Health Library Hip Injuries, Age 12 and OlderFrom Healthwise

A hip injury and pain can make it difficult to walk, go up and down stairs, squat, or sleep on the side that hurts. A clicking or snapping feeling or sound around your hip joint (snapping hip) may bother you or cause you to worry. But if your hip is not painful, in many cases the click or snap is nothing to worry about. Home treatment may be all that is needed for minor hip symptoms.

To better understand hip injuries, it may be helpful to know how the hip works. It is the largest ball-and-socket joint in the body. The thighbone (femur) fits tightly into a cup-shaped socket (acetabulum) in the pelvis. The hip joint is tighter and more stable than the shoulder joint but it does not move as freely. The hip joint is held together by muscles in the buttocks, groin, and spine; tendons; ligaments; and a joint capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint and let the tendons and muscles glide and move smoothly. The largest nerve in the body (sciatic nerve) passes through the pelvis into the leg.

Hip injuries

Injuries are a common cause of hip problems. You may not remember a specific injury, especially if your symptoms began slowly or during everyday activities.

• Overuse injuries occur from repeating the same activity. The repeated activity, such as running or bicycling long distances, stresses the hip joint and may cause irritation and inflammation. Examples of overuse injuries include irritation of the large sac (bursae) that cushions the bones of the hip joint (trochanteric bursitis), irritation of the tendons in the hip ( tendinitis), muscle strain, and hairline cracks ( stress fracture) in the neck of the thighbone (femur).
• A sudden (acute) injury may occur from a fall on the hip, a direct blow to the hip or knee, or abnormal twisting or bending of the leg. Examples of acute injuries that may cause hip pain include a broken hip (hip fracture) or pelvis (pelvic fracture), avulsion fracture, dislocated hip, sprained hip, muscle strain in the groin or buttock, or severe bruising ( contusion).

Treatment for a hip injury depends on the location, type, and severity of the injury as well as your age, general health, and activities (such as work, sports, hobbies). Treatment may include first aid measures; application of a brace, cast, harness, or traction; physical therapy; medicines; or surgery.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

• After an acute (sudden) injury:
  • Pieces of bone are visible in a wound or a bone is sticking through the skin.
  • A leg looks twisted or out of its normal position.
  • You are not able to stand or walk or bear weight on the affected leg.
  • A hip or leg has turned pale, white, blue, or cold.
  • Severe pain occurs with:
    • Any movement.
    • A lot of swelling within 30 minutes of the injury.
    • A new large bump at the site of a suspected fracture or dislocation.
    • Numbness in the buttocks, genital area, or one or both legs.

Note: A person with a severe hip injury needs to be transported on a special board to prevent movement (immobilization board). A special type of splint (traction splint) may be needed. Do not move the person unless there is an immediate threat to his or her life, such as a fire. If the person is in immediate danger, keep his or her head, neck, back, and pelvis supported and in a straight line while you move the person to safety.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• Hip problem without an injury: Go to the topic Hip Problems, Age 12 and Older.
• Bleeding: Go to the topic Cuts or Puncture Wounds.

