Hip pointers are contusions or bruises on the pelvic area caused by trauma to the hip bone or what is known as the iliac crest. The bruising on the hips leads to accumulation of blood in the hip abductor muscles, causing pain when the leg is moved away from the midline or abducted. Bruising also leads to swelling on the overlying muscles causing tenderness and pain when walking. The cluneal nerve located on the iliac crest may also be affected yielding significant pain. Pain may be located on the iliac crest or the greater trochanter. The onset is usually sudden and may be aggravated by walking, running, jumping or other activities involving the hips.
Causes of Hip Pointers
The main cause of hip pointers is contact sports such as basketball, foot ball and soccer. Other causes include falls and motor-vehicular accidents causing direct blow on the iliac crest.
Hip pointers are diagnosed by physical examination and imaging studies such as an X-ray. Diagnosis is based on the damage on the iliac crest.
Treatments for Hip Pointers
Hip pointers usually resolve within one to four weeks depending on the severity and promptness of managements. Mild hip pointer injuries may resolve with conservative treatments, however, severe forms may require management for fractures. Treatments include:
Any bone injury requires rest to prevent further aggravation. Rest is also important in the case of fracture of the iliac crest to allow the bone to regenerate and heal without causing undue tension.
Cold compress should be applied over the affected site immediately after the injury to control bruising, swelling and pain.
Anti-inflammatory drugs such as ibuprofen, mefenamic acid and naproxen may be used for muscle and bone injuries. These reduce inflammation and pain by preventing the production of inflammatory mediators.
When conservative treatments are not effective, further evaluation is done and more extensive managements may be instituted such as:
Physical therapy and chiropractic care
Physical and rehabilitation therapy is needed to restore the optimum motion of the hips. Exercises of the leg may also be advised to continue the rehabilitation at home. Dr. Mohr, your Tampa chiropractor, can help you with specific exercises and stretches to relieve symptoms and help prevent them from coming back.
Injection of steroids and local anesthetics
When pain is so severe, steroids may be administered to reduce the inflammation. This is also done when bursitis of the greater trochanter develops. Patients who do not respond with NSAIDs or non-steroidal anti-inflammatory drugs may be given local anesthetics for temporary relief.
Casting may be done when a fracture on the iliac crest is seen.
Prevention of Hip Pointers
Athletes engaging in contact sports may not be able to avoid blows to the iliac crest, but devices such as hip pads may reduce the impact on the area. Hip pads are worn during high impact activities such as contact sports. The hip pad should be large enough to cover the iliac crest. Hip pads are also available with varied styles and support depending on the sport. Foot ball and hockey hip pads are usually available. Relatively, athletes should adhere on the rules and policies of the game to prevent hip pointers and other injuries.