Hip Labral Tear

Hip Labral Tear

Article by Z.Russell, I.Kelly, A.Clarke

What is a Hip Labral Tear?

The hip or acetabular labrum is a ridge of cartilage that runs around the rim of your hip joint socket. Its purpose is to make the hip socket deeper and more stable. The labrum can be torn from its attachment and cause pain, clicking or catching.

What Causes of a Hip Labral Tear?

The labrum can tear for many reasons. Some people tear their labrum from falls or sporting injuries when you force your hip into extreme positions. Repetitive trauma in sports that require regular rotation of the hip — like golf, soccer, hockey, and ballet, can lead to a torn hip labrum.

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.

Hip Labral Tear Symptoms

What does a hip labral tear feel like?

Some people experience no pain from a hip labral tear, but most will feel pain or ache in their groin, over the lateral hip, or deep in their buttock region. Acetabular labrum tears often cause a feeling of the leg “catching” or “clicking” in the hip socket as you move it. It may also feel like the hip is locking up. Some people get a feeling of giving way within the hip joint.

How is a Labral Tear Diagnosed?

hip labral tear

Your clinical diagnosis of a hip labral tear is a combination of symptoms, clinical signs, for example, a restricted range of movement. It is difficult to get a specific diagnosis without an MRI or MRA (a unique MRI looking at joints and requiring injection into the joint) or by arthroscopic hip surgery.

Please consult your hip physiotherapist or surgeon for their professional opinion regarding your hip labrum.

Hip Labral Tear Treatment

Phase I – Reduce Pain & Protect Your Labrum

In most cases, you need to start treating your labral injury straight away by resting your hip and avoiding those aggravating activities.

You should avoid sitting:

  • with knees lower than your hips.
  • with legs crossed or sitting on your legs with hip rotation.
  • on the edge of the seat and contracting the muscles that flex your hips.

You should also avoid overextending your hip.

Hip Labral Tear Exercises

Hip labral tear exercises commence in phase two.

Phase II – Restore Flexibility & Strength

  • Have your biomechanics, joint and muscle function assessed by your physiotherapist.
  • Restore any limited joint range-of-motion.
  • Improve your soft tissue muscle length and resting tension.
  • Activate your deep stability muscles.
  • Progressively strengthen your intermediate and superficial muscles.
  • Enhance your proprioception and joint position sense.

Phase III – Return to Activity or Sport

  • Aim to improve your functional activities of daily living (ADLs) via goal-focused exercises.
  • Graduate through a return to sport program that is specific to your needs.
  • Agility, speed, power, and sport-specific drills.
  • Modify your return to sport under the advice of your physiotherapist or doctor.
  • Many hip labral tears responded favourably to conservative exercise-based treatment, but some will need hip labral repair surgery.

Hip Surgery for Labral Tears

A percentage of hip labral tears will require surgery to stop the pain and clicking. The procedure should also improve hip joint integrity, which should reduce the future degeneration associated with labral tears.

Surgery involves re-attaching the labrum and occasionally debriding (taking away the torn section) of the labrum. You will require post-operative hip labral repair rehabilitation. Under the guidance of your physiotherapist and surgeon, they will prescribe your exercise regime to facilitate your safe return to sport.

Hip Pain Treatment

A thorough analysis of WHY you are suffering hip pain from a movement, posture, or a control aspect, is vital to solving your hip pain.Only an accurate diagnosis of the source of your hip pain can solve the pain, quickly improve your day to day function, prevent a future recurrence,  or improve your athletic performance.The first choice of short-term therapy has been symptomatic hip treatment. This approach could include local chemical modalities such as cortisone injections or painkillers. Ice or heat could also assist along with some gentle stretching or exercise.However, persisting hip problems will require additional investigations to assess your joint integrity or range of motion, muscle length, strength, endurance, power, contraction timing and dynamic stability control.You should consult a healthcare practitioner who has a particular interest in hip pain and injury management, to thoroughly assess your hip, groin, pelvis, lower limb and spine. Due to the kinetic chain, they all have an impact, especially at the high athletic performance end. A quality practitioner will specifically educate you regarding your condition and combine with exercise and manual therapy as per the Clinical Practice Guidelines. (Cibulka et al., 2017) Hip pain education should also include teaching you specific activity modification, individualised exercises, weight-loss advice (if required), and methods to unload any arthritic joints.Recent research evidence-backed approaches have modernised physiotherapy treatment approaches to effectively managing hip pain. Together with a thorough hip assessment, your hip treatment can progress quickly to restore you to a pain-free hip and perform your regular sport or daily activities in the shortest time possible.For specific rehabilitation advice regarding your hip pain, seek the professional advice of high quality and up-to-date physiotherapist experienced in the assessment, treatment, prevention and optimisation of hip pain and related conditions. After assessing you, they will individually prescribe therapeutic activities based on your specific needs for daily living, values, and functional activities or point you in the direction of the most suitable healthcare practitioner for you and your hip condition.

Hip Pain Treatment Options

Your hip physiotherapist may consider an extensive range of treatment options including manual joint therapy to improve your joint mobility, muscle stretches or supportive taping. Your physiotherapist is also likely to add strengthening and joint control exercises as they deem appropriate for your specific functional and sporting needs.Please click the links below for more information about some of the conventional hip treatments that your physiotherapist may recommend or utilise for your hip pain.