You don’t have to be elderly to have a hip injury: Anyone is susceptible, from young athletes to seasoned marathon runners in their 40s and 50s. Unfortunately, hip injuries are often misdiagnosed in young people and fit adults, says Dr. Craig Levitz, director of sports medicine and chairman of the Department of Orthopedic Surgery at South Nassau Communities Hospital in Oceanside, N.J.
“One of the reasons is that the hip is much more difficult to examine because it is part of the pelvis, which is attached to the [body’s central] skeleton, and is a deeper joint than the knee or shoulder,” Levitz says. And the ability to take an MRI of the labrum—the soft ring of elastic tissue on the outside rim of the hip, the part of the hip that’s most commonly injured—is limited. “So even with the right work-up, you can be misdiagnosed,” he says.
To help you tease out the source of your hip pain, here are the telltale signs of an overuse hip injury—and the signs of something more serious.
Signs of an Overuse Hip Injury
Pain with activity. “Anytime you have pain that’s worse with activity, it’s probably an overuse injury,” says Levitz. The pain is likely from tendonitis, or inflammation of the tendons. “Tendonitis is painful when you’re active and gets better with rest,” he says.
Groin pain. “This is the key sign to look for,” says Levitz. “Groin pain can be serious or from overuse. If it hurts all the time or with movement, it’s often more serious.”
Pain on the outside of the hip. “With tendonitis or bursitis”—inflammation of the small, fluid-filled sacs that protect muscles and tendons—“you get pain on the side of your hip,” says Dr. Joseph Ciotola, an orthopedic surgeon at Mercy Medical Center in Baltimore. “Your hip may hurt when you’re getting up from a seated position or going up stairs. People with wide hips and a narrow pelvis are predisposed to bursitis because the muscles that run over the hip get very tight.”
Pain at night. “An overuse injury like bursitis or tendonitis can cause your hip to hurt when you’re lying on it at night,” says Ciotola.
Injury that improves with rest. An overuse injury usually gets better with rest. “Real hip pain is often in the groin,” says Ciotola. If it doesn’t get better within six weeks, you may have to get an x-ray to see if it’s arthritis or a fracture. The treatment for pulled groin muscles is to wrap the thigh area to compress it, to ice it for 15 minutes several times a day, and then to begin gently stretching the muscles after a week or two.” Try this gentle stretch to ease hip pain: Sit on the floor, bend your legs so that the soles of your feet touch. Using your elbows, gently lower your knees toward the ground. Hold for 10 to 15 seconds but back off if you feel pain.
Signs of a More Serious Hip Injury
Groin pain that doesn’t go away. If you’re still hurting after four to six weeks of rest, you may have arthritis or a fracture.
An inability to bear weight. “No overuse injury leads to not being able to bear weight,” says Levitz. “That’s a much more serious injury such as a fracture.”
Clicking, catching or locking. This may indicate a labral tear—loose or torn cartilage—that will require physical therapy or even surgery, says Levitz.
Deep, aching groin pain. “If the pain shoots down to the knee, that’s a sign of osteoarthritis,” says Ciotola.
Deep pain in the butt. “That’s a sign of an irritated nerve, or sciatica,” says Ciotola. The sciatic nerve is a nerve that runs from the lower part of the spine down the leg.