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Hip morphology in elite golfers: asymmetry between lead and trail hips
  1. Edward Dickenson1,
  2. Philip O'Connor2,
  3. Philip Robinson2,
  4. Robert Campbell3,
  5. Imran Ahmed1,
  6. Miguel Fernandez1,
  7. Roger Hawkes4,
  8. Hutchinson Charles5,
  9. Damian Griffin1
  1. 1Warwick Medical School, Warwick, UK
  2. 2Leeds Musculoskeletal Biomedical Imaging Unit, Leeds Teaching Hospitals, Leeds, UK
  3. 3Radiology Department, Royal Liverpool University Hospital, Liverpool, UK
  4. 4European Tour Performance Institute, European Tour, Virginia Water, UK
  5. 5Department of Clinical Imaging, Warwick Medical School, Warwick, UK
  1. Correspondence to Professor Damian R Griffin, Warwick Medical School, Clinical Sciences Research Institute, University Hospitals Coventry and Warwickshire, Clifford Bridge Rd, Coventry, CV2 2DX, UK; damian.griffin{at}warwick.ac.uk

Abstract

Aim During a golf swing, the lead hip (left hip in a right-handed player) rotates rapidly from external to internal rotation, while the opposite occurs in the trail hip. This study assessed the morphology and pathology of golfers’ hips comparing lead and trail hips.

Methods A cohort of elite golfers were invited to undergo MRI of their hips. Hip morphology was evaluated by measuring acetabular depth (pincer shape=negative measure), femoral neck antetorsion (retrotorsion=negative measure) and α angles (cam morphology defined as α angle >55° anteriorly) around the axis of the femoral neck. Consultant musculoskeletal radiologists determined the presence of intra-articular pathology.

Results 55 players (mean age 28 years, 52 left hip lead) underwent MRI. No player had pincer morphology, 2 (3.6%) had femoral retrotorsion and 9 (16%) had cam morphology. 7 trail hips and 2 lead hips had cam morphology (p=0.026). Lead hip femoral neck antetorsion was 16.7° compared with 13.0° in the trail hip (p<0.001). The α angles around the femoral neck were significantly lower in the lead compared with trail hips (p<0.001), with the greatest difference noted in the anterosuperior portion of the head neck junction; 53° vs 58° (p<0.001) and 43° vs 47° (p<0.001). 37% of trail and 16% of lead hips (p=0.038) had labral tears.

Conclusions Golfers’ lead and trail hips have different morphology. This is the first time side-to-side asymmetry of cam prevalence has been reported. The trail hip exhibited a higher prevalence of labral tears.

  • Golf
  • Hip

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