Acute Phase
Rehabilitation program
Physical therapy
Initial therapy of a hip pointer injury consists of ice, anti-inflammatory and pain medication, compression, and relative rest of the affected hip until symptoms improve. [7] Crutches can be used in the initial treatment phase if walking or bearing weight on the affected leg is painful.
As the pain decreases, ROM and active resistance exercises for the hip may be initiated. Patients may also begin strength and aerobic conditioning, as tolerated.
Medical issues/complications
The formation of a hematoma, with increasing pain and possible cutaneous neurologic compromise, may be an early complication of a hip point, usually arising within the first 24 hours. Additional complications can include development of myositis ossificans. Failure to diagnose a fracture or an intra-abdominal injury frequently leads to complications.
Consultations
Emergent consultation with an orthopedic surgeon is necessary if neurovascular compromise is considered possible in a patient with a hip pointer. Consider consultation with an orthopedic surgeon for patients who have avulsion fractures or unresolved pain lasting longer than 2 weeks. Consult with a surgeon for patients with intra-abdominal injuries.
Other treatment
Aspiration of a hematoma, if present, may provide some pain relief. Injection of a local anesthetic (eg, lidocaine, bupivacaine) may provide short-term pain control.
No evidence supports or refutes the use of corticosteroid injections in hip pointer injuries.
Corticosteroid injections may provide relief if greater trochanteric bursitis develops.
Recovery Phase
Rehabilitation program
Physical therapy
Rehabilitation programs should focus on returning the athlete back to his or her sport. Rehabilitation exercises should emphasize sport-specific strength and motions. [8] Additional padding at the injury site may help limit recurrence or reinjury (padding that is 0.25-0.5-inch thick may alleviate pain and allow the athlete to return to play sooner). Athletes with a hip pointer injury typically recover in 1 to 3 weeks. [9]
Maintenance Phase
Rehabilitation program
Physical therapy
The maintenance phase of the rehabilitation program should focus upon reducing the chance of reinjury. Additional padding or protection added to the hip may limit the risk of reinjury.
