If you are a regular tennis player, with ongoing pain in your hip during or post-match, you maybe in very elite company.
Apart from being extremely talented Australian tennis players, both Lleyton Hewitt and Bernard Tomic have suffered the same hip issue – Femoro-acetabular impingement (FAI).
What is FAI?
FAI is when a small bump on the front of the hipbone has been knocking up against the hip socket causing the joint to be impinged. This bump can develop as a result of genetics or repetitive activities that involve twisting and flexing of the hip into its end ranges, such as the ball strike in tennis. Over time this ongoing bone contact can result in extra bone being formed, increasing the size of the bump and thus further accentuating the impingement. This process can wear away at the cartilage surrounding the socket and lining the hip joint.
This condition is very prominent in young-middle aged tennis playing men. But it also a condition seen in AFL, soccer, dancing and martial arts.
How is FAI diagnosed?
Assessment by a physiotherapist can determine whether FAI is a likely issue in an individual. This can be confirmed with medical imaging, such as an X-ray.
How is it managed?
Both Hewitt and Tomic have had arthroscopic surgery to shave down the excess bone and repair the labrum (cartilage), returning to tennis after extensive rehab. The recovery can take up to three months to resume normal pain free activity. If the condition is not too severe, conservative management, such as physiotherapy and tailored exercise program, can also be effective.
Spot the signs
Daily activities that may be difficult with a hip injury include walking upstairs, sitting in low chairs and putting on socks.
It is important to note that hip pain can present as groin pain or wrap around the back or down the thigh to the knee. If the joint is quite inflamed you may experience a sharp pain when the hip is pulled up to the chest and rotated inwards and/or a dull ache at rest.
Keeping the muscles around the hip strong via a tailored conditioning program including strengthening, power, endurance and co-ordination exercises. Good biomechanics are imperative to ensure the whole kinetic chain is working effectively and reduce any extra compensatory load on the hip joint.
As a former US College Circuit player, current tennis coach and physiotherapist I regularly see both casual and elite athletes “play on” with ongoing hip pain.
If this sounds like you, I strongly suggest you book in an assessment with myself or one of the physiotherapy team at Waverley Park Physiotherapy Centre to ensure you catch this early. Our team are currently involved with the University of Melbourne FASHiON Research into Personalised Hip Therapy, so we are experienced in using evidenced-based learnings to reduce hip pain and the likelihood of ongoing, re-aggravation in the future.
For consultation with Physiotherapist Amy Shipperd on hip or other acute sport injuries, please contact Waverley Park Physiotherapy Centre reception on 9795 0668.