A hip pointer is a bruise or muscle tear over the pelvic bone usually caused by a direct blow. The crest of the hip is the location of several muscle tendon attachment sites, and any direct blow may result in significant soft tissue injury.

Mechanism of Injury

The injury is most likely to occur in contact sports such as football or rugby. In soccer it is common with a fall on your hip while diving for a tackle or ball. Hip pointers are very severe injuries and must be appropriately treated in order to avoid permanent limitations in movement.

Signs and Symptoms

• Immediate, often incapacitating, pain in the region of crest of the hip (iliac crest), often tender to touch.
• An inability to walk, move the thigh forward, or to the side (movements you need to run, cut and kick in soccer).
• Possible swelling and discolouration over the site of the injury.

On-Site Management

P.R.I.C.E. PROTECT the area from further damage. REST the area to promote healing, restrict activity until symptoms subside, sometimes complete rest is required. ICE and gently COMPRESS is NOT recommended. ELEVATION is NOT needed.

Referral. The mechanisms for a Hip Pointer can be similar to that of an iliac crest fracture and a physician should be seen to rule out this more serious injury. Also, physiotherapists have used ultrasound as a beneficial treatment modality for Hip Pointers.

Rehabilitation. Seek treatment from a physiotherapist. Increase range of motion in the hip.

Return to Activity. For moderate to severe contusions, the athlete should not return to playing soccer until he/she has normal hip and thigh strength, hip motion and flexibility and has been given the ok by their physician. The athlete should wear a protective pad over the hip upon return.

Prevention. Athletes should wear protective padding that is appropriate for their sport (soccer, football, hockey, baseball, softball, etc.)

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