Read on: danhwilliams.com

Read time: 2 minutes

Okay, so what can academy footballers tell us about hip pain?
And could sport as a kid be the cause of your hip pain?
 
This is the key paper from 2017..
(yep, really recent)

..the picture shows a clear cam shape in the hip of a 16 year old academy footballer.

That white line across the femoral head ball is the growth plate.
That's how the hip grows. And the images show:

• The top edge of the growth plate overgrown
• The head / neck junction is thicker + flatter
• The ball loses its round shape at the top.

Looks just like my description of it from clinic, right?!

Now from a biological perspective that makes sense..


Nature is thickening up that femoral neck

In a high level athlete, Nature says:

• ‘Protect that femoral neck’
• ‘Minimise the risk of fracture’

Loaded bone sparks piezo-electric charges 
Leading to bone formation (Wolff’s law)

It's how our bones grow straight.
And how kids’ broken arms heal and grow straight.
(sometimes from an incredible degree of bend)


What did the paper find..

At age 9 years, ALL hips were normal.
The cam deformity developed from that age on..

In just 1 or 2 kids?
Nope.
 
Regular sport led to an overall higher alpha angle.
(Alpha angle measures extent of cam shape)

• Normal => +0 degrees or less
• Club or school level sport => +4 degrees
• National or international sport => +8 degrees.

Wow!
 
Those are big differences when it comes to bending a hip.
+4 or +8 degrees of cam means less hip flexion / bend.
0, 4 or 8 degrees less hip flex or bend.

Kick a ball, and those future hips will likely impinge.
In a high impact version of what I was doing last week..

No wonder high level footballers get groin / hip pain.
Any footballer with a ‘groin strain’ you hear about..
Probably has hip impingement.
 
Andy Murray tells a similar story.
(altho' I can't find any tennis studies)
 

It comes back to the insight that struck me last week..
 
‘Most running mammals do NOT need a large range of hip movement’
 
BUT most mammals don't thicken up their femoral neck.
AND go on to play high level football or tennis ⚽️🎾

And that begs the question:

Could a better mix of lower impact sport in adolescence prevent hip problems later on?
 
Hopefully the science keeps on coming 😀

So, analysing academy footballers.
Helps us understand how a can shape hip forms.

AND that deep understanding..
Points to a strategy to beat our own hip pain.

Coming soon: how our big human brains also lead to hip pain.


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