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Rice University catcher, John Clay Reeves, felt pain in his groin after a collision at the plate with an opposing player. He thought he had pulled a muscle, but it turns out he was suffering from a common condition seen in teens and young adults known as hip impingement.
“The issue with hip impingement is not treating it, but diagnosing it,” said Joshua Harris, M.D., a Houston Methodist orthopedic surgeon. “Ball and socket pain will be felt in the groin, which often leads to an initial diagnosis of a pulled groin. Some patients can spend six months to six years seeing three to five doctors before they finally get the correct diagnosis of hip impingement.”
Hip impingement occurs when either the socket or ball of the hip joint is not round, which prevents smooth movement within the joint. In most cases, this abnormal joint movement will lead to a tear of the hip labrum, a rim of cartilage that helps keeps the ball of the joint in the socket. Hip impingement can cause severe hip pain and, if not treated, might lead to the onset of arthritis in the patient’s 40s or 50s.
“We believe that most cases of hip impingement will begin in boys from 12 to 15 and girls from 11 to 13 who play high impact sports, such as soccer, track and basketball,” Harris said. “Between these ages, the bones are still growing and strengthening, so jumping too much can cause the socket and ball to hit repeatedly and will eventually cause one of them to lose their round shape.”
The good news is that the condition can be treated with arthroscopic surgery. An arthroscope, or small fiber optic camera is placed in the joint through a small incision at the hip. The surgeon will shave off bone as needed to make the socket and ball round again and will repair the labrum with sutures, which will relieve pain and improve function in 90 percent of cases.
While hip impingement is not yet preventable, Harris said it typically does not recur after arthroscopic surgery to treat it.
“More than 600,000 hip replacements are performed each year due to hip arthritis, with between 70 and 90 percent of hip arthritis cases stemming from untreated hip impingement,” Harris said. “We believe that treating hip impingement with arthroscopic surgery can delay or prevent the onset of hip arthritis, but studies to confirm that are still pending. Once it’s confirmed, we’ll have made significant headway in treating a large public health issue.”
Reeves has been catching since age 12 and has always experienced tightness in his hips. Since undergoing arthroscopic surgery, the tightness is gone and he’s ready to get back on the field.
“My hip would click and pop, which was painful, but then it would loosen up after stretching it out,” Reeves said. “I always thought it was normal, but I was able to tell a huge difference after having my right hip repaired last year. I’m now back to doing everything I was before with better flexibility and no pain.”
Houston Methodist. “Common hip issue in teens misdiagnosed as pulled muscle.” ScienceDaily. ScienceDaily, 24 February 2015. <www.sciencedaily.com/releases/2015/02/150224182524.htm>.