What Is A Hip Pointer or Iliac Crest Contusion?
A hip pointer injury or iliac crest contusion is a condition of bruise that occurs at the upper part of the hip 1,2. The part of the bone of the hip i.e. the top curve of the pelvis located near the front side of the body is known as iliac crest. Several muscles including the abdominal muscles are attached to this place. Injury to soft tissue and bone usually results from a pointer. This type of injury could also cause severe pain.
A hip pointer or Iliac Crest Contusion is an injury that results from a direct impact to the hip bone i.e. iliac crest and greater trochanter or the bony protusion at the top of the femur. A hip pointer is very common in sports like American football, which increases the chances of high impacting forces that result in bruising of the iliac crest. In some cases, this may also lead to avulsion fracture in which a little part of a bone is pulled away by the connected muscle. This region is specifically at risk when it receives a direct blow because of lack of protection and limited padding from fat storages.
The surrounding area of the hip i.e. the side and front of the hip, the hip abductors or gluteus medius and gluteus minimus and the abdominals starts bleeding resulting in swelling and forcing the hip movement to become even more painful.
What Are The Causes And Risk Factors For Hip Pointer or Iliac Crest Contusion?
A hip pointer or Iliac Crest Contusion is caused due to a direct blow to the iliac crest. A hip pointer very frequently occurs when a helmet mistakenly hits into the bone on the outer side of the hip, due to a hard hit to the ground, and in contact sports like hockey, basketball, football and soccer. A hip pointer is also caused due to negligence in wearing hip pads while performing contact sports as being an athlete extensively increases the chances of meeting with this type of injury.
What Are The Signs And Symptoms Of Hip Pointer or Iliac Crest Contusion?
The Following Are Signs And Symptoms:
- Pain is experienced while performing activity.
- Severe pain.
- Muscle spasms.
- Reduced range of motion.
What Are The Treatment Options For Hip Pointer or Iliac Crest Contusion?
- Cold Therapy for pain.
- Avoiding activities that aggravate the symptoms of hip pointer.
- Non-Steroidal anti-inflammatory medications such as Ibuprofen, Aspirin, Celebrex and Naproxen are helpful to pain arising from hip pointer injury or iliac crest pain.
- Corticosteroid injections where the medication is injected directly into the hip are also used in case of severe pain in iliac crest.
- Sports massage to help reduce swelling, prevent scar tissue formation and loosen up the muscle fibers in hip pointer injury.
- Aspiration may also help in case of hematoma.
3 Best Hip Pointer Exercises
Exercise would accelerate healing of the contusion and also prevent muscle atrophy. Exercises recommended are non-weight bearing graded exercise performed in the pool or the graded exercise as described below. Graded exercises strengthens and stabilizes the muscles acting on the hip joint.4
1. Standing Hip Pointer Stretch Exercise
This exercise is performed by standing with the back toward a hip-high table. Now bend the leg of affected hip to place the foot on top of the table. Keep both the knees beneath the hips with stomach tight and bend the knee of the other unaffected leg. This exercise helps in stretching the bruised hip flexor muscles involved with the hip pointer.
2. Wall Hip Pointer Stretch Exercise
This exercise is performed by standing perpendicular to a wall by keeping the affected hip away from the wall. Place the hand of the healthy side on the wall in order to raise the foot of the healthy side. Put the elevated foot in front side of affected leg and slowly bend the hip away from wall in order to stretch the muscles along the top of the hip. The "C" shape formed by the body while performing this stretch is the evidence that the exercise is being performed appropriately. Hold the position for at least 30 seconds and release. Repeat five times daily on both the sides.
3. Kneeling Hip Pointer Stretch Exercise
This exercise is performed by keeping the knee of the affected hip on the ground and healthy leg in the front side by keeping the foot flat on the ground. Tighten the muscles of stomach to flatten the lumbar spine and gradually move the upper body so as to support the weight of the body by the front foot. Keep on moving in the forward direction until a pain-free stretch is felt in the hip and groin area. At the same time by reaching the head with the arm of an unaffected side smoothly pull the upper body away from the affected side. Hold the position for about 30 seconds.
Watch Hip Pointer or Iliac Crest Contusion Video in 3D
Hip Pointer Recovery Time
Hip Pointer is not a career ending injury. The injury may take several days to weeks to heal, however the patient usually recovers completely.
What Are The Tests To Diagnose Hip Pointer?
A medical history and thorough subjective and physical evaluation is performed to diagnose hip pointer. Typically an x-ray is required for confirming the severity and ruling out the fractures.
1. Hip pointers.
Hall M1, Anderson J.
Clin Sports Med. 2013 Apr;32(2):325-30.
2. The "hip-pointer", a term to describe a specific kind of athletic injury.
Calif Med. 1967 Jun;106(6):450.
3. Bracing treatment for chronic avulsion of the iliac crest apophysis.
Tompkins M1, Ehrlich M.
Clin J Sport Med. 2010 Mar;20(2):122-4.
4. Avulsion fracture of the anterior superior iliac spine in a collegiate distance runner.
Draper DO1, Dustman AJ.
Arch Phys Med Rehabil. 1992 Sep;73(9):881-2.