	Yes	Do you have hip pain or tenderness after an injury?
When to See a Doctor See significance of hip pain or tenderness if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have severe hip pain? Yes Are you not able to put weight on the affected leg? Yes Does any little movement of your hip cause severe pain? Yes Are you not able to bend, straighten, or move your leg normally? Yes Have you had hip surgery and now: Have moderate to severe hip pain? Cannot move the hip or leg? Have new weakness or numbness in the hip or leg? Know or think you have a fever? Call your health professional today if you answer "Yes" to the following question. Yes Do you have a limp? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Do you still have moderate hip pain, a limp, or are not able to move your hip normally after 24 hours of home treatment? Yes Do you have hip stiffness or cannot move your hip normally after 48 hours of home treatment? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had mild hip pain off and on without other symptoms for 1 week or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have hip pain with numbness or tingling in the hip, groin, or leg?
When to See a Doctor See significance of hip pain with numbness or tingling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have hip pain with new numbness or tingling? Call your health professional today if you answer "Yes" to the following question. Yes Has numbness or tingling become worse since you were seen by a doctor? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had hip pain for 2 days with numbness or tingling that comes and goes and you have not seen a doctor? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Did you feel or hear a snap, pop, or grating in your hip?
When to See a Doctor See significance of feeling or hearing a snap, pop, or grating in the hip if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Does your hip feel loose or unstable since you felt or heard a snap or pop in your hip? Yes Are you not able to walk since you felt or heard a snap or pop in your hip? Call your health professional today if you answer "Yes" to the following question. Yes Are you having a hard time walking since you felt or heard a snap or pop in your hip? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had a painful snapping feeling in your hip with movement (such as when you sit or squat) for 48 hours or longer but you are still able to walk normally? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had a snapping or grating feeling in your hip but you do not have pain? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think a hip injury may have been caused by abuse?
When to See a Doctor See significance of abuse if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you think that a hip injury may have been caused by abuse of a child or vulnerable adult? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have pale, white, blue, or cold skin after a hip injury?
When to See a Doctor See significance of pale, white, blue, or cold skin if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have pale, white, blue, or cold skin after a hip injury? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your hip feel loose or unstable after hip surgery or hip replacement?
When to See a Doctor See significance of loose or unstable hip if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Does your hip feel loose or unstable? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Has your hip felt loose or unstable off and on for 1 week? Yes Has your hip felt loose or unstable and your symptoms have become worse since you were seen by a doctor in the past 2 days? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• Groin problem or injury: Go to the topic Groin Problems and Injuries.
• Tailbone or low back injury: Go to the topic Back Problems and Injuries.
• Unexplained leg pain or swelling: Go to the topic Leg Problems, Noninjury.
• Leg injury: Go to the topic Leg Injuries.
• Limping after a toe, foot, or ankle injury: Go to the topic Toe, Foot, and Ankle Injuries.
• Limping after a knee injury: Go to the topic Knee Problems and Injuries.
• Burn, scrape, bite, or bruise: Go to the topic:
  • Burns.
  • Scrapes.
  • Animal and Human Bites.
  • Puncture Wounds.
  • Bruises and Blood Spots Under the Skin.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home treatment may help relieve hip pain, swelling, and stiffness.

• Rest. Try to rest and protect an injured or sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
• Ice will reduce your pain and swelling. Put ice or cold packs on the injured area immediately. Put ice on for 20 minutes out of every hour and do this 4 or more times in the first 1 to 2 days. Wrap the ice in a wet towel. Do not put the ice right on the skin. Do not fall asleep with an ice pack on your skin.
• Sleep on your uninjured hip with a pillow between your knees, or sleep on your back with pillows beneath your knees.
• Gently massage or rub your hip to relieve pain and help blood flow.
• For the first 1 to 2 days after an injury, do not do things that might increase swelling, such as take hot showers, use hot tubs, hot packs, or alcoholic beverages.
• Do not use aspirin for the first 24 hours after an injury. Aspirin may cause more bruising under the skin.
• After 2 to 3 days, if you do not have swelling or the swelling is gone, heat can be put on the area. Moist heat with a hot water bottle, warm towel, or a heating pad set on low may feel good on your hip. You can carefully begin normal activities and gentle stretching.
  • Prone buttocks squeeze, to strengthen the buttocks muscles. These support your back and help you lift with your legs.
  • Pelvic tilts, to stretch the lower back
  • Hamstring stretch, to stretch the muscles in the back of the thigh
  • Hip flexor stretch, to stretch the muscles in the hip that help the hip glide and work smoothly

Do not smoke. Smoking may delay healing because it interferes with blood supply and tissue healing. For more information, see the topic Quitting Tobacco Use.

Cast care tips

If you have a cast, see cast care tips.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Signs of infection develop.
• Numbness, tingling, or weakness develops.
• Pale, white, blue, or cold skin develops.
• Symptoms do not get better with home treatment.
• Symptoms become more severe or more frequent.

The following tips may prevent hip injuries.

