- The term “hip pointer” refers to a bruise of the muscles and soft tissue attachments to the top of the pelvis bone, near the area where your shorts or pants would be
- A hip pointer occurs from direct contact, such as from an opponent’s knee or fall to the court
- Most hip pointers heal very well, with full recovery typically expected at about 3 weeks
In the last few weeks there have been several prominent NBA players sidelined for an injury called a “hip pointer”. We’ll see a fair number of these at all levels of basketball, including at the youth level.
What’s A “Hip Pointer”?
The term “hip pointer” has been used by sports medicine specialists for many decades, and in 1967 Dr. Martin E. Blazina from UCLA specifically noted that the phrase “hip pointer” should be used to describe a deep bruise to an area of the pelvis called the iliac crest (bone on the side of the body roughly near the top of your shorts or pants). So in actuality a hip pointer doesn’t really involve the hip, but the pelvis. Still we use the term somewhat broadly today. A hip pointer is an injury that occurs when there is direct contact to the iliac crest. This can occur by getting hit or falling onto your side and landing on a hard surface.
How the Injury Happens
The pelvic bone can see trauma during basketball if there is a direct blow from an opponent’s knee, or from a fall directly on to the basketball floor.
What’s The Story?
Hip pointers typically result in immediate, intense pain and localized tenderness over the iliac crest or pelvic bone. There will usually be significant bruising and swelling around the front, outside and inside of the hip. Due to the bleeding and swelling, movement of the hip will usually be limited and painful. Decreased range of motion and weakness are also typically seen. In young athletes I’ll typically get an x-ray to look for a fracture around the pelvis. One area particularly vulnerable in the growing athlete is the upper edge of the bone, where growth is still occurring.
Treatment starts with a proper diagnosis from a skilled sports medicine professional. These injures can be very uncomfortable, so crutches may be needed for the first several days, along with “RICE”: rest, ice, compression, and elevation. This will help to reduce inflammation and control the swelling. After the initial healing, the focus will shift to soft tissue mobilization. Soft tissue massage can help improve range of motion of the hip joint, further reduce swelling and prevent scar tissue. The athlete can then be progressed to range of motion, flexibility, strengthening, and sport specific exercises. For many young athletes I’ll prescribe physical therapy.
Time To Return To Play
Once pain free gait has been resumed sports specific training can be initiated. Full return to competition usually takes about 1-3 weeks for older teenagers, but may take longer in younger athletes, and longer still if there’s a fracture to the bone. After full healing, you should expect to be able to participate in full activity without restrictions.
Dr. Kathleen Weber, sports medicine primary care physician and team physician for the Chicago Bulls joined BullsTV host Steve Kashul during Bulls Pre-Game Live on December 19th, 2016. Dr. Weber discussed the NBA’s new Concussion Protocol and the efforts being made to protect all players from returning too soon to the court.
Kashul and Dr. Weber also talked about how the physicians at Midwest Orthopaedics at Rush all work together in treating the Chicago Bulls players.
DonJoy pioneered the concept of functional knee bracing more than 30 years ago. Our first prototypes were simple neoprene sleeves sewn together in the Carlsbad, Calif. garage of our founders, Philadelphia Eagles Offensive Line Captain Mark Nordquist and local lawyer Ken Reed. Those first braces came from a deep understanding of the need for prevention, protection and healing, and DonJoy has led the profession of performance ever since by studying the body, listening to athletes, consulting physicians and pushing the envelope of innovation.
The overall perception of knee bracing technology available to most patients today is that “everyday” knee braces can be unsightly, bulky, heavy, minimally effective, restrictive and uncomfortable. These misconceptions combine to produce “brace anxiety” among many patients, often preventing mainstream adoption and compliance of braces that can help prevent injuries, allow people to remain active while healing, and protect the knee from future injury.
Patients are looking for quick, effective and economic options for maintaining or regaining their life activities; most want to delay expensive, invasive surgeries. While some patients are turning to the use of prescription narcotics (which can lead to addiction) and cortisone shots to manage their pain, these treatment options do not provide stability to the knee.
