Lisa finally got the chance to start for the varsity volleyball team, and she really wanted to impress the coach. But on one play she got overeager and collided with a teammate while going for a spike. She landed flat on her side on the hard gym floor. Lisa felt a sharp, strong pain in her hip and had to be helped off the floor.
After being taken out of the game, Lisa iced her hip and took a couple of aspirin. But the next day her hip still hurt and was swollen and bruised. Her mother took her to see the doctor. It turned out Lisa had a hip pointer, a bruise to one of the bones of her hip.
What Is a Hip Pointer?
Your hip joint involves two bones. Your hipbone is called the iliac (pronounced: ill-ee-ack) crest and the top of your leg bone (femur) is called the greater trochanter (pronounced: troe-kan-tuhr). A hip pointer is a bruise to one of these bones or to the surrounding soft tissue (muscles, cartilage, tendons, etc.).
In rare cases, a hip pointer can also cause what's known as an avulsion fracture, where part of the bone is pulled away by the attached muscle.
Since the bones in your hips don't have a lot of muscle and fat for padding, they're more susceptible to bone bruises. Bone bruises can be painful and take a while to fully heal.
What Causes a Hip Pointer?
Hip pointers are caused by a sudden impact that's hard enough to bruise your iliac crest or greater trochanter or cause damage to the soft tissue of your hip.
Some of the more common causes of hip pointers include:
- Sports that involve direct physical contact. Football, rugby, martial arts, and hockey are obvious sports with lots of physical contact. But people can get hip pointers in sports like baseball, soccer, lacrosse, and field hockey, too — any sport where there's a chance of colliding with another player or a goalpost.
- Sports that are played on hard surfaces. When you fall playing sports like volleyball, basketball, or skateboarding, a hard landing on asphalt or a gym floor can cause a hip pointer.
- Sports that can involve crashes. This means any sport where you're moving fast and can wipe out, such as skiing, snowboarding, cycling, and inline skating.
What Are the Symptoms of a Hip Pointer?
As with most sports injuries, how painful a hip pointer is or how long it takes to heal depends on the severity of the injury. Most hip pointers will be only a minor inconvenience and can be hard to see. But if you have a serious hip pointer, you'll know it.
Look for these symptoms:
- obvious bruising and swelling in the affected area
- pain and tenderness, especially when you press on your hip or move your leg
- reduced range of motion in your hip joint
- weakness in your hip and leg
How Is a Hip Pointer Diagnosed?
If you see a doctor about a hip pointer injury, he or she will examine the area for swelling and bruising. That might include pressing on your hip to see how tender the area is. The doctor will ask questions about how the injury happened.
In some cases, the doctor may call for X-rays or an MRI scan to see if there is a bone fracture or damage to the surrounding tissue. A doctor might also order an MRI or a computerized tomography (CT) scan to rule out any damage to internal organs.
How Is a Hip Pointer Treated?
Doctors don't need to do a lot for most hip pointers. Your doctor will most likely recommend crutches. He or she may also prescribe medication to ease the pain.
Some of the things you can do at home to treat a hip pointer include:
- Use the RICE formula as soon as possible after the injury:
- Rest. Limit the amount of physical activity you do and use your hip as little as possible. If putting weight on your injured leg is painful, it can help to use crutches when you walk.
- Ice. Use a bag of ice or a cold compress to help reduce swelling. This should be done as soon as possible after the injury, but limit the amount of time you spend icing your hip to 10-15 minutes at a time. Your hip doesn't have a lot of padding so it can get cold quickly.
- Compress. Use bandages or wraps to help support your hip and keep the swelling down.
- Elevate. This may be difficult with a hip pointer, but if you are lying down, try putting pillows under your pelvis to elevate your hips.
- Take anti-inflammatory medications. Ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce swelling.
- Return to exercise and sports slowly. Once the pain and swelling subside, it's good to move your hips to aid in your recovery and keep your muscles strong and flexible. But you can increase your chances of getting hurt again if you start playing while you still have pain or your movement is limited. So make sure you're fully healed before getting back in action.
Severe hip pointers can result in a or fracture, or in damage to internal organs like the spleen. These types of more serious hip pointer injuries might require a doctor's help. If you have a hematoma and get fluid buildup in your hip, a doctor may need to drain it.
Surgery for hip pointers is rare. Most can be easily treated and heal in their own time. But if a hip pointer doesn't respond to other treatments (or if a CT scan or MRI reveals internal damage), surgery may be necessary to correct the condition.
Can a Hip Pointer Be Prevented?
It can be hard to prevent a hip pointer. They happen suddenly and can be difficult to see coming. Still, you can help reduce your chances of getting one by following a few simple guidelines when you play sports or exercise:
- Learn and use the proper techniques for the sport you're playing. Practicing and perfecting the way you play will not only make you a better player, it will also make your movements stronger and more confident. That can decrease your risk of a fall or collision.
- Wear protective gear that fits correctly. Be sure your hockey and football pants have hip pads. Make sure they're properly fitted to you so the pads are in the right place. Don't play without them!
- Recognize when you're tired. Playing a sport when you're worn out can make you more likely to crash or stumble. If you feel like you're pushing yourself too far, take a break or ask to come out of the game and let someone else play for a while. Your coach and teammates will appreciate it.
- Know the rules and follow them. There's a reason offenses like spearing are penalized in games like football. The injuries you can get from having someone ram a helmet into your hip — or the equivalent in other sports — can be painful and sometimes serious.
Conditioning exercises that strengthen specific areas of the body are good ways to protect yourself from hip pointers. Talk to your coach or a sports medicine specialist about getting a performance analysis to learn if any areas of your body are vulnerable to injuries like hip pointers.
Reviewed by: Kathleen B. O'Brien, MD
Date reviewed: April 2011
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