Andy Murray’s famous hip
Over the last six months or so there has been quite extensive media interest in Andy Murray's hip injury. It has been quite well known for a couple of years that Andy suffered from hip issues which at times was very evident to see during his matches, yet still he was able to compete at the highest level and win the games’ biggest prizes.
Andy first underwent surgery back in January 2018, an arthroscopy which is more commonly known as 'keyhole surgery'. This minimally invasive surgery is designed to repair any damage to the hip joint, maybe repair the labrum (a cup like cartilage structure which helps stabilise the hip joint) and more often than not, some bone is shaved off from the ball (of the ball and socket) to allow for more clearance and less impingement of the joint. Whilst Andy managed to get back to paying he was still suffering with pain and couldn't get back to the level he was competing at before. This lead to a second operation earlier this year, a more extensive type of surgery which involved placing a metal cap on top of the ball and a metal surface on the socket side of the joint. The hope is that this will allow Andy to return to tennis, but perhaps more importantly lead a more comfortable life where normal activities of daily living are manageable.
Tennis is an extremely dynamic sport, involving lots of twisting and turning. As the distances are relatively small, but the changes in direction are often sharp and repetitive, this places a lot more stress on the joints than it does on the muscles compared to say a larger area sport, like football. Combined with predominantly hard surfaces, this increase the impact forces through a joint.
The hip joint is by nature a stable joint and, being a ball and socket joint, allows it to cope with such levels of rotation but it also has its limits. Having worked in professional tennis, I know first-hand how much the hips are used. They are often a source of stiffness in tennis players as they recruit so much muscle energy to stop and start, the muscles around the hip get tight and this then stiffens up the joint. There is also a lot of repeated bending forward/lunging, and this means a lot of pressure on the front of the hip joint. If there was already a congenital deformity of the hip which caused impingement, this would easily aggravate it, but equally there is the opinion that that this repetitive nature can also lead to the changes. Even just the action of serving which is performed thousands of times a season is extremely load bearing for the hip. Tennis players do take preventive measures to allow for joint protection by having strict strength and conditioning programmes, as well as having mobility and flexibility routines.
It was definitely the last hope for Andy to try and return to top level tennis. Having been privileged enough to spend time with him during my time working with James Ward, it's no surprise to say that he is one of the most dedicated professionals I have met and he has a great team around him to give him the best possible chance. The jury is out and it could go either way but I know that everyone who follows tennis and sport around the world will be hoping to see him compete again at the major events.
Good luck Andy!
Words by Alex Manos.