance specialist will have the athlete go through a series of tests to determine readiness for return to sport, and return can be expected at 4 to 6 months after surgery, depending on the type of sport.
A “sports hernia” is an injury to the soft tissue around the groin, typically involving the abdominal muscles and the adductor muscles of the inner thigh. This injury is most commonly a number of partial tears in the area where the tendons insert on to the bones of the pelvis. The injury can go by other names such as “athletic pubalgia” and “core muscle injury”.
In an athlete, this is an injury that will frequently go on to need surgery. Some of the keys to successful return to sport after surgery are:
Finding a doctor skilled in the diagnosis and surgery for a sports hernia
Working with a physical therapist after surgery with experience in core muscle rehabilitation
Following return to sport protocols carefully, and also making sure you’re mentally confident about your return to sport
Most people should aim for a return to sport at about the start of the 13thweek after surgery, although some elite athletes will follow an aggressive protocol that might allow a return in the 4thto 6thweeks after surgery.
The repetitive nature of running means that runners are unfortunately at risk for a number of overuse running injuries. The most common injuries include patellofemoral pain (PFP), iliotibial band syndrome (ITBS), shin splints or medial tibial stress syndrome (MTSS), Achilles tendonitis (AT), plantar fasciitis, stress fractures, and muscle strains.
A high percentage of runners with these injuries will unfortunately stop running permanently due to the injuries. While there are many factors that may contribute to the development of an overuse injury, a recently published biomechanical study supports the idea that strong hips- especially the hip abductors/glutes- are keys to pain free running.
“Wear and tear” of the cartilage in a joint is a common issue, especially in active people as they age. This type of arthritis is called osteoarthritis. As the cartilage wears away, it becomes frayed and rough, and the joint space between the bones decreases. This can result in bone rubbing on bone.
Osteoarthritis develops slowly and the pain it causes worsens over time. If you are an active person in your 40s or 50s and you have hip arthritis you’ve traditionally had a limited number of options. You could modify activity, lose weight, maintain proper exercise, or take medication. And when all else fails you could consider surgery.
A “total hip replacement” is an outstanding operation for individuals with hip arthritis, but the problem is that it’s not recommended for younger people. Also, almost all surgeons recommend against high-impact activity after a total hip replacement. And that’s where hip resurfacing enters the picture. This procedure may offer the chance to save the athletic life of the very active adult with hip arthritis.
I see a lot of folks in my clinical practice with hip and knee arthritis and many of them have extensive running histories. Most of these folks believe that it’s the long term running that eventually led to the arthritis, but the belief that running causes knee arthritis is probably a myth. The idea that running can lead to arthritis makes sense. You run on a hard surface for long distances and over many years the impact leads to wear and tear. Seems pretty logical, right? Well the available evidence points us in a different direction.
By Dev K. Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: Core muscle injury (otherwise commonly called “sports hernia” is being diagnosed more often these days Treatment generally starts without surgery, utilizing physical therapy, but some athletes may require surgery Surgery for core muscle injury has shown…
By Marc Safran, M.D. Professor of Orthopedic Surgery, Stanford University And Dev Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: FAI surgery is sometimes necessary to return the athlete to sports participation Results from FAI surgery at Stanford are generally excellent, with 95% of athletes returning to…
By Dev K. Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: The term “hip pointer” refers to a bruise of the muscles and soft tissue attachments to the top of the pelvis bone, near the area where your shorts or pants would be A hip pointer occurs…
By Dev Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: The FIFA 11+ warmup program results in reductions to all soccer related injuries by an incredible 30% to 70% The program works for males and females, across multiple age groups You must consistently use the program at…
By Dev Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: The coach will often have to make a decision on return to play during competition One tactic would be to observe the player in pregame warmup for any pain or poor movement A second in-game method…