Seattle Seahawks quarterback Sam Darnold's right hip injury went from a feared fracture to a muscle problem in less than a day, and the way the team reached that answer mirrors what doctors do for anyone who takes a hard fall onto the hip. Imaging comes first, because the treatment for a broken bone and a strained muscle is very different.

Darnold was sacked by New England's Dre'Mont Jones on Seattle's opening drive of the Sept. 9 season opener and did not return. He had X-rays and a CT scan at Harborview Medical Center in Seattle, and coach Mike Macdonald said after Seattle's 13-10 win that a fracture had been ruled out. Darnold then had an MRI on his right hip the next morning.

"The hip is intact, and it's good," Macdonald said the next day on Seattle Sports 710 radio, describing the injury as more of a muscle issue, NBC Sports' Pro Football Talk reported. He said he could not yet say how long Darnold would be out.

The Team's Update and What Remains Unconfirmed

The Seahawks have not released a formal diagnosis or a return date. Macdonald said the team was still working through test results and trying to determine the best prognosis. He also acknowledged the injury was painful.

NFL Network's Ian Rapoport reported that Darnold is expected to miss Seattle's Sept. 20 game at Arizona but could miss just a few weeks, and NFL insider Tom Pelissero described an unusual muscle strain in the hip area, according to Bleacher Report. The team has not confirmed which muscle is involved or how severe the injury is. Seattle does have some breathing room, since its next game comes 11 days after the opener.

MedicalDaily is not diagnosing Darnold. His case is useful only as an illustration of a common sequence: rule out structural damage to the bone, then treat the soft tissue.

Imaging Decides Between Fracture and Strain

After a hard impact, the first question is whether the bone is broken. According to the American Academy of Orthopaedic Surgeons' patient site, OrthoInfo, most hip fractures can be diagnosed with an X-ray.

X-rays do not catch everything. The AAOS says a very sensitive MRI can sometimes detect a small or incomplete fracture that cannot be seen on an X-ray, and a CT scan can give doctors a detailed cross-sectional view when they need more information about a break.

That is why a normal first X-ray does not always end the workup when pain is severe or a person cannot bear weight. Doctors may order more imaging before calling an injury a strain.

Muscle injuries follow a different path. In its guidance on muscle strains in the thigh, the AAOS says a grade 1 strain is mild and usually heals fairly quickly, while a grade 3 strain is a severe tear that may take months to heal. Most strains are treated with rest, ice, compression, and elevation, followed by physical therapy as pain and swelling ease. The group says recovery can take 10 days to 3 weeks for a mild strain and up to 6 months for a severe one, and the muscle should be at full strength and pain-free before a return to sports.

Older Adults Face the Highest Fracture Risk

For most readers, the stakes of a hip injury are not a playing schedule but independence. The CDC has reported that at least 300,000 older people are hospitalized for hip fractures each year, that more than 95% of hip fractures are caused by falling, usually sideways, and that women account for about three-quarters of hip fractures.

A young athlete absorbing a high-energy hit and an older adult slipping in a kitchen can both break a hip, but their bones are not equally strong. The AAOS says most hip fractures occur in people 65 or older, and in patients with weakened bones even a simple twisting or tripping injury can cause one.

Signs that point toward a fracture include pain in the groin or upper thigh, being unable to stand or put weight on the leg, and an injured leg that looks shorter than the other or is turned inward or outward, according to the AAOS. Some fractures are less painful at first, and a person may still be able to bear some weight.

Anyone with those signs after a fall should not try to walk it off. Call 911 or go to an emergency department, and avoid moving an older adult who cannot get up.

Practical Steps After a Hard Hip Impact

Milder symptoms, such as soreness that still allows walking, bruising without deformity, or pain that improves over a day or two, can often be evaluated at urgent care or by a primary care doctor. Many urgent care centers can take X-rays the same day.

Tell the clinician exactly how the injury happened and whether you can bear weight. If an X-ray is normal but pain remains severe, ask whether an MRI is needed. An MRI may require prior authorization from an insurer, so a clear record of symptoms can help support the request.

Cost can be a barrier. People without insurance can ask about self-pay imaging prices, which vary widely, and community health centers can often evaluate an injury and arrange referrals using a sliding fee scale.

For a confirmed strain, follow the rehabilitation plan and resist returning to full activity too early. For older adults, a fall is also a reason to ask a doctor about bone density testing, medications that affect balance, and fall hazards at home.

Darnold's return will depend on how his injury responds to treatment, and Seattle has not set a date. For everyone else, the lesson from his week is simple: after a hard fall on the hip, find out whether the bone is intact before deciding how to heal.

Key Questions Answered

What happened to Sam Darnold? He injured his right hip when he was sacked on Seattle's opening drive on Sept. 9. Tests ruled out a fracture, and his coach described the injury as more of a muscle issue.

When will he return? The Seahawks have not given a timeline. NFL Network reported he is expected to miss the Sept. 20 game at Arizona and could miss just a few weeks.

Why do doctors order imaging after a hip injury? To rule out a fracture, which is treated very differently from a muscle strain. X-rays come first, and MRI can find some fractures that X-rays miss.

Can an X-ray miss a hip fracture? Sometimes. The AAOS says MRI can detect a small or incomplete fracture that cannot be seen on an X-ray.

How long does a muscle strain take to heal? The AAOS says mild strains can heal in about 10 days to 3 weeks, while severe strains can take up to 6 months.

What are signs of a broken hip after a fall? Pain in the groin or upper thigh, inability to stand or bear weight, and a leg that looks shorter or turned.

Who is most at risk of a hip fracture? Older adults, especially women and people with weakened bones. More than 95% of hip fractures are caused by falls, according to the CDC.