What is Hip Stress Fracture

A hip stress fracture is one or more tiny cracks in the hip bone. This type of fracture happens because of repeated stress on the hip bone. Stress fractures are often caused by increasing your level of physical activity too quickly.

Most hip stress fractures happen in the femoral neck. The femoral neck is the area of the upper leg bone (femur) that connects the ball of the femur to the rest of the femur. The ball of the femur fits into the socket of the pelvis to form the hip joint.

A stress fracture may happen on the bottom side of the femoral neck (compression fracture) or on the top side of the femoral neck (tension fracture). In some cases, a hip stress fracture may get worse over time and may cause a complete break in the hip bone.

What are the causes?

This condition is caused by repeated stress and impact that weakens the hip bone over time.

What increases the risk?

This condition is more likely to develop in:

• Women, especially women who have any of the following conditions:
  • An eating disorder.
  • Amenorrhea that is caused by overtraining. This is the stopping of menstrual flow for 3–6 months in a woman who previously had periods.
  • Osteoporosis. This is thinning and loss of density in the bones.
• People who are involved in intense physical training.
• People who often do athletic activities on hard surfaces, such as dancers or runners.

What are the signs or symptoms?

The most common symptom of this condition is deep, aching pain in the front of the groin. The pain often gets worse with activity, and it may go away when you rest. Pain may get worse over time. Other symptoms of a hip stress fracture may include:

• Stiffness of the hip.
• Limping.
• Pain in the hip or thigh.
• Inability to use the leg to support any body weight (bear weight) without pain.

How is this diagnosed?

This condition is diagnosed based on a physical exam and your medical history. During your physical exam, your health care provider will check your hip joint for pain and loss of motion. You may also have tests, including:

• X-rays.
• CT scan.
• MRI.
• Bone scans.

How is this treated?

Treatment for this condition depends on the severity and location of your fracture. Treatment may include:

• Using crutches until your health care provider says that you can bear weight on your hip.
• Medicines that help to reduce pain and swelling, such as NSAIDs.
• Taking X-rays to make sure that your fracture is not getting worse.
• Physical therapy.
• Surgery to repair the fracture (open reduction). This may be necessary if:
  • You have a tension fracture.
  • Other treatment methods have not worked.
  • Your stress fracture gets worse.

Follow these instructions at home:

Activity

• Rest your injured hip for as long as told by your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Avoid any activities that cause pain or irritation in your hip.
• If physical therapy was prescribed, do exercises as told by your health care provider.

Safety

• Do not use your injured leg to support your body weight until your health care provider says that you can.
• If you were given crutches, use them as told by your health care provider.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
• If directed, apply ice to the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Warm up and stretch before being active.
• Cool down and stretch after being active.
• Always begin new exercises or training gradually.
• Give your body time to rest between periods of activity.
• Make sure to use equipment that fits you. Wear athletic shoes that have enough support and padding.
• Avoid activities that put stress on your hip, such as repetitive movements.
• If you have an underlying condition that caused your hip stress fracture, work with your health care provider to manage your condition.
• Make sure you get enough calcium and vitamin D.

Contact a health care provider if:

• Your pain gets worse or it does not get better with treatment.

Get help right away if:

• Your pain suddenly gets worse.
• You cannot move your hip.