The recognition of hip injuries in athletes is a relatively new thing. They were once dismissed as chronic groin problems or curious lower back pain. Technology hadn’t advanced enough to get us to where we are today. Arthur Staple has a terrific, must read piece in Newsday on this topic.

Staple’s piece is a thorough one and addresses potential causes of an increase in frequency of such injuries. He touches on the potential role that PEDs play but offers no definitive statement. He focuses instead on the fact that athletes are larger and perform at a higher rate of speed.

I believe these points to be reasonable, however, I’d like to submit my concerns regarding the universal increase in the intensity and frequency of current training regimens.

First of all, training programs have been incorporating a significant amount of plyometric training for both the upper and lower extremities. We’ve been witnessing this in the development of such programs over the last two decades. Plyometrics became popular after it was discovered Russian sprinters like Valeri Borzov were doing something called “jump training” and were dominant at the 1972 Olympics. Plyometrics are done at an intensity that’s puts more pressure on joints than does the sport activity itself. An example is jumping up and down off platforms that are two feet off the ground. By design they weren’t to be done often, but the frequency of them in today’s programs has increased. Moreover I am not unconvinced that similar upper body training has not increased the frequency of isolated glenoid labrum tears in the shoulder. Excessive loading on the labrum’s of the hip and shoulder might be taking place during plyometric training.

Second, the focus of individual flexibilty has changed. Techniques are often more joint intensive. Athletes have been incorporating less passive and isolated stretching in favor of more multi-joint options.
Some are designed in a way that can put more pressure on the hip complex. I used one such technique in a clinical setting – one I call the “extreme catcher” that ended up aggravating patients. I no longer recommend or use them. Put more simply, they just might be stretching too hard.

Finally, one thing that will not be changed is the presence of weight lifting programs that were once considered taboo. Last week I saw an athlete in our weight room at school perform a power clean. He is a collegiate baseball player now. Its now the norm. Baseball players lift weights like football players and we’re not going back for a wide variety of reasons. Players from now on will have more muscle size and power. However the game itself has not changed in that it is still one that is performed at high speed and repeatedly over several months out of the year. Training techniques might need to take into account that as players are now going to be performing with larger muscles adaptations in training might need to occur.

Posted under Uncategorized