A hip pointer is a bruise on the pelvis caused by a direct blow to the iliac crest. It usually occurs in contact sports or from a fall onto the hip. Symptoms include severe pain in the upper outer hip, tenderness, swelling, bruising, and decreased range of motion. Treatment involves rest, ice, anti-inflammatory drugs, and sometimes corticosteroid injections. Physical therapy may be needed to regain mobility and strength through exercises like stretching, strengthening the core muscles like the abdominals and hip muscles, and improving range of motion. Full recovery usually takes 1 to 3 weeks but can take longer if a fracture is involved.

1. Hip Pointer
Emily Carda & Holly Zimmer

2. Definition:
A hip pointer is a
contusion (bruise) on
the pelvis caused by
direct blow to the iliac
crest.

3. Preventions
o Maintaining excellent
flexibility, strength and
endurance of the hip, pelvis and
lower back muscles may
prevent some hip pointers.
o For athletes it is important to
wear proper padding to prevent
a traumatic blow.
o Most, however, are the
unfortunate result of significant
contact and are not preventable

4. Causes:
 Hip pointer injuries
usually occur in contact
sports, from a collision,
or from falling directly
onto the hip.
 Hip pointers injuries can
occur in contact sports
such as football or
hockey. It may also be
caused by a fall onto the
hip in sports such as
soccer or skiing.

5. Diagnosis
o Hip pointers present with a
history of a contact injury in
the area.
o Pain and tenderness along
the crest of pelvis is also seen.
o The patient may walk with a
limp and have difficulty
moving the hip away from the
body against resistance. X-
rays are taken to rule out
fractures.

6. Signs/Symptoms
* Severe pain on upper, outside part of the
iliac crest
* Tenderness in the top area of your hip
* Pain with activity
* Swelling
* Bruising
* Soreness
* Muscle spasms
* Decreased range of motion
* Limp/abnormal gait

7. General Treatment
Physical examination in a person with a suspected hip
pointer should include:
- Abdominal examination to exclude trauma to intra-
abdominal organs
- Visual inspection
- Palpation
- Passive and active ROM assessment
- Sensory testing
- Gait analysis

8. General Treatment continued…
Hip pointers may be treated with:
* Rest
* Nonsteroidal antiinflammatory
drugs (NSAIDs)
* Ice
* For severe pain, your doctor may
inject a steroid directly into your
hip

9. Physical Therapy
o On average it takes 1 to 3 weeks to recover from a
hip pointer.
o In more serious cases of hip pointer, the hit can be
so severe that a fracture of the bone results. While
the treatment may not change, a fracture will likely
cause a delay in healing and more painful
symptoms.
o A physical therapist may be recommended to help
you regain mobility and build muscle strength.

10. Physical Therapy Treatments
•Core Strengthening
•Cryotherapy or Cold Therapy
•Electrotherapeutic Modalities
•Gait Training
•Hip AROM
•Hip PROM
•Hip RROM
•Hip Joint Mobilization
•Isometrics
•PNF
•Soft tissue mobilization
•Stretching/flexibility exercises

11. Possible Treatment Goals
•Improve Fitness
•Improve Function
•Improve Muscle Strength and Power
•Increase Oxygen to Tissues
•Improve Proprioception
•Improve Range of Motion
•Self-care of Symptoms

12. Muscles involved in Hip
Pointers
Sartorious
Rectus Femoris
Abdominals
Tensor Fascia Lata

13. Sartorious
 The sartorious is a muscle that has its origin at the
anterior superior iliac spine on the iliac crest.
 Injury to the sartorious is the most common cause
of hip pointer.
 The sartorious muscle helps with:
• Abduction
• Lateral/External rotation
• Hip flexion
• Knee Flexion

14. Rectus Femoris
 The rectus femoris is a
quadriceps muscle that has
its origin near the iliac
crest.
 This muscle is responsible
for flexing the hip joint and
extending the knee.
 When the rectus femoris is
injured, it may be painful to
flex the hip joint.

15. Tensor Fascia Lata
 The tensor fascia lata is
a gluteal muscle that has
its origin at the anterior
superior iliac spine and
on the anterior part of
the iliac crest.
 It is responsible for
abducting, flexing and
medially/internally
rotating the femur.
 When the tensor fascia
lata is bruised, moving
the hip can be painful.

16. Abdominals
 The internal and
external oblique
muscles are
abdominal muscles
that have bony
attachments to the
iliac crest.
 These muscles are
responsible for
allowing the trunk to
twist and turn.
 When injured during
a hip pointer, moving
the trunk and hip
may be painful.

17. Bibliography
 29, Brown June. "Hip Injuries | Injury/Pain | Core Knowledge |
Core Performance." Core Performance | Powered by Athletes'
Performance. 29 June 2009. Web. 22 Nov. 2010.
<http://www.coreperformance.com/knowledge/injury-pain/hip-
injuries.html>.
 Waryasz, Gregory. "Hip Pointer Injuries | LIVESTRONG.COM."
LIVESTRONG.COM - Health, Fitness, Lifestyle | LIVESTRONG.COM.
12 May 2010. Web. 22 Nov. 2010.
<http://www.livestrong.com/article/121671-hip-pointer-injuries/>.
 Martinez, John M. "Hip Pointer: EMedicine Sports Medicine." EMedicine -
Medical Reference. 6 Mar. 2009. Web. 19 Nov. 2010.
<http://emedicine.medscape.com/article/87322-overview>.
 Kellicker, Patricia. "Hip Pointers - EmpowHER.com." Women's Health
and Wellness Information, Tips - EmpowHER.com - Improving Health,
Changing Lives. Nov. 2008. Web. 22 Nov. 2010.
<http://www.empowher.com/media/reference/hip-pointers>.