Sylvia Czuppon1, Heidi Prather2, Devyani M Hunt3, Karen Steger-May4, Nancy J Bloom5, John C Clohisy6, Richard Larsen7, Marcie Harris-Hayes8. 1. Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, 4444 Forest Park Avenue, Campus Box 8502, St. Louis, MO 63108(∗). Electronic address: czuppons@wustl.edu. 2. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO(†). 3. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO(‡). 4. Division of Biostatistics, Washington University, St. Louis, MO(§). 5. Division of Biostatistics, Washington University, St. Louis, MO(¶). 6. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO(#). 7. Department of Athletics, Washington University, St. Louis, MO(∗∗). 8. Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO(††).
Abstract
BACKGROUND: Athletic activity is a proposed factor in the development and progression of intra-articular hip pathology. Early diagnosis and preventive treatments in "at-risk" athletes are needed. OBJECTIVES: Our primary objective was to report hip range of motion (ROM) and prevalence of positive impingement testing in asymptomatic college freshman athletes. Our secondary objective was to determine whether an association exists between hip ROM and a positive flexion-adduction-internal rotation (FADIR) test. DESIGN: Cross-sectional study. SETTING: Collegiate athletic campus. PARTICIPANTS: Four hundred thirty (299 male, 131 female) freshman athletes reporting no current or previous hip pain. METHODS: During the athletes' preseason medical screening, trained examiners performed a hip-specific exam to obtain data for hip ROM and impingement testing. MAIN OUTCOME MEASUREMENTS: Bilateral passive ROM measures included hip flexion, and hip internal and external rotation with the hip flexed 0° and 90°. RESULTS: Mean age of male participants was 18.5 ± 0.8 and female participants was 18.3 ± 0.6 years (P = .003). Male participants demonstrated less hip ROM than female participants in flexion (115.8 ± 11.2° versus 122.0 ± 10.5°, P < .001), internal rotation in 90° flexion (26.9 ± 9.8° versus 34.7 ± 10.7°, P < .001) and 0° flexion (29.0 ± 9.8° versus 38.9 ± 10.1°, P < .001), and external rotation in 90° flexion (44.7 ± 10.9° versus 49.7 ± 10.4°, P < .001) but not for external rotation in 0° flexion (39.8 ± 11.1° versus 37.6 ± 11.5°, P = .06). Pain with FADIR test on the right and left hip were reported in 11.9% and 14.5% of athletes, respectively. Gender and a positive FADIR were not related (male 12.2%, female 15.3%, P = .36). CONCLUSIONS: In asymptomatic college freshman athletes, male athletes generally demonstrated less hip ROM than female athletes. In addition, a positive FADIR was more prevalent than previously reported in healthy young adults. Preseason screenings that use these baseline data in conjunction with other examination findings may allow identification of athletes at future risk for hip pain and/or injury. LEVEL OF EVIDENCE: IV.
BACKGROUND: Athletic activity is a proposed factor in the development and progression of intra-articular hip pathology. Early diagnosis and preventive treatments in "at-risk" athletes are needed. OBJECTIVES: Our primary objective was to report hip range of motion (ROM) and prevalence of positive impingement testing in asymptomatic college freshman athletes. Our secondary objective was to determine whether an association exists between hip ROM and a positive flexion-adduction-internal rotation (FADIR) test. DESIGN: Cross-sectional study. SETTING: Collegiate athletic campus. PARTICIPANTS: Four hundred thirty (299 male, 131 female) freshman athletes reporting no current or previous hip pain. METHODS: During the athletes' preseason medical screening, trained examiners performed a hip-specific exam to obtain data for hip ROM and impingement testing. MAIN OUTCOME MEASUREMENTS: Bilateral passive ROM measures included hip flexion, and hip internal and external rotation with the hip flexed 0° and 90°. RESULTS: Mean age of male participants was 18.5 ± 0.8 and female participants was 18.3 ± 0.6 years (P = .003). Male participants demonstrated less hip ROM than female participants in flexion (115.8 ± 11.2° versus 122.0 ± 10.5°, P < .001), internal rotation in 90° flexion (26.9 ± 9.8° versus 34.7 ± 10.7°, P < .001) and 0° flexion (29.0 ± 9.8° versus 38.9 ± 10.1°, P < .001), and external rotation in 90° flexion (44.7 ± 10.9° versus 49.7 ± 10.4°, P < .001) but not for external rotation in 0° flexion (39.8 ± 11.1° versus 37.6 ± 11.5°, P = .06). Pain with FADIR test on the right and left hip were reported in 11.9% and 14.5% of athletes, respectively. Gender and a positive FADIR were not related (male 12.2%, female 15.3%, P = .36). CONCLUSIONS: In asymptomatic college freshman athletes, male athletes generally demonstrated less hip ROM than female athletes. In addition, a positive FADIR was more prevalent than previously reported in healthy young adults. Preseason screenings that use these baseline data in conjunction with other examination findings may allow identification of athletes at future risk for hip pain and/or injury. LEVEL OF EVIDENCE: IV.
Authors: R Stephen J Burnett; Gregory J Della Rocca; Heidi Prather; Madelyn Curry; William J Maloney; John C Clohisy Journal: J Bone Joint Surg Am Date: 2006-07 Impact factor: 5.284
Authors: Marc R Safran; Giovanni Giordano; Derek P Lindsey; Garry E Gold; Jarrett Rosenberg; Stefano Zaffagnini; Nicholas J Giori Journal: Am J Sports Med Date: 2011-07 Impact factor: 6.202
Authors: Eric L Sauers; Kellie C Huxel Bliven; Michael P Johnson; Susan Falsone; Sheri Walters Journal: Am J Sports Med Date: 2013-11-08 Impact factor: 6.202
Authors: Marc J Philippon; R Brian Maxwell; Todd L Johnston; Mara Schenker; Karen K Briggs Journal: Knee Surg Sports Traumatol Arthrosc Date: 2007-05-12 Impact factor: 4.342
Authors: Bruce Mitchell; Paul McCrory; Peter Brukner; John O'Donnell; Emma Colson; Robert Howells Journal: Clin J Sport Med Date: 2003-05 Impact factor: 3.638
Authors: August Estberger; Anders Pålsson; Ioannis Kostogiannis; Eva Ageberg Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-09-12 Impact factor: 4.342
Authors: Lindsey Brown-Taylor; Jordan Wilson; Michael McNally; Jennifer Perry; Rebecca D Jackson; Timothy E Hewett; John Ryan; Michael V Knopp; Jason E Payne; Stephanie Di Stasi Journal: Gait Posture Date: 2019-11-11 Impact factor: 2.840