What is happening inside the hip?
The femoral neck is the narrow section connecting the ball of your hip joint to the long shaft of your thigh bone. With repeated high-impact loading — running, sprinting, contact landings — small areas of the bone can develop micro-damage faster than the body can repair it. The result is a stress reaction that, if loaded further, becomes a stress fracture.
Stress fractures here are classified by where the crack sits. A fracture on the lower (compression) side of the neck is squeezed back together with weight-bearing and tends to heal more predictably. A fracture on the upper (tension) side is pulled apart with weight-bearing and carries a much higher risk of progressing to a displaced fracture that needs surgery.
Signs you should not ignore
- Deep groin or front-of-hip pain that builds over weeks, not from a single tackle
- Pain that worsens with running, jumping, or carrying weight, and eases with rest
- A noticeable limp or shortened stride after training
- Pain when standing on the affected leg or at the extremes of hip movement
- Night pain or pain at rest in more advanced cases
Why some players are more at risk
Stress fractures rarely come from training alone. Most cases involve a combination of high training load, low energy availability (eating less than the body uses), poor bone mineral density, or a recent change in footwear, surface, or running volume. Female athletes and adolescents with rapid growth phases are at higher relative risk.
| Risk factor | Why it matters |
|---|---|
| Sudden training-load jumps | Bone needs weeks to remodel to new loads |
| Low energy availability | Bone formation slows when fuel is short |
| Previous stress fracture | Past injury predicts future risk in the same region |
| Disordered eating or RED-S | Hormonal and bone effects compound load risk |
| Family history of low bone density | Lower baseline bone strength |
| Vitamin D deficiency | Impaired bone mineralisation |
What happens at the clinic
A sports doctor or physio will take a careful history — when the pain started, how training has changed, eating patterns, menstrual history where relevant — and examine the hip. Tests like single-leg hopping or end-range hip movements often reproduce the pain. They will usually order an MRI rather than rely on a plain X-ray.