Hip pain in teenagers is common and can manifest in various areas, including the front of the hip or groin, the outer hip, or the buttock region. The adolescent years, marked by rapid growth spurts and high-intensity sports, create a unique environment where the musculoskeletal system is susceptible to injury. Understanding the underlying causes is important, as some conditions are minor while others require immediate medical attention to prevent long-term damage. Because of open growth plates and increased physical stress, a teen’s hip pain must be assessed differently than an adult’s.
Growth Plate and Developmental Concerns
The most serious causes of hip pain during adolescence relate to the open growth plates, which are areas of cartilage near the ends of bones that allow for linear growth. This cartilage is structurally weaker than the surrounding bone and is a common site of injury. The most significant condition in this age group is Slipped Capital Femoral Epiphysis (SCFE), which typically affects children between the ages of 10 and 16.
SCFE occurs when the top of the thigh bone (the femoral head) slides backward off the neck of the femur at the growth plate. This slippage happens because the growth plate is temporarily weakened during a growth spurt. The condition can develop gradually (stable SCFE) or occur suddenly (unstable SCFE), but both types require surgical stabilization to stop further progression.
A frequent challenge with SCFE is that the pain is often felt not in the hip itself, but is referred down the leg to the thigh or the knee. Any adolescent with unexplained knee or thigh pain must have their hip examined to rule out SCFE. A delay in diagnosis can lead to more severe slippage and complications, making early recognition of this referred pain pattern important.
Overuse and Repetitive Stress Injuries
Many instances of hip pain in active teenagers stem from chronic, repetitive motions that lead to inflammation of soft tissues surrounding the joint. These issues, known as overuse injuries, develop over time rather than from a single traumatic event. A common example is hip flexor tendonitis, which causes pain in the front of the hip or groin due to inflammation of the iliopsoas tendon. This condition is frequently seen in athletes in sports requiring repeated hip flexion, such as running, dancing, or soccer.
Another common overuse injury is trochanteric bursitis, which presents as pain on the outer side of the hip. The trochanteric bursa is a fluid-filled sac that cushions the large bony prominence on the side of the thigh bone. Repetitive friction from overlying tendons, such as the iliotibial band, can cause this bursa to become inflamed. Muscle strains, or “pulled muscles,” also fall into this category, developing when muscles surrounding the hip, like the hamstrings or quadriceps, are gradually overloaded through intense training.
These chronic issues often relate to a rapid increase in training intensity or volume, or underlying muscle imbalances. Unlike the structural concerns of the growth plate, overuse injuries respond well to rest, physical therapy, and activity modification. The pain is intermittent and worsens with the specific activity causing the irritation.
Acute Trauma and Referred Pain
Pain that begins suddenly, often during a specific movement or incident, points toward an acute traumatic injury. One injury unique to the adolescent skeleton is the avulsion fracture, where a forceful muscle contraction pulls a piece of bone away from the pelvis at an attachment point. Because the tendons can be stronger than the still-soft growth centers (apophyses), explosive actions like sprinting, jumping, or kicking can cause this type of fracture.
Another acute possibility is a labral tear, which involves the ring of cartilage that lines the hip socket and provides stability. These tears can occur from a twisting motion, a fall, or a direct impact during sports. Symptoms often include a sharp pain in the groin and sometimes a clicking or locking sensation within the joint.
Beyond direct injury, pain felt in the hip may not originate there; this is known as referred pain. Serious hip conditions can be felt solely in the knee or thigh due to shared nerve pathways. Additionally, issues in the lower back or sacroiliac joint can cause discomfort that is perceived as hip or buttock pain.
Recognizing Warning Signs and When to See a Doctor
While many hip aches are simple muscle soreness, certain symptoms should prompt an immediate medical evaluation. The inability to bear weight on the affected leg, or pain so severe that it causes a noticeable limp, suggests a more serious underlying bone or joint problem. This mechanical inability to walk is a potential sign of an unstable fracture or significant slippage of the growth plate.
Pain accompanied by systemic symptoms, such as a fever, chills, or significant warmth and swelling around the joint, requires urgent medical attention, as this can indicate an infection within the hip joint itself. Pain that consistently wakes the teenager from sleep, or pain that does not improve after 7 to 10 days of rest, is also a warning sign. Timely diagnosis is important to ensure the best possible long-term hip health, especially given the risk of serious growth plate issues like SCFE.