The female hip is very different from that of the male and in some ways more complicated to treat. The main pathology encountered is a combination of hip impingement (mainly Pincer rather than CAM), labral tearing and laxity or hypermobility of the joint.
It is important that all elements of the pathology are treated for a successful outcome.
The young female (17 – 25 years) often plays high-level field sports (camogie, football, hockey, soccer)
Older active female
Active Females (35-55 years) are involved in recreational activities (running, yoga, pilates, etc.)
Initially the pain is often severe and located deep in the front of the groin or to the side of the hip. Prolonged sitting, driving, forward stooping or squatting become painful and limited. The pain can often be unpredictable, some days can be relatively pain free and other days the pain may result in limping and difficulty with simple activities.
The hip may ‘catch’ and ‘lock’ and clicking becomes persistent. Eventually the severe pain is replaced with a more persistent discomfort and ache in and around the hip, buttocks and lower back, and can even refer down to the outside or front of the thigh to the knee.
Activities become progressively more difficult and the flexibility of the hip becomes reduced. Eventually all sports and activities become too uncomfortable as symptoms become more intense.
The majority of female athletes present with Pincer impingement and a labral tear; a small CAM deformity is also commonly present.
It is important that every female athlete is assessed for evidence of hip joint laxity.
This can arise from a poor bony structure of the hip joint (from birth) known has dysplasia (‘miss-shapen’). The acetabulum (socket) has developed ‘too shallow’ to properly contain the femoral head (ball). This places enormous strain on the hip joint especially during regular sports and results in progressive thickening and eventual tearing of the labrum of the hip.
The hip capsule is a strong ‘coat’ wrapped around the hip joint and is essential to the stability of the hip; the hip capsule can often be very lax in female athletes.
The combination of a shallow acetabulum (socket) and hip capsule laxity may result in hip instability which may result in pain and disability, damage to the labrum and surface of the hip, eventually leading to arthritis of the hip.
Mr. Carton performs capsular repair surgery for all his female athletes helping to protect the hip against developing instability post operation. This is a vital procedure which is still uncommonly performed in centres across the world.