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Stress Fracture of the Hip

What is a stress fracture?

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During running and other high-impact activities, the hip joint absorbs some of the greatest forces in the body. Repeated high-impact activities and overuse can result in a stress fracture of the hip. A stress fracture is a break in the bone that occurs when minor injuries to the bone build up beyond the capacity of the bone to repair itself. Stress fractures of the hip are critical to diagnose and treat quickly because without treatment, they can lead to severe damage to the hip joint, even in young athletes.

What are the symptoms of stress fractures?

Stress fractures of the hip cause pain in the groin or front of the hip that is activity related. Most people with stress fractures will have pain when running that goes away with rest. If the pain is ignored and the stress fracture worsens, pain may become constant. Runners, women and people with low body mass index (BMI) are typically considered at highest risk for stress fractures, but anyone who undergoes a rapid increase in activity is at risk.

How are stress fractures diagnosed?

Your physician may suspect a stress fracture based on your symptoms and an examination, but imaging is needed to verify the diagnosis. A stress fracture may be seen on x-ray, but in many cases, x-rays are not detailed enough to show subtle fractures. If x-rays are normal, an MRI or bone scan is a more accurate way of diagnosing a stress fracture. The area where stress fractures of the hip occur is called the femoral neck. This is where the hip joint connects to the femur (the thigh bone).

How are stress fractures treated?

The treatment of stress fractures in the hip depends on the severity of the fracture. In mild cases, the athlete is treated with crutches and activity modification until symptoms resolve. In severe cases where the fracture area is large or symptoms do not respond to rest, surgery to stabilize the fracture may be required. If a stress fracture goes unrecognized and the individual continues to stay active, the fracture can worsen, leading to a complete break. This can have serious consequences and requires urgent surgery; therefore, it is important to recognize a stress fracture early to prevent this from happening.

Another risk factor for stress fractures is poor nutrition and inadequate energy intake to support a patient’s training program, so many patients with stress fractures benefit from analysis of their diet, as well as their exercise regimen.