BY DR MUHAMMAD HARITH ROSDI

Dr Muhammad Harith Rosdi is a Sports and Exercise Medicine specialist and clinical lecturer at the IIUM. His passions include medical education, pain, and regenerative medicine.

" Hip pain does not always come from the hip joint itself."

- Dr Muhammad Harith

Rosdi

The other felt the pain when he tried to clear the ball. Both were still able to walk and even jog, but sprinting or kicking the ball caused pain. After a thorough clinical assessment and imaging tests, including X-ray and ultrasound of the hip, both were diagnosed with hip apophysitis.

These are common in sports medicine. Hip and groin pain account for about five per cent of sports-related injuries. These injuries often occur in sports that involve rapid acceleration, sudden changes in direction, and kicking movements, such as football.

If the condition is not properly assessed, the diagnosis may be wrong, and the treatment may not be suitable. As a result, up to forty per cent of athletes with hip and groin pain may miss training or competition.

This may not seem significant to the public, but it can be very important for young athletes such as these twins, who play for the national U-16 football team.

POSSIBLE CAUSES

Hip pain in young athletes can come from many different structures around the hip and groin. The hip joint itself is only one possible source. In many cases, the pain comes from nearby muscles, tendons, or bones that are stressed during sports.

One common cause is muscle strain, especially involving the adductor muscles in the groin or the hip flexor muscles in the front of the hip. These injuries often happen during sprinting, kicking, or sudden changes in direction.

Another possible cause is tendon irritation or tendinopathy, which may develop gradually from repeated training without adequate recovery. Some athletes may also develop bursitis, which is irritation of small fluid-filled sacs that reduce friction around the hip.

In certain cases, the pain may come from the lower back or the sacroiliac joint, which can sometimes feel like hip pain. Among teenagers who are still growing, another important cause is hip apophysitis.

HIP APOPHYSITIS

Hip apophysitis occurs when the growth plate where a tendon attaches to the bone

becomes inflamed. In young athletes, these areas are still developing and are weaker than the surrounding muscles and tendons.

During sports such as football, repeated kicking, sprinting, and sudden turning movements place strong pulling forces on these attachment points. When this happens repeatedly, the growth plate can become irritated and painful.

Several areas around the hip can be affected. Common sites include:

• Anterior superior iliac spine( ASIS), where the sartorius muscle attaches

• Anterior inferior iliac spine( AIIS), where the rectus femoris muscle attaches

• Iliac crest, which is connected to the abdominal muscles

• Ischial tuberosity, where the hamstring muscles attach

Athletes with hip apophysitis often report pain that worsens during activities such as sprinting, kicking, or jumping.

Several factors increase the risk of this condition. These include rapid growth during adolescence, intense training, repetitive kicking movements, and tight or weak hip muscles.

The good news is that most cases improve with rest, activity modification, and proper rehabilitation exercises. Early recognition is important because continuing intense training can worsen the condition and delay recovery.

CLINICAL PEARL

Hip pain does not always come from the hip joint itself.

In many cases, the pain comes from nearby structures such as the muscles around the groin, the lower back, or the sacroiliac joint. Doctors may also need to rule out other conditions, such as an inguinal hernia.

CONSULTING THE DOCTOR

Most mild muscle pain after training will improve with rest. However, athletes and parents should not ignore hip or groin pain that does not improve within a few days.

Seek medical attention if the pain starts suddenly during sports, especially after a kick, sprint, or a sudden change of direction.

Athletes should also see a doctor if the pain persists despite rest or keeps returning when they resume training.

Another warning sign is when the pain interferes with normal movement. If an athlete finds it painful to sprint, kick, change direction, or even walk comfortably, a proper assessment is needed.

Other symptoms that should prompt medical evaluation include swelling, limping, leg weakness, or a clicking sensation in the hip.- The HEALTH