The labrum is a structure within the hip joint which helps to deepen the socket, making it more stable. Hip labral tears occur when the labrum, a band of cartilage surrounding the hip joint, is injured or a part of the labrum separates or pulls away from the socket. Labral injuries can be the result of trauma, such as a fall or a car accident, but are most commonly caused by repetitive stress to the hip joint along with wear and tear of the hip joint. Individuals who participate in sports such as hockey, soccer, or long-distance running or performing repetitive stress irritating the hip—which require extremes of motion, repetitive twisting, or sharp movements like cutting—are most often diagnosed with labral tears.
Many people with labral tears in the hip do not experience symptoms; however, some labral tears can result in significant pain or limitations. Pain in the front of the hip or groin resulting from a hip labral tear can cause an individual to have limited ability to stand, walk, climb stairs, squat, or participate in recreational activities.
This can become a painful scenario, which can lead to the inability to perform certain activities, or require surgical fixation treatment beyond simply conservative means. This can require either an arthroscopic or a small open incision to repair the labrum, this can be performed on an outpatient basis, and although the recovery phase will require several weeks of limited weight bearing and therapy, it has been shown to be consistently helpful in terms of returning someone to their previous level of pain-free activity.
- Deep ache in front of thigh usually gradual onset
- Stiffness in the hip
- Weakness in the hip joint muscles or a feeling of the joint “giving way”
- Pain increasing with prolongs sitting and walking
- Sharp pain on squatting
- Painful click or catch on hip movements; the feeling of something unpleasant stuck in the hip
Clinical evaluation is done by gathering information about condition and medical history. Although a hip labral tear may be the result of a single injury, it most likely is a condition that develops as a consequence of repetitive irritation in the hip. Diagnostic imaging (i.e., X-ray, MRI) helps in confirming the diagnosis. An X-ray helps to identify any bony abnormalities, such as those that occur with hip impingement, which may be contributing to your pain. An MRI helps to identify a labral tear.
Education: Identify and change any external factors causing pain, such as exercise selection, footwear, or the number of exercises patient performs.
Pain management: Apply ice to the area and decrease or eliminate specific activities causing symptoms. Particular movements that aggravate the symptoms around hip joint has to be identified, and design an individualized treatment plan, beginning with a period of rest, and gradually adding a return to specific activities as appropriate. Prescribing pain-management techniques helps in reducing or eliminating the need for medication, including opioids.
Manual therapy: Hands-on treatments to gently move muscles and joints to decrease pain and improve motion and strength. These techniques often address areas that are difficult to treat on your own.
Movement reeducation: Back and hip may be moving improperly, causing increased tension at the hip joint. Self-stretching techniques for the lower body helps to decrease pressure and help restore normal motion in the back, hip, and leg. There are, however, certain hip motions to avoid following an injury to the hip labrum. Exercises that improve range of motion while protecting the area that has the labral tear has to be prescribed by a skilled Physiotherapist.
Muscle strengthening: Muscle weaknesses or imbalances can be the cause or the result of hip pain. Based on the specific condition, safe, individualized, progressive resistance program should be designed.
Functional training: Once pain, strength, and motion improve, more demanding activities can be included in the exercise regime. To minimize tension on the hip, it is essential to teach body safe, controlled movements. Based on movement assessment and goals, a series of activities are created to help in learning how to use and move body correctly and safely.