Summary

The occurrence of hip injuries among college athletes has increased over time, being more prevalent in impingement type sports; these findings will further allow for the improvement in early intervention and preventative measures of hip injuries.

Abstract

Introduction

Hip and groin pain is a common complaint among athletes of all ages, with Femoral Acetabular Impingement being increasingly recognized as a significant cause of hip dysfunction in adolescents. To our knowledge, no previous studies have examined the epidemiology of hip injuries within a specific biomechanical classification system. The purpose of this study was to describe the injury rates, mechanisms, time loss, and rates of surgery for hip/groin injuries across 25 collegiate sports sub-classified by biomechanical demands.

Methods

Data from the 2009-2010 to 2013-2014 academic years was obtained from the National Collegiate Athletic Association Injury Surveillance Program (NCAA ISP). Rates of hip/groin injuries, mechanism of injury, time lost from competition, and surgical treatment rates were calculated. Differences between sex-comparable sports were quantified using rate ratios (RR) and injury proportion ratios (IPR). The sport-specific biomechanical classification system described by Nawabi et al. was applied for subgroup analysis.

Results

In total, 1,984 hip injuries were reported in 25 NCAA sports between the years 2009/10 – 2013/14, resulting in an overall hip injury rate of 53.06/100,000 Athletic Exposures (AEs). The sports with the highest rates of hip injuries per 100,000 AEs were men’s soccer (110.84), men’s ice hockey (104.90), and women’s ice hockey (76.88). Subgroup analysis by sport-specific biomechanical stress demonstrated that the highest rate of hip injuries per 100,000 AEs occurred in impingement sports (96.9), followed by contact (60.33) and cutting sports (57.92). The lowest rate of hip injuries per 100,000 AEs occurred in endurance sports (27.93). Impingement sports had the highest proportion of athletes with time loss greater than 14 days (7.8%), followed by cutting (5.1%) and contact sports (4.9%). For impingement-type sports, the most common mechanism of injury was no apparent contact (48.2%), followed by gradual/overuse injury (20.1%). The proportion of athletes undergoing surgery per injury was highest in impingement sports (2.08%), followed by contact, (1.3%) and cutting (1.1%).

Conclusion

Hip and groin injuries in collegiate athletes are most common in impingement type sports, which require competitive kicking, skating, acceleration/deceleration and frequent changes of direction. The most common mechanisms of injury were no apparent contact and gradual/overuse injuries. Impingement-type sports had the most significant time lost and the highest need for surgery. These findings can help guide preventative measures as well as early intervention to limit the progression of hip and groin injuries in adolescent athletes.