Hip Injuries On The Rise Around MLB

A-Rod, Utley among stars to deal with surgery, recovery

MLB.com—June 4, 2009

Mike Lowell followed the Marlins' strength and conditioning programs religiously.

He worked out properly.

He stretched properly.

But late in the season he felt tightness in his right groin. Nobody could figure out why exactly because he had completed every program asked of him. But regardless of how hard he worked, the groin always tightened.

Lowell, who played for the Marlins from 1999-2005 before he joined the Red Sox in 2006, learned later he had a torn labrum in his hip and required surgery.

He is not alone. Hip injuries have been diagnosed more frequently in Major League Baseball. Lowell, who had successful surgery to repair the labrum Oct. 20, 2008, is one of several notable players who have had hip surgeries in recent months. Others include Yankees third baseman Alex Rodriguez, Phillies second baseman Chase Utley, Mets first baseman Carlos Delgado and Royals third baseman Alex Gordon. Phillies pitcher Brett Myers had successful hip surgery Thursday.

"You know, Tommy John got a surgery named after him. I think they should name this one after me," Lowell joked.

But why all the hip injuries all of a sudden?

"I think the main reason is improved recognition of the pathology," said orthopedic surgeon and hip specialist Bryan T. Kelly, who peformed Myers' surgery at Hospital for Special Surgery in New York. "They were treated with rest and anti-inflammatories, and they would get persistent problems with it. Now we're beginning to recognize that a lot of problems that seem to be muscle strains or muscle pulls are ending up these [hip] problems."

Athletes often complain of anterior hip pain or groin pain. They will mention locking or clicking or catching or giving out, which is what Myers described before he learned he needed surgery.

Gordon said his injury came up gradually.

Gordon, like the others, chose to get it fixed.

THE SURGERY

Gordon might not have been so lucky had he played 20 years ago.

"Accessing the hip joint to treat some of these bone spurs was too dangerous because the surgery was worse than the disease," Kelly said. "Over the last 10 years arthroscopic approaches to this have become more accessible. More training is being done. We have better tools and instrumentations that are allowing us into the joint, so a lot of these procedures that weren't done at all because they were too dangerous or done only by a few people because the surgeries were too big and people didn't want to do it, are being done with more frequency and more safely."

Perhaps the most interesting reason these injuries maybe be occurring more regularly is that elite athletes start playing at an earlier age and they specialize in a sport at an early age. Decades ago athletes might shift from one sport to another - football in the fall, basketball in the winter, baseball in the spring, for example. If a particular activity put a tremendous amount of torque on the hip joint and that athlete did it a couple months out of the year instead of year-round, it stands to reason that the one who did it for a longer period of time might be more likely to develop an injury.

"The way that a bone grows - there's something called the growth plate," Kelly said. "The growth plate fuses somewhere between the ages, say, of 11 to 15, depending if you're male or female and how mature you are. If you subject your hip to a lot of repetitive rotational forces, there is some thought this may result in abnormal remodeling of the hip."

Kelly said one should be aware that "repetitive rotational loads" may not be as benign as previously thought when considering hip development, although he pointed out there has not been enough research to make a recommendation. But just like coaches are told to watch the adolescent elbow, they might want to have similar concerns about the hip.

"Unfortunately it's a mismatch between what your functional requirements are in your sport and your physiological capacity in your hip joint," Kelly said. "If there's a mismatch you can try to do things ... but those things are things that athletes probably aren't going to want to do because it will affect their performance. I think it's identifying the problem and treating it before there's any permanent damage."

Read the full story at mlb.com.

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