Abstract
PurposeTo investigate how range of motion of the hips and the lumbar spine are affected by continued elite, alpine skiing in young subjects, with and without a magnetic resonance imaging verified cam morphology, in a 2-year follow-up study. The hypothesis is that skiers with cam morphology will show a decrease in hip joint range of motion as compared with skiers without cam, after a 2-year follow-up.MethodThirty adolescent elite alpine skiers were examined at the baseline (mean age 17.3 ± 0.7 years) and after 2 years. All skiers were examined for the presence of cam morphology (α-angle > 55°) using magnetic resonance imaging at the baseline. Clinical examinations of range of motion in standing lumbar flexion and extension, supine hip flexion, internal rotation, FABER test and sitting internal rotation and external rotation were performed both at the baseline and after 2 years.ResultsSkiers with and without cam morphology showed a significant decrease from baseline to follow-up in both hips for supine internal rotation (right: mean − 13.3° and − 10.9° [P < 0.001]; left: mean − 7.6° [P = 0.004] and − 7.9° [P = 0.02]), sitting internal rotation (right: mean − 9.6° and − 6.3° [P < 0.001]; left: mean − 7.6° [P = 0.02] and − 3.3° [P = 0.008]) and sitting external rotation (right: mean − 16.9° and − 11.4° and left: mean − 17.9° and − 14.5° [P < 0.001]) and were shown to have an increased left hip flexion (mean + 8.4° and + 4.6° [P = 0.004]). Skiers with cam were also shown to have an increased right hip flexion (mean + 6.4° [P = 0.037]). Differences were found between cam and no-cam skiers from baseline to follow-up in the sitting internal rotation in both hips (right: mean 3.25°, left: mean 4.27° [P < 0.001]), the right hip flexion (mean 6.02° [P = 0.045]) and lumbar flexion (mean − 1.21°, [P = 0.009]).ConclusionYoung, elite alpine skiers with cam morphology decreased their internal rotation in sitting position as compared with skiers without the cam morphology after 2 years of continued elite skiing.Level of evidenceII.
Highlights
Hip and groin pains are common problems in the population, and especially in athletes
The scientific literature has shown growing evidence that a cam morphology might lead to decreased range of motion (ROM), damage to the cartilage, labrum tears and predispose to the development of hip joint osteoarthritis (OA) [4, 6,7,8,9]
The aim of the present study is to investigate how the ROM in the hip joints and the lumbar spine is affected by continued elite, alpine skiing in young subjects with and without an MRI-verified cam morphology after 2-year follow-up
Summary
Hip and groin pains are common problems in the population, and especially in athletes. FAIS is either present as an abnormal morphology at the femoral head-neck junction (cam) or as an abnormality in the acetabular shape or orientation causing over-coverage of the femoral head (pincer) [4, 5]. These two can be present together, as a mixed type. Agricola et al [7] reported that individuals with both an α-angle > 83° and limited hip joint IR (< 20°) were at high risk of end-stage OA within 5 years (adjusted odds ratio 25.21)
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