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Hip Stress Fractures

Stress fractures represent a variety of injuries and are commonly overuse injuries caused by repetitive stress to the bone. Up to 20% of all sports related injuries are stress fractures. Stress fractures in the leg bones are relatively common sports injuries often found in running and jumping athletes usually associated with increased intensity of training workload.

Stress fractures of the hip are well documented in long distance runners and military recruits. Stress fractures from overuse injury to the joint typically develop over a period of time rather than by traumatic injury.

The hip is a ball and socket joint. The socket, called the acetabulum, is in the pelvis and the head of the thigh bone is the ball that fits into the socket. Stress fractures can affect the pelvis (the socket) or the neck of the thigh bone (the ball).

  • Pelvic stress fractures are hairline cracks. They are rare and can be difficult to diagnose. Symptoms include aching groin and hip pain that worsens with activity and persists during rest. These symptoms are common to other problems like muscle strain or inflammation.
  • Stress fractures involving the neck of the femur are fractures of the thigh bone and account for about 11% of stress injuries in athletes. Early diagnosis and treatment are important. Delays in diagnosis often occur because symptoms are easily missed or are common to other hip conditions and injuries. Symptoms are hip or groin pain which worsens with weight bearing and range of motion.

Stress fractures are partial or complete fractures caused by repetitive loading. When the bone is under constant stress without time to rest and repair, it is unable to repair microcracks which can lead to significant bruising of the surrounding bone that accounts for the severe pain symptoms.

Another type of stress fracture, sometimes called an insufficiency fracture, is the result of the normal stresses of daily life on abnormally weak bone. Diseases that cause weakened bone include osteopenia and osteoporosis, tumors, cancers, and infection. Insufficiency fractures typically affect the pelvis and are usually seen in the elderly, most frequently in women, because the pelvis bears the entire weight of the upper body. These fractures can also affect the neck of the thigh bone.

The expert team at LALL Orthopedics + will review your medical history and conduct a physical exam. X-rays will reveal abnormalities such as fracture severity. A bone scan will reveal areas of reactive bone problems such as tumors and infections. A CT scan may be ordered to gain more detailed images of the bone and an MRI may be used to provide detail about the soft tissue structures surrounding the bone. Our team will review the results of all tests and make a treatment plan to address your needs.

Treatment options depend on the severity and stability of the fracture, as well as the patient’s age and overall health.

  • Conservative Treatment – Most stress fractures can be treated with non-operative conservative measures including rest, icing, anti-inflammatory medication, physical therapy, and walking aids to support limited weight bearing. The goal is pain control, function restoration, and prevention of additional fractures. In many instances, the expert clinicians at LALL Orthopedics + may recommend using cutting-edge regenerative medicine such as Stem-Cell Therapy or Platelet-Rich Plasma (PRP) injections to help improve overall healing times and strength of tissue repair.
  • Surgical Treatment – In certain high-risk stress fractures, such as those surrounding the neck of femur, complications of complete bone injury include the need for total hip replacement. In these high-risk cases, prevention of complete bone injury is the mainstay of treatment with use of same-day outpatient minimally-invasive surgical stabilization procedures. Based on focused clinical exam and imaging, the expert team at LALL Orthopedics + will determine your injury severity and outline the optimal treatment algorithm to achieve a rapid healing response with either conservative or surgical means.

Delay in diagnosis is common, increases the risk of complete fracture displacement and serious injury, which may necessitate a total hip replacement in the young athlete. Our clinicians understand the risks and have the skills, training, and expertise to evaluate the need for treatment. If you have pain in the groin or thigh during and/or after physical activity, we recommend scheduling a consultation with LALL Orthopedics +. Early diagnosis is vital to reduce the risk of further damage and to improve overall patient outcomes.

Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified and triple fellowship-trained hip surgeon. Dr. Lall and the team at LALL Orthopedics + specializes in diagnosing and treating hip stress fractures. Schedule a hip consultation today.

LALL Orthopedics + has offices in Paramus, NJ, Philadelphia, PA and Belvidere, IL. Our team regularly sees patients from Bergen County, Hackensack, and Morristown, NJ.

At a Glance

Ajay C. Lall, MD, MS, FAAOS

  • Board Certified – Orthopedic Surgery
  • Triple Fellowship Trained
  • Performs over 750 Surgeries Per Year
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