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PART 2:
HIP/PELVIC INJURIES
Well here it is March already. This year keeps picking
up speed doesn’t it? Last month we talked about the
painful groin injuries that can occur. For this month
I’d like to go over those injuries that can happen at
the hip and pelvic region. Remember a few years ago when
Jeremy McGrath dislocated his hip practicing on his
Budlight KTM? Let’s take a look at a few of the common
injuries to the hip;
Hip
Dislocation
A hip dislocation occurs when the head of the thighbone
(femur) slips out of its socket in the hip bone
(pelvis). In approximately 90% of patients, the
thighbone is pushed out of its socket in a backwards
direction (posterior dislocation). This leaves the hip
in a fixed position, bent and twisted in toward the
middle of the body. The thighbone can also slip out of
its socket in a forward direction (anterior
dislocation). If this occurs, the hip will be bent only
slightly, and the leg will twist out and away from the
middle of the body. The hip dislocation is very painful.
Patients are unable to move the leg and, if there is
nerve damage, may not have any feeling in the foot or
ankle area.
Treatment - If there are no other complications,
the physician will administer an anesthetic or a
sedative and manipulate the bones back into their proper
position (this is called a reduction). In some cases the
reduction must be done in the operating room with
anesthesia. A formal procedure with an incision may be
required to reduce the hip. Following treatment, the
surgeon will request another set of X-rays and possibly
a computed tomography (CT) scan to make sure that the
bones are in the proper position.
Rehabilitation - It takes sometimes 2 to 3 months for
the hip to heal after a dislocation. The rehabilitation
time may be longer if there are additional fractures. An
orthopedic surgeon may recommend traction for a short
period of time, followed by controlled exercises using a
continuous passive motion machine. Patients can begin
walking with crutches when free of pain. A walking aid,
such as a cane, should be used until the limp
disappears. A hip dislocation can have long-term
consequences, particularly if there are associated
fractures. As the thighbone is pushed out of its socket,
it can disrupt blood vessels and nerves. When blood
supply to the bone is lost, the bone can die, resulting
in avascular necrosis or osteonecrosis. The protective
cartilage covering the bone may also be damaged, which
increases the risk of developing arthritis in the joint.
Hip Fractures
A broken hip is a common injury, especially in elderly
individuals. In the United States, hip fractures are the
most common broken bone that requires hospitalization;
about 300,000 Americans are hospitalized for a hip
fracture every year.
A "broken hip" and a "hip fracture" mean the same thing!
Hip fractures are generally separated into two types of
fractures:
 Femoral
Neck Fractures
A femoral neck fracture occurs when the ball of the
ball-and-socket hip joint is fractured off the femur.
Treatment of a femoral neck fracture depends on the age
of the patient and the amount of displacement of the
fracture.
Intertrochanteric Hip Fractures
An intertrochanteric hip fracture occurs just below the
femoral neck. These fractures are amenable to repair
more often than femoral neck fractures. The usual
surgical treatment involves placement of a plate and
screws to stabilize the fracture.
Treatment of a hip fracture almost always requires
surgery. In some cases, such as some stress fractures of
the hip, or in patients who have severe medical problems
that prevent surgical treatment, non-operative treatment
may be recommended. However, most all hip fractures are
treated with surgery. The type of surgery that is
preferred depends on the type of fracture.
Rehabilitation - Patients are usually allowed to begin
walking immediately following surgery. In some cases, if
there were small fracture fragments or difficulty with
alignment of the fracture, weight may be restricted.
Most commonly, patients will get up with the physical
therapist within a day following surgery. Time for
complete healing is usually about 12 weeks, but most
patients are walking well before that time.
Hip
Pointer
A hip pointer injury is extremely painful, acute injury
to the iliac crest of the pelvis. The injury causes
bleeding into the abdominal muscles, which attach to the
iliac crest. The bone and overlying muscle are often
bruised, and the pain can be intense. Pain may be felt
when walking, laughing, coughing, or even breathing
deeply. Hip pointers are the result of a direct blow to
the iliac crest, whether from a direct hit from a
helmet, or a hard fall.
Treatment includes rest from aggravating activities for
the first 1 to 2 weeks. This is the only real way to
heal a Hip pointer. Ice and medication can be helpful to
reduce pain and inflammation for the first 7 to 10 days
after the injury. It's important that the athlete not
return to quickly to activity. If you still has pain or
tenderness, this may cause you to compensate by altering
your gait (the way you walk). The result is another
injury to another body part.
There are other injuries that pertain to the hip that
include various sprains and strains involving the hip
flexors/extensors muscles, piriformis muscles, IT (Iliotibial
Band) muscle, and the groin muscles too.
The one thing we don’t see much of in the motocross
racer the Hip Replacement. Hip replacement (arthroplasty)
is a surgical procedure that replaces diseased parts of
the hip joint with new, artificial prosthesis. This
surgery improves both mobility and comfort in a painful
hip joint. The most common reason for hip replacements
is osteoarthritis of the hip joint. Other disease may
also result in a hip replacement when pain and lose of
function limit one's daily activities or quality of
life. I do know of one motocrosser that had a hip
replacement due to some issues pertaining to leg-length
discrepancy. That rider is doing well now is back to
racing.
Well that’s it for this month. Check in with us next
month to see what the hot topic for discussion is for
April. If you have anything you’d like to know more
about just send us an email at
keithmxatc@yahoo.com. Just
maybe we’ll use it next month. See ya!!!!
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Josh Demuth,
2-time National Arenacross Champion, '06 Bookoo Arenacross Champion:
"I had a lot of injuries in my Arenacross career. Without having
someone like Keith on the series to help me and the other riders
out, we might make it through a tough night of racing. He's always
been able to get us right back on the track and in the winner's
circle."
Isaiah Johnson: " I was very fortunate to have someone like
Keith on the Arenacross series when my injury occurred. He even went
to the hospital after the event to check up on me since it was a
very serious injury."
