Hip injuries can be extremely debilitating to any athlete, especially one whose sport requires forceful loading of the joint while rotating. Baseball fits that in so many ways: throwing across your body charging in from third, the act of swinging a bat, pushing off the rubber, landing after your pitch, etc. Understanding what hip injuries are serious and which ones aren't is key to understanding whether or not a player will return.
Starting off with the injury you'll find most often at the hip (hip flexor strain), we can see that there are many muscles around the joint.
Hip flexor strains occur the same way as they do anywhere else in the body, too much force applied to the area. This can come from force produced by the muscle or from an external source like a collision or landing awkwardly. These injuries, depending on the severity, run the gamut of a few days off to a lengthy DL stay. If they go on the DL, you can safely assume that the severity is at least a high mild to low moderate strain. Some teams are more conservative with their players and may put them on the DL for a mild hip flexor strain though.
The next part is what confuses people because often words are interchanged when they mean different things. The cartilage of the hip is the cartilage that is on the top part of the femur and also at the point where the femur and hip meet. It helps, when acting with the labrum (which we'll cover next) to allow the hip joint to move and glide smoothly. If the cartilage wears away, this is where arthritis starts to set in. This is for the most part irreversible, although the newest surgical procedures are beginning to improve on these. It will be more time though before these procedures are to the point of being common.
The labrum of the hip is similar to the labrum of the shoulder except that it is much stronger and deeper than the shoulder joint. The labrum also strengthens the joint by causing a negative pressure when combined with the joint capsule and ligaments. The hip joint is geared toward strength and some mobility while the shoulder joint is geared towards mobility first and then strength. Severe traumatic hip injuries (dislocations) are relatively rare in baseball because of its strength, but acetabular labral tears (the term used to differentiate between the labrum in the shoulder) are becoming more common.
Acetabular labrum tears do not happen due to overuse as much in the shoulder but occur more when it gets pinched between the femur and the hip joint. This occurs when range of motion (ROM) becomes limited or calcifications such as bone spurs start forming. Eventually the labrum gets pinched, becomes torn, and never heals on it own.
Often these tears do not require surgery and can be treated instead with a course of rest, anti-inflammatory medicine, and therapy. This can be the case for a couple of weeks to a month or two. If surgery is needed, the surgeon goes in with a scope and cleans it up. The length of time differs for the exact location of the tear and what was done, but generally they are on crutches for 3-6 weeks. Traditional therapy follows with eventual return to play being in 2-6 months depending on the size and location of the tear as well as the exact procedure done.
More and more baseball players are being diagnosed with injuries to the actual joint of the hip. This is due to increased awareness and better MRI techniques. By knowing the time it takes to return to play, you can better plan your fantasy team or simply know when to buy tickets to see your favorite player again.