Young people between the ages of 15-25 account for half of all ACL injuries.
A person who has torn their ACL has a 15 times greater risk of a second ACL injury during the initial 12 months after ACL reconstruction, and risk of ACL injury to the opposite knee is two times that of the restructured knee.
Many athletes don’t return to sport after ACL reconstruction due to fear of re-injury.
BRACING FOR PREVENTION
Given the physicality of football, it’s easy to understand why collegiate and professional linemen wear braces on both knees. The line of scrimmage is an environment prone to knee injuries, so team doctors, athletic trainers and coaches don’t hesitate to equip their players with bilateral (both knees) custom braces.
As with helmets and shoulder pads, knee braces have become standard equipment to assist in preventing season-ending knee injuries. And the same logic holds true with skiing, snowboarding, soccer, basketball, volleyball, professional rodeo, water sports and others. An ounce of prevention is worth a pound of cure.
BRACING POST INJURY
Why brace after ACL reconstruction? Clinicians will typically prescribe a functional knee brace after the patient has regained full range of motion—that’s usually between three to five months after surgery. Graft strength of the new ACL is considerably weaker than the native (original) ACL during the first 12 months, so a brace during this early period helps protect it from harmful forces that occur in everyday life or in sport.
Bracing also elevates a patient’s confidence, allowing them to return to their previous or enhanced level of activity. Just look to athletes including Robert Griffin III, Tiger Woods, Adrian Peterson, Tom Brady, Lindsey Vonn, Matt Ryan and Peyton Manning just to name a few. Another important reason? Peace of mind. A functional knee brace provides not only confidence for the patient, but confidence for the surgeon, knowing that their patient’s knee is protected.
Basketball is a fast-moving sport that demands endurance from the players and strength and flexibility in the knees-sudden stops, pivots and jumps put pressure and strain on this area of the leg, often leading to injuries.
You can work to prevent knee injuries and pain by taking care of your body. Use these exercises, all of which work to strengthen the ligaments and muscles around your joints, to become a better player with strong, resilient knees.
Sometimes, simple, traditional bodyweight exercises are all you need. That’s the case with lateral lunges, which put a slight twist on the traditional movement, placing all the focus on strengthening your quads and your knees.
This movement also improves force absorption in the knees and teaches your body how to control your weight during fast, directional movements.
Directions: Stand with feet hip-width apart and keep your upper body straight. Step out with your right foot and lean down into your right leg so that you’re squatting on just one side. Keep the left leg and back straight-don’t lean forward. Push off from your right foot to return to start. Repeat on the left side for one rep. Aim for 8 to 10 reps.
BODYWEIGHT QUARTER SQUAT
The benefit of a bodyweight quarter squat is a matter of pure volume. As opposed to a parallel squat, where the body often tires after 8 to 10 reps, quarter squats allow you to do 20 to 30 reps, directing extra attention to your knees and quads.
Directions: Push hips back, keep back straight and “sit down” just slightly so that your knees are at a 45-degree angle. Return to start to complete one rep. Aim to complete 20 to 30 quarter squats, in the middle of your workout.
PHYSIOBALL LEG CURL
This exercise helps to strengthen your knees, hamstrings and core-all of which play an important role when pivoting and stabilizing your body during a game. This is a great exercise for the end of your workout, being slower-paced and performed on the ground.
Directions: Lay on a mat, and place your heels on a physioball so that your legs are straight out in front of you. Keeping your core engaged and hips raised, roll the ball in toward your body, so your knees are bent and the physioball is now below the balls of your feet. Return to start for one rep. Aim for 10 to 12 reps.
It’s important for basketball players to focus on strengthening their knees and the muscles and ligaments surrounding them. Not only will it help you stay injury free, but it will make you a stronger player as well. Incorporate these simple exercises into two or three workouts during the week to feel a difference in your knees and your game.
BY FARA ROSENZWEIG for betterbraces.com