Female Athlete Hip Injuries: A Narrative Review

Abstract

In this narrative review, we highlight sex-specific anatomic and biomechanical features of the hip region in female athletes, as well as the potential impact of these characteristics on observed disparities in both intra-articular and extra-articular injury patterns between female and male athletes. It is our goal to broaden the scope of knowledge related to hip pathology in active female athletes among sports medicine providers with the hope of better optimizing sport participation and performance in female athletes. Data Sources: A literature review was conducted using PubMed database and Google Scholar search engine. Search terms included sport, female, athlete, sex differences, injury, hip, and all diagnoses discussed in this review. Cross-reference of these articles identified additional resources. Main Results: Sex-specific differences in both static design and dynamic function contribute to disparities in hip injury patterns between female and male athletes. Intra-articular injuries, including labral and ligamentum teres pathology, as well as extra-articular injuries, including iliopsoas tendon dysfunction, gluteal and proximal hamstring tendinopathy, ischiofemoral impingement, bone stress injuries, and certain nerve entrapment syndromes, seem to affect female athletes more commonly than male counterparts. Conclusions: Given unique anatomic and functional considerations, the growing population of female athletes worldwide warrants specialized care and consideration. Potential predisposition to specific hip injuries should be taken into consideration during diagnostic evaluation of hip pain in the female athlete.

Athleticism and sex impact neural processing of sound

“…Given that sex differences in auditory processing are pervasive post-puberty, it is necessary to determine whether sports participation affects male and female athletes differently. In athletes, sex differences are known to exist in visual processing 36 , 37 , skeletal injury rates and severity 38 , 39 , and risk, symptoms, and severity of a sports-related concussion 40 , 41 . Evidence suggests estrogen plays a role in these athlete sex differences 42 – 46 , similar to the sex differences seen in auditory processing.…”

Sex-Specific Differences in Perceived Injury Management and Prevention in High School Student-Athletes

“…Additionally, high school girls are more likely to suffer a severe lower extremity injury resulting in greater than three weeks of time loss or medical disqualification than boys 5 . Recognizing sex differences for specific preventable injuries along with structural, biomechanical, neuromuscular, and hormonal risk factors is imperative to mitigating injury risk [6][7][8][9] .…”

Lost in research translation: Female athletes are not male athletes, especially at the hip

“…[118][119][120][121][122][123][124][125][126][127] The unacceptable disconnect between the male athletes being studied and the majority female population being affected by variant hip morphology warrants strategic investment in research on hip shape development in young active females. While hip pain may originate from nonmorphologic factors such as gastrointestinal or genitourinary conditions, 128,129 the potential for overlapping symptoms from gynecological conditions 129 adds to the diagnostic complexity in individuals identified as female sex at birth. While we focus here on sex as a biological variable, we also acknowledge that gender identity (e.g., girl or woman) may contribute to differences in structure and movement, and thus warrants study.…”