A hip pointer is a painful injury resulting from a direct blow to the hip region. The force involved is severe enough to cause a bone bruise to either the outside edge of the pelvis (the iliac crest), or the outer aspect of the hip (greater trochanter of the femur). Hip pointer injuries usually occur in contact sports, from a collision, or from falling directly onto the hip. The hip area is susceptible to this type of injury because of the relatively small amount of surrounding soft tissue in the hip area of most athletes. The resulting pain from a hip pointer can limit an athlete's sports participation from days to weeks, depending on the severity of the hip pointer.
Diagnosis of Hip Pointer Injury
- Physical examination – visual inspection of the hip may reveal a bruise over the hip. Motor strength is preserved, and skin sensitivity is normal.
- Imaging studies – plain x-rays are normal in hip pointer injuries. CT scans may be performed if pain is severe, to rule out a subtle fracture. CT scans can also show accompanying soft tissue injury, such as deep soft tissue hematoma, or bleeding in the pelvis.
Treatment of Hip Pointer Injury
- RICE protocol – Like most injuries, initial treatment should consist of cessation of activity (rest), application of cold packs (ice), wrapping for support (compression), and elevation of the affected body part, if possible.
- Anti-inflammatory medication – Over the counter medications such as ibuprofen can help relieve the pain of a hip pointer injury. More serious injuries may require prescription medication for adequate relief.
- When pain decreases, physical therapy may be used to regain lost strength and flexibility related to inactivity.
Possible Complications of Hip Pointer Injury
- Hematoma formation – Hip pointer refers to bruising of bone. However, bleeding into the adjacent soft tissues may occur. The resulting hematoma may increase and prolong pain related to the injury.
- Myositis Ossificans – This is a soft tissue disorder related to trauma. Abnormal bone forms within soft tissue after trauma, which can lead to chronic pain and loss of flexibility.
Follow-up and Prognosis
Athletes can return to play following a rest and rehabilitation period. Pain should have almost completely resolved, and full range of motion regained, prior to resuming play. Padding should be worn over the injured area, at least until the athlete has been pain free for several weeks.
Normally, a hip pointer injury will sideline an athlete for 1-3 weeks, depending on the severity of the injury. If pain is prolonged beyond 3 weeks, further work up may be appropriate to rule out additional injuries.
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