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Hip Labral Tear Overview

by Jaydee Vykoukal, PT, DPT May 09, 2018 0 Comments


wearing groin brace

Whether young or old, hip labral tears can be problematic because of the debilitating stiffness and pain that often occurs with prolonged periods of sitting or standing. If you are suffering from groin pain or buttocks pain, a right or left hip labral tear may be the culprit. The key to knowing where to start with recovery for your torn labrum is to arm yourself with the knowledge to find the right treatment. This guide will help you get started on the right foot.

Understanding a Labral Tear Hip

The labrum of the hip is a cartilage structure that encircles the acetabulum (the “socket” of the joint) , which provides innate stability to the ball and socket joint. It essentially seals the hip joint (acetabulum to the head of the femur) to allow appropriate fluid distribution for lubrication, boost range of motion, and promote proper pressure distribution. Understanding the functional importance of the hip labrum will help you evaluate and carefully manage your hip acetabular labral tear injury.

  • Location of Hip Labral Tear Pain

    Whether it’s a big or small labral tear in the hip, this type of injury is classified according to its location and morphology. Labral tears in both hips are most often categorized as anterior or posterior.

  • Anterior Labral Tear Hip

    It is believed that the high prevalence of an anterior labral tear in the front of the hip is associated with mechanically weaker tissue, poor vascular supply, and this area often accepts the brunt of the weight bearing stress in comparison to the other areas of the labrum. It is most often seen with pivoting activities. 

  • Posterior Labral Tear Hip

    A posterior labral tear in the hip is located deep in the buttock region. An injury to this area is much less common and is associated with repetitive squatting. 

Hip Labral Tear Causes

What causes a labral tear in the hip? With recent studies, medical researchers have found that the abnormal structure and shape of the labrum, femoral head, or acetabulum may lead to the condition.

In many cases, a partial hip labral tear is caused by a traumatic injury such as bad falls, dislocation, collisions, a car accident, and sudden twisting movements. It can also occur as a result of degenerative changes (osteoarthritis), bony abnormalities (hip/femoroacetabular impingement), internal snapping hip, or extreme sports activities that require frequent hyperextension or external rotations.

The risk factors for the condition include:

  • Weak core
  • Pelvis/lumbar spine stiffness
  • Acetabular dysplasia (a shallow hip socket)
  • Weak glutes
  • Poor posture
  • Flat feet
  • General joint restriction

Hip Labral Tear Symptoms

What does a hip labral tear feel like? It is important to be aware of hip labral tear symptoms and signs to prevent the injury from getting worse. Some patients do not feel any pain down the leg, but most will suffer from aches or discomfort deep in the buttock region, over the lateral hip, or in the groin. You may also experience:

  • Joint stiffness
  • Weakness in the hip muscles
  • A feeling of instability in the hip
  • Painful clicking or popping sensation
  • Locking of the joint after prolonged sitting, standing or walking
  • Decreased athletic performance

Hip labral tear symptoms (lower back pain and restricted mobility) may happen suddenly after a serious trauma or impact injury. However, it can also come on gradually if the hip joint progressively degenerates.

Hip Labral Tear Diagnosis

A labral tear of the hip often goes unnoticed because of the overlap of symptoms with hip bursitis, hip flexor tendonitis, and other hip injuries. This is the reason why it is necessary to be familiar with the hip labral tear pain pattern. Work closely with your orthopedic doctor and a specialist for accurate hip labral tear diagnosis.

  • Physical Examination

    Your medical history and lists of symptoms are the first tools that the doctor will use to diagnose the problem. During the physical examination, your doctor will likely observe the way you get up, stand, and walk to assess your mobility. To evaluate the pain and check your hip’s range of motion, your legs will be moved in different positions. Plus, there are special tests and positions they can utilize to specifically assess the integrity of the labrum.

  • Hip Labral Tear Test

    If the diagnosis is still in question, your doctor can perform a couple of imaging tests to find out the exact cause of your pain. Here are some of them:

  • Labral Tear Hip X-ray

    An X-ray may be required if the doctor suspects that there is a fracture or structural abnormality within the hip joint.

  • MRI Arthrogram Hip Labral Tear

    An MRI arthrogram is helpful if the hip labral tear diagnosis remains unclear. Clear, detailed images of your hip’s soft tissues (e.g., muscles, tendons, articular cartilage, labrum) are needed to rule out the condition. In some rare cases, a doctor will suggest injecting contrast material into the joint space to verify a hip labral tear.

Hip Labral Tear Recovery

Will a hip labral tear heal on its own? Unfortunately, a torn labrum in the hip doesn’t have the ability to heal on its own once the tissue is damaged because of the poor blood flow this area receives. A combination of treatment methods is needed to fully treat the injury.

Complete hip labral tear management without surgery usually takes three to six months. Conservative treatment focuses on resolving symptoms and maximizing hip stability to reduce the future risk of issues like arthritis. However, if symptoms are not manageable or become worse, surgery is usually the next recommended choice.

When it comes to arthroscopic surgical interventions to repair a labral tear hip, recovery time may take four to six months. However, most often you should wait to go back to strenuous activities six months after hip arthroscopy surgery

Regardless of which option is best for your symptoms and the severity of your tear, you will most likely need to go through several months of comprehensive hip labral tear physical therapy to regain strength and flexibility in the joint. Your personalized timeline and necessary treatments will vary with your specific needs, so talk to your physical therapist.

Care and Prevention of a Hip Labral Tear

Figuring out how to properly treat and prevent a hip labral tear means addressing the specifics of your condition with a trusted healthcare professional. The correct guidance and follow-up is important so  that you can return to your desired activities quickly without hip pain. It’s important to determine and change any external factors that will cause re-injury, such as movements that require repetitive hip extension or rotation. The best way to prevent the injury from recurring is to maintain appropriate lower-extremity muscular strength, mobility, and overall balance.

Sources:

https://health.ucsd.edu/specialties/surgery/ortho/areas-expertise/sports-medicine/conditions/hip/Pages/labral-tears.aspx

https://www.mayoclinic.org/diseases-conditions/hip-labral-tear/diagnosis-treatment/drc-20354878

https://www.webmd.com/a-to-z-guides/acetabular-labral-tear-treatment

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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