Hip Labral Tear
The hip or acetabular labrum is a thin ridge of cartilage that runs around the edge or rim of your hip joint socket. A Hip Labral Tear can occur when the labrum is torn from its attachment and cause pain, clicking or catching.
The purpose of the acetabular labrum is to make the hip socket deeper and more stable.
Pain is usually deep, although may present as vague groin pain. Symptoms are usually exacerbated with weight-bearing and twisting activities.
What are the causes of a Hip Labral Tear?
The hip labrum can tear for many reasons.
Some people tear their labrum traumatically from falls or sporting injuries when the hip is forced into extreme positions. It can also be damaged by repetitive micro-trauma in sports that require regular rotation of the hip – like golf, soccer, hockey, and ballet. This can be exacerbated with conditions such as Femero-Acetabular Impingement (hyperlink to specific page) which exaggerate the damage to the labrum due to the abnormal shape of the hip bones. Studies show that up to 22% of athletes who complain of groin pain have a labral tear in the hip. However, almost 75% of cases of torn acetabular labrum have no known direct cause.
How is a Hip Labral Tear diagnosed?
Labral tears can be diagnosed by an experienced Musculoskeletal or Sports Physiotherapist through careful examination of a combination of signs and symptoms. These can include the location of the pain, the activities that make the problem worse (such as running, deep squatting, getting out of cars) and pain on specific range of motion tests of the hip joint. It can be difficult to get a specific diagnosis without investigations such as a MRI which, if required, can be arranged through our network of Sports Physicians or Orthopaedic Surgeons.
If you have persistent groin pain that is not improving with conservative treatment, you should contact Leading Edge to have one of our experienced physiotherapists examine your hip to determine if you may indeed have an undiagnosed hip labral tear.
How do you treat a Hip Labral Tear?
The hip labrum has a poor blood supply – this means that if there is a tear in the labrum or if it partially separates away from the edge of the hip socket, it is unlikely to heal. This can lead to persistent inflammation in and around the socket.
The first thing to do when managing this condition is to control the inflammation within the joint. This requires rest from the aggravating activities such as deep squatting, cutting/twisting activities, prolonged sitting in low chairs. It may also require a visit to our network of Sports GPs or Orthopaedic surgeons for anti-inflammatory medications.
If the inflammation is controlled and the joint “settles down” you can function quite well with a torn hip labrum – as long as the cause of the tear is addressed. The most common cause (apart from traumatic tears) is repetitive micro-trauma. This can occur either as a result of Femoro-Acetabular Impingement and/or Poor Hip Control repetitively pinching and irritating the labrum.
Your Leading Edge physiotherapist will prescribe a series of progressive and tailored rehabilitation exercises to address the hip control issues identified in your assessment to reduce the amount of impingement on the hip. They will then provide a progressive return to sport plan that will help you return to sport as soon and as safely as practical.
If conservative management fails and there is persistent pain and clicking, surgical repair may be required. The procedure also aims improve the hip joint shape and integrity, which should reduce the future degeneration associated with labral tears and femoro-acetabular impingement.
Surgery involves re-attaching the labrum and occasionally debriding (taking away the torn section) of the labrum and any thickening of the bones around the joint causing the femoro-acetabular impingement. You will require post-operative hip rehabilitation under guidance of your Leading Edge physiotherapist and surgeon to facilitate your safe return to sport.
I think I have a Hip Labral Tear, what should I do right now?
To help your injury resolve as fast as possible:- avoid or modify activities and positions, which cause your pain. Recovery is easier if you stop irritating the hip.
- avoid sitting with knees higher than your hips.
- avoid sitting with legs crossed or sitting on you legs so that the hip is rotated.
- avoid sitting on the edge of the seat and contracting the muscles that flex your hips.