RAVENNA, Ohio — Olivia Bragg of Ravenna may play basketball and perform on the band dance line, but since the age of seven she has dedicated her springs and summers to softball.
It's her favorite sport, the one she wants to play in college. But during her freshman year of high school, something felt off.
“I started noticing there was like a pain in my hip, like when I would go up during my pitching and I would land. It was like something was like pinching and my hip,” Olivia said.
The pain became progressively worse.
“Towards the end of the year, I was like collapsing when I would land. Like I couldn't throw,” Olivia said.
But like most young athletes she kept trying.
“My first of the five warmup pitches that I got, my hip collapsed. I went down on the field and I started crying, and my dad came out of the dugout. I was like, 'Dad I just tore my hip, I think,'” Olivia said.
She wasn’t wrong.
Doctors diagnosed Olivia with what’s becoming an increasingly common condition in female athletes called impingement. It’s related to her anatomy.
“About one in three male patients will have hip anatomy where the ball is not as round as it could be and about one in four females will have a hip that's similarly shaped,” said University Hospitals orthopedic surgeon, Michael Salata, M.D.
“The ball is larger than your socket. So when I lift my leg up to pitch and when I land the ball was pinching my labrum in my socket. And that repeated motion, eventually, the ball rubbing on the socket just shredded my labrum in half,” Olivia said.
Injuries like Olivia's often develop when athletes do one sport or movement repeatedly without rest. Growth spurts can play a part, but typically it's overuse and repetitive motion that bring these issues to light.
Olivia’s hip pain eventually impacted on her daily life.
“I couldn't move without my hip hurting,” she said.
Olivia went to University Hospitals Drusinsky Sports Medicine Institute where Dr. Salata repaired her hip joint this past March.
She spent the next few months in physical therapy where she eventually worked up to sport-related training.
She returned to softball in July and just started her junior year of high school.
“My range of motion has increased an insane amount,” Olivia said.
Even though the risk is higher in males, Dr. Salata says 70% of arthroscopic hip surgery in the U.S is done on female patients and University Hospitals is certainly seeing an uptick in cases. And while ACL injuries are the highest risk for girls, hip injuries are second, and the two may be connected.
“Patients that have hip impingement have been shown to have a higher risk of tearing their ACL, and that's based on how the mechanics of the upper hip joint work and how and the pressures that they put onto their knee joint,” Dr. Salata said.
Hip impingement is not the only hip issue they see. Another condition impacts about one in 100,000 athletes. Typically those who require the most flexibility.
“Hip dysplasia, which is where the hip was formed a little too shallow and that can lead to a similar kind of inside out injury to those same structures that live along the rim of the socket,” Dr. Salata said.
Hip dysplasia is more often discovered in athletes that require a wide range of motion in their hips, such as gymnasts, cheerleaders and dancers.
Fixing these issues can also help young athletes avoid early onset of arthritis later in life.
So what do athletes need to remember?
“While it's important to kind of maintain your skill set as you're trying to kind of excel at the next level, you really need to build in periods of rest. So, whether that's two weeks in between seasons or a week here, just give the kids a break occasionally. Also, the kids need to listen to their body if something doesn't feel right, it's probably not right,” Dr. Salata said.