The Phinjury Report: Mike Pouncey’s Hip

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I was immediately worried when Mike Pouncey left the Dolphin’s preseason game due to injury against the Dallas Cowboys last Friday night. While he was able to return to play later in the quarter there now reports that he will miss the rest of preseason and possibly the season opener due to an undisclosed hip injury. labramIn this article we will review some of the most common hip injuries for NFL players and Mike Pouncey’s past injuries to determine a few possibilities for his season.

What we hope it is: Hip Pointer.

Hip pointers are a specific name for a bone contusion that occurs at the hip. These deep bruises originate when the player comes in contact with another player or the ground and bleeding occurs in the bone tissue. This injury is the most common hip injury in the NFL1 but is not a career ender by any means. The pain associated with the bruising can affect the consistency of a player’s ability week to week. Most large muscles of the hip attach proximally near the joint which when bruised can cause an increase pain and inflammation with movement2. The average amount of time missed is 1-3 weeks for a hip pointer injury if so then expect to see Pouncey back for the season opener as long as there are no complications.

What it might be: Hip Bursitis.

 Bursa are small sacs filled with a lubricating liquid to allow joints pain free movement. When a large impact occurs at the level of the joint especially in joints that have had a past history of injury (Pouncey had left labral surgery 2014 which we will talk about later) these sacs can become inflamed which increases pain with movement.  Reports from Omar Kelly3 are saying the organization is debating between possible minor surgeries or continuing to play while managing pain for Pouncey. This possible surgery would be a bursectomy or the removal of the inflamed bursa. The recovery for this injury is 2 weeks of therapy to regain pain free motion but is highly dependent on the healing time of the surgical site and can be up to a month and a half until the player is ready to take the field. If bursitis is the cause of hip pain the team will need to make the important decision between choosing the surgery option or not.

Worst Case Scenario: Labral Tear.

Mike Pouncey missed the entirety of the 2014 season due to a labral tear on the same hip (editor’s note: it was not the same hip) this recent injury occurred, making it a strong possibility for re-injury. The labrum is a strong fibrous structure that surrounds the pocket of the hip joint to create increased stability between the femur and hip. When the Labrum is torn and left untreated the athlete may be able to continue physical activity but will be at a very high risk of chronic osteoarthritis. This arthritis can require major surgery to repair the entire joint and in worst case scenarios require an entire hip replacement. This osteoarthritis can be prevented by a more minor surgery in which the labrum is reattached together. While this minor surgery can save a player’s season the normal recovery process takes around 3 months4.

labramtearIf the surgery was scheduled tomorrow this would allow Pouncey to be back earliest in late November, possibly week 10 against the LA Rams. The first six weeks of recovery are similar to the bursectomy, focusing on increasing functional motion that is pain free while allowing the surgical site to heal. Once the athlete can walk without a noticeable limp or pain they are progressed back into football specific activities from anywhere to 3-6 months until they are medically cleared for game play.

While a lot of reports on Pouncey’s injury are pointing towards the possibility of a labral tear any of the options above could be possible. As more information about the injury is released I hope you are able to use this article as a guide to determine what to expect from Mike Pouncey this season.  For up to date information on this and other Miami Dolphin injuries you can follow me on Twitter @phinjuryreport

 

Will Merring, SPT.

  1. Hall M, Anderson J. Hip pointers. Clin Sports Med. 2013 Apr. 32(2):325-30
  1. Serner A, Jakobsen MD, Andersen LL, Hölmich P, Sundstrup E, Thorborg K. EMG evaluation of hip adduction exercises for soccer players: implications for exercise selection in prevention and treatment of groin injuries. Br J Sports Med. 2014 Jul. 48 (14):1108-14.
  1. Kelly O. Dolphins preparing to play season opener without Mike Pouncey. Sun Sentinel. http://www.sun-sentinel.com/sports/miami-dolphins/sfl-dolphins-preparing-to-play-season-opener-without-mike-pouncey-20160821-story.html. Aug 21 2016. Accessed August 21 2016.
  1. Genuario J. Femoral Acetabular Impingement and Labral Tears of the Hip. Steadman Hawkins Clinic. http://www.shcdenver.com/Portals/902/web-content/files/JamesGenuario/FAI.pdf Accessed August 21 2016.
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