Question
Hello,

My Son is a 14 year old soccer player and had been complaining for the past 4-6 weeks of pain in his right groin with a clicking sound every time he rotated his thigh towards the outside (open). He then went to see a physiotherapist that told him he had pulled his "hip-flexor". My son received 2 therapy sessions this week but was told he could continue playing soccer but, in yesterday's practice while trying to reach a ball with his right leg, he felt the click and has in much pain. The team's massage therapist told him that his femur was not in the right position and tried to manupulate it while massaging his leg. I wonder if my chiropractor will be able to adjust his hip to the bone or determine whether this is the case of a Hip Labrum tear.

I'd really appreciate your guidance.

GQ in Washington St

Answer
OUCH!  I am sorry that your son is having this pain.  

It is possible to give a tentative diagnosis if there is a moderate to severe tear.  If you have a very competent, strong in sports chiropractic, it is possible for him to give a probable diagnosis.  If not, consider seeing an orthopedic surgeon.  

An X-ray will give a good indication as to the general anatomical condition of the joint, but a hip arthrogram would give as close to a definitive answer as possible.

In the mean time until you have it examined and have the arthrogram done:
旸ecrease anteriorly (front of the hip) directed forces on the hip and avoid pivoting
motions, especially in a loaded position by avoiding the following:
 -avoiding sitting with -knees lower than hips
 -legs rotated or crossed
 -hip flexor muscles contracted (sitting/ high knees)
 -pressure on femur; i.e., weight-bearing
?avoid excessive hip hyperextension, especially while walking on treadmill,
 with prone hip extension and with lunges
?avoid weight-training of quadriceps (leg press), hip flexors (straight leg raises
 or sit-ups) and hamstrings(curls) to prevent excessive forces applied to the hip
?functional activities should be pain free
?cycling using upright bicycle instead of recumbent bicycle to avoid excessive
  hip flexion and constant recruitment of hip flexors to maintain feet on pedals.

I hope this helps some and I hope that you can get him in for the tests soon.

Please let me know if you have any questions

Sincerley,
-Dr. Kaldy
www.LasVegasChiro.com
[email protected]