Practice Location:
James R. Urbanik MD,
Sports Sciences Institute
3475 Erwin Road
Durham, NC 27707
Orthopaedic Surgeon | Sports Medicine | Hip Specialist
Conditions Treated
Hip Conditions
The labrum is a ring of cartilage that lines the hip socket or acetabulum. It provides stability for the hip joint and is also responsible for distributing pressure in the hip during physical activity.
The labrum can tear for many reasons including direct trauma, femoracetabular impingment (FAI), or hip instability. Not every labrum tear causes hip pain. Learn more about the labrum in the Patient Education section.
Your hamstring is a group of three muscles that run from the back of the pelvis to the knee. Strains occur when the muscle is overstretched but does not tear. These can heal over time on the own with rest and rehabilitation.
Partial or Complete hamstring avulsions can require surgery in select instances. Learn more about hamstring injuries in our Patient Education section.
Iliopsoas impingement occurs when the tendon of the strong iliopsoas muscle slides painfully across the front of the hip joint. This condition can occur after a hip replacement or in very flexible individuals. Over time, chronic impingement can cause damage to the iliopsoas tendon.
Femoracetabular Impingement or FAI is a condition in which the neck of the femur hits against the bone of the hip socket or acetabulum. Over time this rubbing or impingement can lead to damage of the labrum and hip cartilage.
The hip is supported by the gluteal muscles or buttocks. These strong muscles are responsible for keeping the pelvis stable as you walk and run. As we age the gluteal muscles can become weak and tear where they connect to the femur bone on the side of the hip. Similar to a rotator cuff injury in the shoulder, these injuries can require physical therapy, injections, and even surgery to regain function.
During hip arthroscopy the capsular ligaments are cut in order to see inside the joint. After surgery some patients bodies will have difficulty healing the capsule back together, or can create too much scar tissue leading to continued pain and discomfort after surgery. This problem is rare but requires special techniques to diagnose and correctly treat.
Painful snapping in the hip can be from several causes. Internal Snapping Hip occurs from the iliopsoas tendon rubbing across the hip joint. External Snapping Hip occurs when the Iliotiobial Band (ITB) slides across the side of the greater trochanter of the femur bone. Both diagnoses can often be treated with specialized rehabilitation, but in some cases can require surgery.
Ischiofemoral Impingement (IFI) is a rare condition in which the side of the femur bone collides with the bottom of the pelvis (ischium bone) during activity. Prior surgery, bone structure, and changes in walking pattern or gait can all contribute to this condition occurring.
Dr. Scott supports local high school and collegiate athletics. She is the team physician for the Duke University Fencing Team and also provides specialized hip musculoskeletal care for athletes on all teams at the university. She provides treatment for injuries of the shoulder, knee, ankle, and hip for her team athletes.
Borderline Dysplasia is a condition in which the hip socket is slightly shallow. It is a diagnosis made by measuring the hip socket on xrays and other imaging scans. Although some people with borderline dysplasia will live their entire lives with no hip problems, other people will begin to develop hip pain and dysfunction related to the shallow hip socket. A hip preservation specialist is required to determine if borderline dysplasia is present and what role it may be playing in your hip pain.
Hip conditions including traumatic injury, impingement or dysplasia can cause damage to the cartilage of the hip socket and head of the femur. Continued damage to the cartilage over time is referred to as arthritis. The goal of hip preservation surgery is to intervene before arthritis is present to prolong the life of the hip and alleviate pain and dysfunction.
Knee & Shoulder Conditions
The meniscus is a firm c-shaped ring of cartilage which acts as a shock absorber in the knee. Tears can create pain, clicking, locking and mechanical symptoms. Some children are born with abnormally shaped mensci, called "discoid meniscus" which can cause knee pain and swelling in childhood or adolescence.
The quadriceps is the strong group of muscles which attach to the kneecap to extend the knee. As we age, we become more likely to experience tears or other damage to the quadriceps tendon. A fully torn tendon requires urgent surgery to reattach the muscles to the kneecap.
The Anterior Cruciate Ligament (ACL) is an important stabilizer of the knee critical for maneuvers like twisting, pivoting, and cutting. ACL tears are a common injury in active adolescents and adults. Children and adolescents in particular require specialized techniques for reconstructing the ligament without damaging the growth plates of the shin and thigh bone.
Instability of the kneecap as the knee flexes and extends can result in recurrent pain and swelling in the front of the knee. Dislocation of the kneecap can occur, which may require surgery to stabilize. Factors such as extreme flexibility, alignment of the femur and shinbone, and the shape of the kneecap can all contribute to these injuries.
Chronic Exertional Compartment Syndrome (CECS) results in pain, swelling, tingling and numbness in the lower leg with physical activity. This condition is diagnosed by measuring the pressures in the muscular compartments of the leg during and after exercise.
Osteochondritis Dissecans (OCD) is a condition of cartilage which affects children and adolescents; it most commonly occurs in the knee and elbow. If left untreated these injuries can worsen over time, eventually leading to early-onset arthritis.
Damage to the patellar tendon can occur from sports with repetitive jumping or sprinting, such as basketball, gymnastics, and football. In rare cases the patellar tendon can tear, requiring emergent surgery to reattach the tendon.
Active pre-teens and adolescents are particularly at risk for injuries to the growth plates in the bones of the skeleton. Growth plate injuries are common in the shoulder, hip, and knee, but can occur in other places in the body as well. These injuries require evaluation and management by a physician trained in these disorders. Rest, rehabilitation, or surgery may ultimately be required.
A shoulder dislocation or subluxation can occur from sudden trauma to the shoulder such a hard fall or tackle. When this occurs, the labrum surrounding the shoulder socket is often damaged, making it easier for the shoulder to re-dislocate in the future. Hyperflexibility conditions such as Ehlers Danlos Syndrome can also cause excessive motion in the shoulder joint leading to pain, catching, and a feeling of instability.
Active children and adults alike can develop stress injuries in the bones of the lower or upper body from repetitive use. Sports that are played year-around are a risk factor for these injuries. Lower body stress injuries are common in runners and dancers; upper body stress injuries can be seen in baseball and other year-around sports, however any kind of athlete can develop a bone stress injury.