Hip Labral Tear

Hip Labral Tear


Article by S. Armfield, Z.Russell

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.

Acute Injury Signs

Acute Injury Management.

Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.

For detailed information on specific injuries, check out the injury by body part section.

Don't Ignore these Injury Warning Signs

Joint Pain

Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.

Tenderness

If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.  

Swelling

Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.

Reduced Range of Motion

If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.

Weakness

Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.

Immediate Injury Treatment: Step-by-Step Guidelines

  • Stop the activity immediately.
  • Wrap the injured part in a compression bandage.
  • Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
  • Elevate the injured part to reduce swelling.
  • Consult your health practitioner for a proper diagnosis of any serious injury.
  • Rehabilitate your injury under professional guidance.
  • Seek a second opinion if you are not improving.

Article by John Miller

Elite Sports Injury Management

You probably already know that a sports injury can affect not only your performance but also your lifestyle. The latest research continues to change sports injury management considerably.  Our challenge is to keep up to date with the latest research and put them to work for you.

How we treated you last year could vary significantly from how we treat you this year. The good news is that you can benefit considerably from our professional knowledge.

What Should You Do When You Suffer a Sports Injury?

Rest?

Rest from painful exercise or a movement is essential in the early injury stage. "No pain. No gain." does not apply in most cases.  The rule of thumb is - don't do anything that reproduces your pain for the initial two or three days.  After that, you need to get it moving, or other problems will develop.

Ice or Heat?

We usually recommend avoiding heat (and heat rubs) in the first 48 hours of injury. The heat encourages bleeding, which could be detrimental if used too early. In traumatic injuries, such as ligament sprains, muscle tears or bruising, ice should help reduce your pain and swelling.

Once the "heat" has come out of your injury, you can use heat packs. We recommend 20-minute applications a few times a day to increase the blood flow and hasten your healing rate. The heat will also help your muscles relax and ease your pain. If you're not sure what to do, please call us to discuss your situation specifically.

Should You Use a Compressive Bandage?

Yes. A compressive bandage will help to control swelling and bleeding in the first few days.  In most cases, the compressive dressing will also help support the injury as you lay down the new scar tissue. This early healing should help to reduce your pain. Some injuries will benefit from more rigid support, such as a brace or strapping tape. Would you please ask us if you are uncertain about what to do next?

Elevation?

Gravity will encourage swelling to settle at the lowest point.  Elevation of an injury in the first few days is beneficial, especially for ankle or hand injuries.  Think where your damage is and where your heart is. Try to rest your injury above your heart.

What Medication Should You Use?

Your Doctor or Pharmacist may recommend pain killers or an anti-inflammatory drug. It is best to seek professional advice as certain medications can interfere with other health conditions, especially asthmatics.

When Should You Commence P