Incidence and treatment of game-related hip pointers between high school and collegiate football athletes

Background Hip pointers are typically perceived as minor trauma with little cause for concern. Despite the possibility of long-term sequelae, limited research has been conducted on this topic.Methods In this prospective cohort study, 89 high schools (4A to 6A) and 41 universities across all Football Bowl Subdivision (FBS) conferences were evaluated for game-related hip pointers over 12 (2010–2021) and 16 (2006–2021) seasons, respectively. Recruitment criteria were based on institutional size, level of sport skill, and the presence of a full-time athletic training staff. Outcomes of interest included total injuries, injury severity, injury category, primary type of trauma, injury situation, imaging and surgical procedures, player position, environmental factors, and playing surface. Injury incidence rates (IIRs) were calculated as injuries per 10 games = (number of injuries ÷ number of games) × 10.Results Of 6031 games, 170 hip pointers were documented, with 63 (37.1%) reported during high school and 107 (62.9%) during collegiate play. Multivariate analyses of variance indicated a significant competitive level effect by total injuries (F4,165 = 3.459; P = 0.01), primary type of trauma (F10,159 = 2.967; P = 0.003), and injury situation (F9,160 = 1.993; P = 0.04). Post hoc analyses indicated a significantly lower (P < 0.05) incidence of hip pointers (0.2, 95% CI 0.1–0.2 vs 0.5, 0.4–0.6) primarily during rushing plays (0.1, 95% CI, 0.1–0.1 vs 0.2, 0.1–0.2) among high school vs college athletes, respectively.Conclusion A significantly greater incidence of hip pointers occurred during collegiate play when compared to high school competition. Addressing better ways to protect the hip, however, is recommended at both competitive levels.