What if the hip was the culprit?

In previous articles, we looked at some of the risk factors for groin injuries and ways to prevent them. Beyond prevention, when we’re caught with pain in this area, it’s not always easy to get out of it. Although it may seem very simple, pain in the groin area is not systematically caused by muscle damage. Another cause of pain may be femoral-acetabular abutment (FAI), also known as hip abutment. This is a pathological collision between the femoral head and the acetabulum, which may be due to an anatomical anomaly in one or both of these structures that make up the hip.

Although FAI can be asymptomatic, it is now recognized as a common cause of hip pain in athletes. In fact, it is the leading cause of osteoarthritis of the hip in the male population. According to a recent systematic review on the subject, male participants in high-level impact sports at a young age are 1.9 to 8 times more likely to develop FAI. More specifically, field hockey players are 10 times more at risk.

In the light of these results, particular attention should be paid to workload progression when planning field hockey training. One way would be to increase the intensity and duration of on-ice training, especially after a period of inactivity. Making sure you warm up properly when you start out with exercises that are not performed at full intensity, keeping initial contact with the ice short, and limiting certain technical gestures to large amplitudes at the start of practice and during the first training sessions are all ways of reducing the risks when resuming the activity. In short, a progression that takes adaptability into account should be aimed at to avoid injuries among developing youngsters.

It’s important to know that only a portion of players with FAI will develop osteoarthritis as they age. In other words, the development of FAI is not an end in itself, but a risk factor for osteoarthritis. Consulting a health professional to prevent or treat this type of injury will increase your chances of practising your sport healthily and performing to your full potential.

Written by Maxime Provencher, M. Physiotherapy

References:
Nepple JJ, Vigdorchik JM, Clohisy JC. (2015) What Is the Association Between Sports Participation and the Development of Proximal Femoral Cam Deformity? A Systematic Review and Meta-analysis. Am J Sports Med.