How to treat and prevent the dreaded hip stress fracture.
Pain in the hip joint (sometimes perceived as groin pain) that worsens at the foot strike when running or hopping on just that leg can signal a hip stress fracture. It can also hurt when lying down. With continued activity, the pain usually gets worse over time.
Hip injuries are common in all athletes, but this type of injury is especially common in runners and triathletes. A femoral neck stress fracture—a crack near the ball at the top of the femur—is the most serious. Stress fractures are almost always caused by overuse, usually by runners who try to “load” miles too fast in preparation for a big race. The bone simply cannot take the pounding.
If you have this type of pain, here are two questions to ask yourself: Have I upped my training workload too fast, too soon? And, how is my bone density? These aren’t the only two factors involved, but they are the most common.
Low bone density (osteopenia) or very low bone density (osteoporosis) have several possible causes: genetics, as it tends to run in families; inadequate dietary calcium intake (1,300 milligrams a day is the recommended minimum); and for women, a history of menstrual disorders (e.g., not getting a period for more than six months can cause a low level of circulating estrogen).
The good news is that these variables can be altered or compensated for to help alleviate the problem.
Employ dynamic rest. Stop any activity that impacts the hip joint. Use intense upper-body and core workouts to maintain fitness.
Supplement. Eat more calcium- and vitamin D-rich foods or take supplements.
Slowly strengthen. Your lower body will need some work once you’re ready to resume activity. When you are pain free, gradually add lower-body strengthening exercises back into your workouts. Multi-directional lunges and squats will help, but avoid high-impact activity until your doctor gives you the all clear.
Up your calcium and vitamin D intake. Easy food sources are milk and yogurt; or take supplements. This is especially important if you have a family history of osteoporosis.
Follow the 10 percent rule. Never up your weekly running mileage by more than 10 percent.
Train your hips and core. The stronger the muscles in your core, glutes, hips and legs are, the more support your hip joints will have against repetitive impact. Make sure planks, multi-directional lunges, squats, squat jumps and skater plyos are a regular parts of your workouts.
New York City sports medicine specialist Jordan D. Metzl, M.D. is a 33-time marathon finisher and 13-time Ironman. His book, The Athlete’s Book of Home Remedies, has more than 1,000 tips to fix all types of injuries and medical conditions.