Post-Hip Dislocation
Ross Hauser, M.D., Marion Hauser, M.S.,R.D.

Because the hip joint is a ball-and-socket joint with massive ligaments, it is a very stable joint. It is therefore injured less frequently. However, athletes are getting bigger and stronger as the years go by, therefore the amount of forces on the athletes are tremendously high and increasing every year. The most common hip dislocations occur posteriorly because of the greater strength of the anterior capsule of the joint. They are also more common because in sports such as football, rugby, hurling, and soccer, the individual is hit in the front of the thigh, forcing the thigh/hip complex backward, resulting in hip dislocations. This tears the ligamentum teres and the posterior capsule.

The vascular supply to the femoral head is stretched and torn as the posterior displacement increases. Once the hip is surgically reset (put back in place), the athlete must use crutches for two weeks after the injury. Protected weight-bearing is continued for two to six months, depending on the surgeon's school of thought. (Henry, J. Traumatic injuries to the hip. In The Hughston Clinic Sports Medicine Book, published by Williams & Wilkins, Philadelphia, PA, 1995, pp. 392-402.)

Generally, the athlete is not allowed to return to athletics for a minimum of three months. Long-term consequences of posterior hip dislocations can include sciatic nerve injury, avascular necrosis of the femoral head (hip joint damage due to decreased blood supply), and significant arthritis and cartilage damage.

A joint dislocation significantly disrupts all the structures that support the joint. The athlete will be out of commission for a minimum of three months if he/she does traditional sports medicine treatments. Even after all of that time, there is no guarantee that you will be left with a strong hip joint. If strengthening the hip has not been accomplished, then the athlete is on the way to sustaining another dislocated joint in the future. For most athletes who choose the traditional route of treatment for joint dislocations, you will be looking at three to six months of abstinence from your sport, followed by months of rehabilitation and babying of the joint. There must be a better way.

We recommend Prolotherapy after any joint dislocation occurs.  If the athlete desires to get back to athletics as soon as possible, then weekly or biweekly Prolotherapy is given, and often with strong proliferant solutions. Often, after just a few Prolotherapy sessions, workouts may begin. A total of four to six Prolotherapy sessions are usually required to resolve the joint weakness. Prolotherapy, in this case, can speed the recovery process, allowing an athlete to return to playing sooner than with the traditional route. More importantly, the athlete comes back with a stronger hip.

Post-Fracture Pain
It is common for athletes, especially in high-velocity sports such as football, rugby, and soccer, to sustain fractures of the pelvis, ilium, sacrum, coccyx, hip, or for that matter, anywhere in the body. Generally, the fractures heal well. One thing that is commonly forgotten, however, is that when the bone is fractured, so are blood vessels, ligaments, and tendons. The persistent pain and/or weakness that occur after fractures are often a result of ligamentous structures that never healed. If an athlete sustained such a force to fracture a bone, it can be assumed that ligament damage also occurred. Once the cast is removed, in our opinion it is advisable for the athlete to receive Prolotherapy to the injured ligaments. Ligaments have a terrible blood supply compared to the bones. Even if the bone heals, there is no guarantee that the ligaments will also heal. As a matter of fact, it is more likely, in such a case, that the ligaments will not heal completely.