Hip Pain in Dancers, Just a Pulled Muscle?

Dr. Kevin Ho - Orthopaedic Surgeon

Translation: Stacey Yeung - Dance Science Researcher

25 March 2020

The hip joint is a ball and socket joint and lined with a thin layer of hyaline cartilage. The rim of the hip joint is lined with a special ridge of soft tissue called the labrum that adds stability to the hip joint. Groin sprain and strain are not uncommon in dancers after performing extreme hip movements. While many of these soft-tissue injuries tend to settle over time, there are cases in which the pain may persist and limit the dancing activities. The possible cause for such pain includes underlying labral tear, cartilage lesions or Femoroacetabular Impingement (FAI), also known as hip impingement.

Hip impingement occurs when something prevents the smooth, normal free movement of the ball-and-socket joint. This condition can occur at any age but more frequently in adolescents and young adults. Repetitive grinding of the femoral neck onto the rim of the acetabulum can lead to cartilage and labral failure.

There are two types of hip impingements:

  • Cam impingement

  • Pincer impingement

 

The diagnosis can be made by reviewing the patient’s health history and a physical examination. Other tests may include:

  • Radiography (X-rays) of the hip

  • Magnetic Resonance Imaging (MRI) which visualizes the soft tissue cartilage and labrum Computed Tomography (CT) scan

 

Some patients with mild symptoms can manage with non-operative therapy:

  • Reduce the level of physical activity

  • Physiotherapy

  • Non-steroids anti-inflammatory (NSAIDs)

  • Hip injections

In some cases, surgery may be needed to manage the underlying problem. The recent arthroscopic technique in hip surgery has gained a favorable outcome in FAI.

舞者的髖關節疼痛,代表只是肌肉拉傷嗎?

作者:何其威醫生 - 骨科醫生

​中文翻譯:楊子慧 - 舞蹈科學研究員

 

髖關節是球窩關節,它的內膜上襯有一層薄薄的透明軟骨。髖關節的邊緣襯有隆起的特別軟組織-孟唇,它可增加髖關節的穩定性。舞者在進行劇烈的髖部動作後,出現腹股溝扭傷和拉傷的情況並不少見。儘管許多軟組織損傷會隨著時間的流逝而逐漸復原,但在某些情況下疼痛可能會持續,並限制舞者的舞蹈活動。而造成這種疼痛的原因可能包括底層孟唇撕裂、軟骨損傷或股骨髖臼綜合症(FAI)(亦稱為髖關節撞擊)。

 

當有東西阻礙球窩關節順滑、正常的自由動作,便會發生髖關節撞擊。這種狀況可以在任何年齡層發生,但在青少年和年輕人中更為常見。股骨頸在髖臼邊緣上的重複碾磨可導致軟骨和盂唇衰退。

 

髖關節撞擊有兩類:

  • 凸輪撞擊

  • 鉗形撞擊

 

髖關節撞擊可通過檢閱患者的健康歷史和進行體格檢查作出診斷。其他測試可包括:

  • 髖部X光

  • 磁力共振成像 (MRI) 來檢視軟組織軟骨和孟唇、電腦斷層(CT)掃描

 

一些症狀較輕的患者可以採用非手術治療:

  • 減少體力活動的水平

  • 物理治療

  • 採用非類固醇消炎藥

  • 髖關節注射

 

某些個案可能需要進行手術來解決潛在的問題。最新的關節鏡技術在治療股骨髖臼綜合症的手術中取得了良好的效果。

Reference

1. Kolo FC, Charbonnier C, Pfirrmann CW, Duc SR, Lubbeke A, Duthon VB, et al. Extreme hip motion in professional ballet dancers: dynamic and morphological evaluation based on magnetic resonance imaging. Skeletal radiology 2013;42(5):689-98.

2. Leunig M, Beaule PE, Ganz R. The concept of femoroacetabular impingement: current status and future perspectives. Clinical orthopaedics and related research 2009;467(3):616-22.

3. Charbonnier C, Kolo FC, Duthon VB, Magnenat-Thalmann N, Becker CD, Hoffmeyer P, et al. Assessment of congruence and impingement of the hip joint in professional ballet dancers: a motion capture study. The American journal of sports medicine 2011;39(3):557-66.

4. Palmer AJR, Ayyar Gupta V, Fernquest S, Rombach I, Dutton SJ, Mansour R, et al. Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial. Bmj 2019;364:l185.

Disclaimer Statement:

This article was accomplished by the author in his/her personal capacity. The opinions expressed in this article do not reflect the view of the official statement of CUHK and HKADMS. It is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with an appropriate professional for specific advice related to your situation.

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