Hip Injuries and Labral Tears in the National Football League

Background: Injuries to the hip account for approximately 10% of all injuries in football, but definitive diagnosis is often challenging. Although these injuries are often uncomplicated contusions or strains, intra-articular lesions are increasingly found to be sources of hip pain. Purpose: The objective was to define the incidence and etiologic factors of intra- and extra-articular hip injuries in the National Football League (NFL). Study Design: Descriptive epidemiology study. Methods: The NFL Injury Surveillance System was used to define all hip-related injuries from 1997 to 2006. Injuries were included if the athlete missed more than 2 days. All hip and groin injuries were included for evaluation. The authors also report on NFL players with intra-articular injuries seen at their institution outside of the NFL Injury Surveillance System. Results: There were a total of 23 806 injuries from 1997 to 2006, of which 738 were hip injuries (3.1%) with an average of 12.3 days lost per injury. Muscle strains were the most common injury. Intra-articular injuries resulted in the most time lost. Contact injuries most likely resulted in a contusion, and noncontact injuries most often resulted in a muscle strain. In the authors' institutional experience, many of the athletes with labral tears have persistent adductor strains that do not improve despite adequate therapy. Conclusion: Hip injuries represent a small but substantial percentage of injuries that occur in the NFL. A majority of these injuries are minor, with a return to play within 2 weeks. Intra-articular injuries are more serious and result in a significant loss of playing time. The sports hip triad (labral tear, adductor strain, and rectus strain) is described as a common injury pattern in the elite athlete.