title: Gender-Dependent Differences in Hip Range of Motion and Impingement Testing in Asymptomatic College Freshman Athletes.
abstract: BACKGROUND
  Athletic activity is a proposed factor in the development and progression of intra-articular hip pathology. Early diagnosis and preventive treatments in "at-risk" athletes are needed.
  
  
  OBJECTIVE
  Our primary objective was to report hip range of motion (ROM) and prevalence of positive impingement testing in asymptomatic college freshman athletes. Our secondary objective was to determine whether an association exists between hip ROM and a positive flexion-adduction-internal rotation (FADIR) test.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Collegiate athletic campus.
  
  
  METHODS
  Four hundred thirty (299 male, 131 female) freshman athletes reporting no current or previous hip pain.
  
  
  METHODS
  During the athletes' preseason medical screening, trained examiners performed a hip-specific exam to obtain data for hip ROM and impingement testing.
  
  
  METHODS
  Bilateral passive ROM measures included hip flexion, and hip internal and external rotation with the hip flexed 0° and 90°.
  
  
  RESULTS
  Mean age of male participants was 18.5 ± 0.8 and female participants was 18.3 ± 0.6 years (P = .003). Male participants demonstrated less hip ROM than female participants in flexion (115.8 ± 11.2° versus 122.0 ± 10.5°, P < .001), internal rotation in 90° flexion (26.9 ± 9.8° versus 34.7 ± 10.7°, P < .001) and 0° flexion (29.0 ± 9.8° versus 38.9 ± 10.1°, P < .001), and external rotation in 90° flexion (44.7 ± 10.9° versus 49.7 ± 10.4°, P < .001) but not for external rotation in 0° flexion (39.8 ± 11.1° versus 37.6 ± 11.5°, P = .06). Pain with FADIR test on the right and left hip were reported in 11.9% and 14.5% of athletes, respectively. Gender and a positive FADIR were not related (male 12.2%, female 15.3%, P = .36).
  
  
  CONCLUSIONS
  In asymptomatic college freshman athletes, male athletes generally demonstrated less hip ROM than female athletes. In addition, a positive FADIR was more prevalent than previously reported in healthy young adults. Preseason screenings that use these baseline data in conjunction with other examination findings may allow identification of athletes at future risk for hip pain and/or injury.
  
  
  METHODS
  IV.
authors.affiliation: Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, 4444 Forest Park Avenue, Campus Box 8502, St. Louis, MO 63108(∗). Electronic address: czuppons@wustl.edu.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Czuppon
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO(†).
authors.forename: Heidi
authors.initials: H
authors.lastname: Prather
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO(‡).
authors.forename: Devyani M
authors.initials: DM
authors.lastname: Hunt
authors.affiliation: Division of Biostatistics, Washington University, St. Louis, MO(§).
authors.forename: Karen
authors.initials: K
authors.lastname: Steger-May
authors.affiliation: Division of Biostatistics, Washington University, St. Louis, MO(¶).
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Bloom
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO(#).
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.affiliation: Department of Athletics, Washington University, St. Louis, MO(∗∗).
authors.forename: Richard
authors.initials: R
authors.lastname: Larsen
authors.affiliation: Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO(††).
authors.forename: Marcie
authors.initials: M
authors.lastname: Harris-Hayes
mesh_terms: D000293:Adolescent; D056352:Athletes; D003430:Cross-Sectional Studies; D005260:Female; D057925:Femoracetabular Impingement / Q000503:physiopathology / Q000517:prevention & control*; D064368:Healthy Volunteers; D006621:Hip Joint / Q000502:physiology*; D006801:Humans; D008297:Male; D010808:Physical Examination / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012737:Sex Factors