Increasing
Alpha Angle is Predictive of Athletic-Related “Hip” and
“Groin” Pain in Collegiate National Football Prospects
Alpha Angle is Predictive of Athletic-Related “Hip” and
“Groin” Pain in Collegiate National Football Prospects
Larson
CM, Sikka RS, Sardelli MC, Byrd JWT, Kelly BT, Jain RK, & Giveans MR. Arthroscopy. 2013, E-pub ahead of print.
CM, Sikka RS, Sardelli MC, Byrd JWT, Kelly BT, Jain RK, & Giveans MR. Arthroscopy. 2013, E-pub ahead of print.
Take Home Message: High-level football
players often have femoroacetabular impingement. Furthermore, cam-type
deformities may be related to hip symptoms.
players often have femoroacetabular impingement. Furthermore, cam-type
deformities may be related to hip symptoms.
Femoracetabular impingement (FAI) is a common radiographic abnormality, particularly
among high-level athletes (50 to 95% of athletes) but it remains unclear if FAI
is related to symptoms or patient characteristics. Therefore the purpose of this study was to
assess hip radiographic abnormalities (including FAI) among National Football
League prospects and correlate these findings with symptoms, position, and body
mass index. At the National Football
League’s Scouting Combine, staff collected 125 players’ demographic information
medical histories, as well as pelvis and bilateral hip radiographs. A player underwent hip and pelvis radiographs
if a hip was symptomatic, there was a history of contusion, or the player was
in an “at-risk” position (e.g., kickers, punters). A player’s hip was
classified as symptomatic if there was prior or current activity-related groin
pain, groin strains, sports hernia symptoms, or prior surgery. A player’s hip was classified as asymptomatic
if there was no history of any activity-related symptoms. Characteristic of FAI was found in 112
players (90%) and 207 hips (87%). Interestingly, only 31% of the hips (75 of
239) were classified as symptomatic, with the remainder being
asymptomatic. Symptoms were more common in
hips with some form of cam-type FAI compared
to the rest of the cohort. Furthermore, as the extent of cam deformity
increased (greater alpha angle) athletes tended to reporter greater hip/groin
pain. The authors found no relationship between FAI and body mass index, player
position, or if the player was drafted.
among high-level athletes (50 to 95% of athletes) but it remains unclear if FAI
is related to symptoms or patient characteristics. Therefore the purpose of this study was to
assess hip radiographic abnormalities (including FAI) among National Football
League prospects and correlate these findings with symptoms, position, and body
mass index. At the National Football
League’s Scouting Combine, staff collected 125 players’ demographic information
medical histories, as well as pelvis and bilateral hip radiographs. A player underwent hip and pelvis radiographs
if a hip was symptomatic, there was a history of contusion, or the player was
in an “at-risk” position (e.g., kickers, punters). A player’s hip was
classified as symptomatic if there was prior or current activity-related groin
pain, groin strains, sports hernia symptoms, or prior surgery. A player’s hip was classified as asymptomatic
if there was no history of any activity-related symptoms. Characteristic of FAI was found in 112
players (90%) and 207 hips (87%). Interestingly, only 31% of the hips (75 of
239) were classified as symptomatic, with the remainder being
asymptomatic. Symptoms were more common in
hips with some form of cam-type FAI compared
to the rest of the cohort. Furthermore, as the extent of cam deformity
increased (greater alpha angle) athletes tended to reporter greater hip/groin
pain. The authors found no relationship between FAI and body mass index, player
position, or if the player was drafted.
Clinically,
many elite football players have radiographic hip abnormalities but most do not
have a history of groin/hip pain. This
study is the second that we have reviewed on SMR that suggested that over 90% of
collegiate football players have FAI. The competitive football
populations are clearly more likely to have radiographic hip abnormalities. The question remains what to do about it and
what are the implications of these findings.
In this current study, symptoms were more common in those with some form
of cam-type FAI. It would be interesting
to follow these athletes over time to determine if more of these athletes
eventually develop symptoms. This seems
likely since a recent study found
that cam-type deformities are associated with hip osteoarthritis. Now that we
are aware of the large number of football players with radiographic hip abnormalities
one lingering question is whether we should target this population to prevent the
onset of symptomatic and radiographic changes?
If so, then what interventions would be appropriate? How do you treat patients with symptomatic
FAI?
many elite football players have radiographic hip abnormalities but most do not
have a history of groin/hip pain. This
study is the second that we have reviewed on SMR that suggested that over 90% of
collegiate football players have FAI. The competitive football
populations are clearly more likely to have radiographic hip abnormalities. The question remains what to do about it and
what are the implications of these findings.
In this current study, symptoms were more common in those with some form
of cam-type FAI. It would be interesting
to follow these athletes over time to determine if more of these athletes
eventually develop symptoms. This seems
likely since a recent study found
that cam-type deformities are associated with hip osteoarthritis. Now that we
are aware of the large number of football players with radiographic hip abnormalities
one lingering question is whether we should target this population to prevent the
onset of symptomatic and radiographic changes?
If so, then what interventions would be appropriate? How do you treat patients with symptomatic
FAI?
Written
by: Nicole Cattano
by: Nicole Cattano
Reviewed
by: Jeffrey Driban
by: Jeffrey Driban
Related Posts:
Larson CM, Sikka RS, Sardelli MC, Byrd JW, Kelly BT, Jain RK, & Giveans MR (2013). Increasing Alpha Angle is Predictive of Athletic-Related “Hip” and “Groin” Pain in Collegiate National Football League Prospects. Arthroscopy PMID: 23357573
I am a Junior Athletic training major and have never heard of FAI so i enjoyed reading a quick little piece on it to learn about it! I also found it very interesting that so many football players are getting this. Why are football players getting it at such a high rate but no other sport?
Marisa Rizzo
Marisa-Thank you for your comment. FAI is a diagnosis that is becoming more popular. I think it is a pathology that we always treated as chronic hip pain and now have a better idea of the pathophysiology behind it.
Football players are constantly in a crouched position when in their stance. Not to mention the repetitive amount of blows and extreme motions forced by external forces through their available range of motion.
That being said…FAI is not just a football pathology. We tend to find it in Soccer, Hockey, and Basketball players as well.
I think that it will follow a course similar to that of shoulder impingement. We will begin to understand what causes it more, and potentially how to avoid or prevent it.
Thanks for your comment, and best of luck to you in your studies!