Football hip injuries are the most talked about story in the NFL this week, and the questions reaching my clinic have nothing to do with Seattle. They come from parents in Franklin, high school linemen in Columbia, and weekend flag football players around Nashville who felt something pull in the groin and now want to know how worried to be.
Here is what I tell them. The hip is a deep joint wrapped in thick muscle, so an injury that looks dramatic on television is usually a muscle problem. A much smaller group involve the joint itself, and sorting the two apart is most of the work.
What happened to Sam Darnold’s hip?
Seattle Seahawks quarterback Sam Darnold injured his right hip on a sack during the first drive of the September 9, 2026 season opener, and imaging ruled out a fracture. He limped off, went to the sideline medical tent, and was ruled out before halftime.
A CT scan that night showed no break in the bone. After further testing, Seattle’s head coach described the hip as intact and the problem as a muscle issue, and reporting has indicated Darnold is expected to miss at least one game.
A sports medicine physician who reviewed the tackle on video raised the possibility of a labral tear at the back of the socket. The team has not confirmed that. Video is not a diagnosis.
I have no role in his care and have never seen his images. His case is useful because the same sequence plays out every fall in Middle Tennessee.
What are the most common football hip injuries?
The most common football hip injuries are muscle strains, and groin strains lead the list by a wide margin. A 10-year surveillance study of college football recorded 1,618 hip injuries, with adductor strains accounting for 38.6 percent, hip flexor strains 28.6 percent, and hip contusions 18.2 percent.
Most were noncontact, cost less than six days of playing time, and never required surgery. In the NFL, a 10-season review found hip injuries made up 3.1 percent of all reported injuries, with an average of 12.3 days lost each.
Adductor strain (the groin pull)
An adductor strain is a stretch or tear of the inner thigh muscles that pull the leg toward the midline. Players feel a sharp catch high in the groin during a cut, a kick, or a hard change of direction.
Pain sits along the inner thigh. It gets worse when the athlete squeezes the knees together against resistance, and that one test tells me a great deal in about five seconds.
Hip flexor strain
A hip flexor strain involves the muscles at the front of the hip that lift the thigh, most often the iliopsoas (the deep hip flexor running from the low back to the thigh bone) or the rectus femoris (the quadriceps muscle that crosses both hip and knee). Sprinting and kicking are the classic mechanisms.
Pain shows up at the front of the hip or in the crease where the leg meets the torso, and it flares when the athlete lifts the knee against pressure. I have written a fuller breakdown of hip flexor strain symptoms and treatment.
Hip pointer (hip contusion)
A hip pointer is a deep bruise over the bony ridge at the top of the pelvis, caused by a direct hit or a hard landing. It hurts out of proportion to the damage because the tissue there is thin and the blow lands on bone. Most settle in one to three weeks with padding, ice, and limited activity.
What is a hip labral tear, and why does it concern surgeons?
A hip labral tear is a tear in the labrum, the ring of cartilage that seals the rim of the hip socket and helps hold the ball of the thigh bone in place. It matters because the labrum sits inside the joint, where healing is slower and rehabilitation alone is less reliable.
Joint injuries are the minority of football hip injuries. In that NFL series, only about 5 percent were intra-articular, meaning a fracture, a labral tear, or an instability event inside the joint. Those produced the longest absences.
One pattern is worth knowing. That same NFL study described a “sports hip triad”: a labral tear, an adductor strain, and a rectus femoris strain together. The authors noted that players with labral tears often carried groin strains that would not settle with therapy.
So a groin strain that refuses to heal is sometimes just a groin strain. Sometimes it is a joint problem wearing a muscle costume.
What does a hip labral tear feel like?
Deep groin pain is the hallmark. Patients often cup the front and side of the hip with a thumb and fingers when I ask them to point to it, and clicking, catching, or a sense of giving way raises my suspicion.
Symptoms worsen with deep bending, twisting, and long stretches of sitting. Many tears build up from repeated impingement rather than one violent play, which is why hip impingement (FAI) and labral tears are discussed together.
How do doctors tell a muscle strain from a labral tear?
The exam separates most of them and imaging confirms the rest. Muscle injuries hurt when the injured muscle contracts against resistance or stretches; joint injuries hurt when the hip is bent, brought across the body, and rotated inward.
Imaging follows a sequence. X-rays come first to check bone alignment and impingement shape. A CT scan is used right away after a violent injury to rule out a fracture or a dislocation, which is the test that cleared Darnold on game night.
MRI shows the soft tissue, and it is how football hip injuries get their final label. An MR arthrogram, which adds contrast dye inside the joint, is the most sensitive way to see a labral tear. The American Academy of Orthopaedic Surgeons grades strains from 1 to 3 by how much tissue is torn.
How long do football hip injuries take to heal?
Recovery ranges from a few days for a mild strain to roughly seven months after surgical repair of the labrum. Grade matters more than the name of the injury.
Recovery timelines for common football hip injuries
- Grade 1 strain: a few days to about two weeks
- Grade 2 strain (partial tear): three to six weeks
- Grade 3 strain (complete tear or bony avulsion): two to three months, and surgery is occasionally considered
- Hip pointer: one to three weeks
- Labral tear treated without surgery: a rehabilitation trial of six to twelve weeks
- Arthroscopic labral repair: return to sport usually takes six to nine months, and football series report return rates around 80 to 90 percent
Those numbers describe elite athletes with daily access to a training staff. A high school running back in Spring Hill and a 45-year-old in a Nashville rec league heal on a slower clock.
Here is what I tell my patients about rushing back. Re-injury rates climb when an athlete returns before strength on the hurt side matches the other leg.
Symmetry beats the calendar.
When should hip or groin pain be evaluated?
Any athlete who cannot bear weight after a hip injury should be seen the same day. These findings also move an injury out of the wait-and-see category:
- A pop or tearing sensation at the moment of injury, with rapid swelling or bruising
- Groin pain that has not improved after three to four weeks of rest and rehabilitation
- Deep groin pain with clicking, catching, or locking
- A hip that feels unstable or gives way
- Pain at rest or pain that wakes the athlete at night
- Numbness, tingling, or a leg that looks rotated or shortened after a collision
One more point about young players. A hard contraction can pull a fragment of bone off the pelvis at the growth plate instead of tearing the muscle. It looks like an ordinary groin pull, so a teenager with a sudden severe groin injury needs an X-ray.
What does this mean for athletes in Middle Tennessee?
Most football hip injuries in Franklin, Nashville, Columbia, and the surrounding towns get better with a structured plan and time. The small number that do not should not be ignored for a season.
After more than twenty years in practice, the cases I remember are rarely the dramatic ones. They are the athletes who limped through four months of “it is just a groin pull” and turned up with a joint problem that had been there all along.
My surgical practice is hip and knee replacement, and I perform more than 700 joint replacements a year. I also see and evaluate hip and groin injuries in our general orthopaedic clinic at the Bone and Joint Institute of Tennessee. When an athlete needs arthroscopic labral surgery, I hand that patient to a fellowship-trained sports medicine partner in the same building.
To schedule an evaluation: Dr. Cory Calendine sees patients at the Bone and Joint Institute of Tennessee, 3000 Edward Curd Lane, Franklin, TN 37067. Call (615) 791-2630 or request an appointment online.
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Medical disclaimer
This article is for education only and does not replace professional medical advice, diagnosis, or treatment. Dr. Calendine has no involvement in the care of any athlete named here, and nothing above is a diagnosis. Always consult a qualified provider about your own symptoms. Individual results vary.