Keep bones strong

• Eat a nutritious diet with enough calcium and vitamin D, which helps your body absorb calcium. Calcium is found in dairy products, such as milk, cheese, and yogurt; dark green, leafy vegetables, such as broccoli; and other foods.
• Exercise and stay active. It is best to do weight-bearing exercise, such as walking, jogging, stair climbing, dancing, or lifting weights, for 45 to 60 minutes 4 days a week. Weight-bearing exercises help new bone growth by working the muscles and bones against gravity. Exercises that are not weight-bearing, such as swimming, are good for your general health, but do not help new bone growth. Talk to your health professional about an exercise program that is right for you. Begin slowly, especially if you have not been active. For more information, see the topic Fitness.
• Do not drink more than 1 alcoholic drink per day. People who drink more than this may have a higher chance for developing osteoporosis. Alcohol use also increases your chance of falling and breaking a bone.
• Stop or do not begin smoking. Smoking also increases your chance for developing osteoporosis. It also interferes with blood supply and healing. For more information, see the topic Quitting Tobacco Use.
• Cut down on caffeine. Caffeine in coffee and soda pop may increase calcium loss from your body and increases your chance for developing osteoporosis.

Prevent hip injuries

• Wear your seat belt in a car.
• Do not carry objects that are too heavy.
• Use a step stool. Do not stand on chairs or other unsteady objects.
• Wear protective gear during sports or recreational activities, such as roller-skating or soccer. Supportive splints, such as wrist guards, may lower your chance for injury.
• Do not do activities that make one side of the pelvis higher than the other, such as running in only one direction on a track or working sideways on a slope. Keep your hips level.

Reduce falls

• Remove any obstacles from your walking path and fix anything in your house that may cause you to fall. Household hazards that can cause falls include slippery floors, poor lighting, cluttered walkways, throw rugs, raised doorway thresholds, and electrical cords.
• Keep furniture or other items that have sharp edges away from normal walking pathways in your house.
• Use nonskid floor wax, and wipe up spills immediately.
• Have your vision and hearing checked regularly. If you have poor vision or hearing, you may have a harder time keeping your balance.
• Know the side effects of any medicines you are taking. Ask your health professional or pharmacist whether the medicines you are taking can change your balance. For example, sleeping pills or sedatives can change your balance.
• Check the condition of your shoes on a regular basis. Wear low-heeled shoes that fit well and give your feet good support.
• Have a lot of lights in your house, especially on stairways, porches, and outside walkways. Use night-lights in areas such as hallways and bathrooms. Add extra light switches or use remote switches, such as switches that go on or off when you clap your hands, to make it easier to turn lights on if you have to get up during the night.
• Have sturdy handrails on stairways.
• Put grab bars and nonskid mats inside and outside your shower or tub and near the toilet and sinks. Use shower chairs and bath benches.
• Be safe when you go outdoors. Use a cane or walker if you need to. Walk on the grass when the sidewalks are slippery. If you live in an area that gets snow and ice in the winter, sprinkle salt or cat litter on slippery steps and sidewalks.

If you live alone, you may want to get an emergency contact bracelet or necklace. If you fall and cannot get to the phone, you can press the button on your bracelet or necklace. This calls 911 or an emergency number for you so that help can be sent.

Exercises to stretch and strengthen your hip and back area

Warm up and stretch before exercising to prevent muscle strains and injury.

• Prone buttocks squeeze, to strengthen the buttocks muscles. These support your back and help you lift with your legs.
• Pelvic tilts to stretch the lower back.
• Hamstring stretch to stretch the muscles in the back of the thigh.
• Hip flexor stretch to stretch the muscles in the hip that help the hip glide and work smoothly.

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms? How long have you had your symptoms?
• How and when did an injury occur?
• Have you had any injuries in the past to the same area? Do you have any continuing problems because of the previous injury?
• Do you have hip pain when you walk? How far can you walk without discomfort? Does the pain get better or worse as you continue to walk?
• What activities make your symptoms better or worse?
• What sports activities are you involved in? Have you recently started a new activity?
• Do you think that activities related to your job or hobbies caused your symptoms?
• What home treatment measures have you tried? Did they help?
• What prescription and nonprescription medicines do you take?
• Do you have any health risks that may increase the seriousness of your symptoms?

• Back Problems and Injuries
• Groin Problems and Injuries
• Hip Fracture
• Knee Problems and Injuries
• Leg Injuries
• Leg Problems, Noninjury
• Osteoarthritis
• Osteoporosis
• Rheumatoid Arthritis
• Toe, Foot, and Ankle Injuries

Author:	Jan Nissl, RN, BS	Last Updated: October 27, 2006
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.