Exercises for a Hip Labral Tear

The labrum is a ring of cartilage that provides stability to the hip’s ball and socket joint for everyday function. Unfortunately, with overuse, trauma, or muscle imbalances, this type of injury is most common in athletes but can happen to anyone. If you’re dealing with a hip labral tear, exercises designed to promote circulation and healing are vital for recovery, whether surgery is necessary or not. Keep reading to learn about the best exercises for a hip labral tear.

Foam Rolling Exercises

Most often, the primary indicator of a hip acetabular labrum tear is pain ranging from dull and achy to sharp in nature. It also includes groin pain, buttocks pain, and occasionally back pain. Start with these foam rolling exercises to address pain in larger muscle groups.

More Pain Relief Options

1. Glute Roll

The glutes are often stiff with a hip injury like a labral tear. The pressure of the foam roller will require some adjustment at first, but you can always reduce the pressure on your sore muscles by getting more support from your free limbs. Keep in mind that you should be able to stay relaxed. Make sure you are only putting pressure on the muscles themselves and avoid direct pressure on bones and joints.

• Lay your foam roller on the ground
• Then, sit on the foam roller with your legs you in front of you
• Prop your hands behind you on the floor  for balance as you make a figure 4 with your legs
• To massage the right glutes (particularly the gluteus medius) bring the outside of the right ankle to rest on the left knee so that the right hip is in external rotation- don’t force this move if it aggravates your symptoms
• Use your left leg and arms to guide your movement as you roll back and forth on the glutes 
• Roll slowly and stay relaxed- going back and forth for 1-5 minutes
• Repeat on the other leg as needed
• If you don’t have a foam roller, you can also try a tennis ball, lacrosse ball, or even just your hand

2. Groin Roll

Another common problem area is the groin and the hip adductor muscles that run along the inside of the thigh. Be gentle with this area to prevent aggravation and adjust your pressure or positioning as needed.

• With the foam roller on the ground, lie on your side with your affected side up
• Your top leg will be bent to approximately 90 degrees at the hip and knee
• Bring the foam roller close to your body so that it is parallel with your trunk and place the inner thigh on the foam roller
• Roll the foam roller back and forth under your thigh with your top arm
• When you find a sore spot on the inner thigh, stop and slowly bend and extend the knee until the muscle relaxes
• Repeat for 10 repetitions on each sore spot for up to a few minutes

3. Quad Roll

Finally, the quad and hip flexor muscles are also commonly tight with hip pain. Make sure you stay off the knees and pelvis as you roll up and down.

• Keep the foam roller on the floor
• Lie on your stomach so that the front of your thighs are on top of the roller 
• Use your arms to guide rolling up and down on your thighs
• Roll back and forth slowly, stopping to hold on any sore spots while rhythmically bending the knee as needed too

Additionally, you can roll out the back of the legs (hamstrings) or even the side of the hips (iliotibial band).

4. Self-Massage of the Hip

Outside of a foam roller, you can use other massage tools to maximize your pain relief too. This can range from a massage roller ball or vibrating tool to even just your hands.

• Grab a massage roller ball
• Place the tool against any sore muscle in the upper thigh
• Apply enough pressure to get relief without the muscles tensing up
• Roll slowly back and forth
• Address any areas you’d like in the side, front, back, or front of the thigh
• Continue for 1-5 minutes

Tips, Tools & Techniques for Self Massage

Movement Exercises

Appropriate movement is crucial for keeping the hip joint as healthy as possible. The right moves will promote muscular balance, hip range of motion, and boost circulation to injured areas.  While stretching can be a great tool for general hip pain, it should only be implemented for a labral tear if your hip flexibility or range of motion is limited. Otherwise, stretches have found to provide little relief for this particular injury. Instead, combination moves that provide hip range of motion and strength together are ideal.

5. Side Lunge

This move stretches the inner thigh and groin area while also building lower leg and core strength. It’s a great combination move to get you back on track with your hip recovery.

• Start by standing with your feet hip width apart and the abs tight
• Bring your left leg out to the side while keeping the knee straight, while keeping your foot on the ground
• As you reach with your left leg, bend the right knee as if to squat
• Continue to bring the left leg out to the side as push your butt back and bend the right leg
• Hold for 10 seconds and repeat 5-10 times for 2-3 sets
• Repeat on your right leg as well

6. Side-Lying Hip Adduction

Working the inner thigh muscles, the hip adductors, while actively moving the hip is a great way to boost the recovery process. Since this exercise works the groin directly, start gently and slowly to ensure that your hip can tolerate the exercise well before proceeding.

• Lie on your side with the hip you want to work on the bottom
• To stabilize your body, flex and rotate the top leg so that the bottom of your foot is resting on the ground in front of your waist
• Tighten the abs and the lower inner thigh
• Lift the straight lower leg straight up toward the ceiling as high as is comfortable
• Hold for 1-5 seconds
• Repeat 10 times for 2-3 sets
• Switch and repeat on the other leg

If this movement is too hard or straining on your groin, sit in a chair or lie on your back and squeeze a ball between your knees instead. While you’re lying on your side, you can also work the top hip with hip abduction leg lifts too (lifting the top straight leg straight up toward the ground).

7. Straight Leg Bridge

This exercise requires a foam roller or sturdy step to get started. While a bridge is traditionally done with the knees bent and feet flat on the floor, doing it with straight legs instead will help you strengthen the glutes and hamstrings while also providing a great hip extension stretch.

• Grab a foam roller or sturdy step 
• Lie on your back and place your lower legs (near the bottom of the calves) on the foam roller
• While keeping the legs completely straight, tighten your abs and butt as you lift the hips up toward the ceiling
• Lift as high as you can without arching the low back
• Hold for 1-5 seconds for 10-15 repetitions
• Repeat for 2-3 sets

Strengthening Exercises

Strengthening the hips and core is the most essential part of a home exercise program for a hip labral tear. It’s what will restore function and balance to the hips to allow you to get back to your daily activities and sports as soon as possible. Always focus on keeping good form and keeping the core activated with each of the exercises below.

8. 3-Way Hip Motion

This awesome and functional hip stabilizing exercise hits almost every major muscle group around the hip. Tune in and notice if one direction out of the three is more difficult or tiring than the others- then make sure to be extra diligent with your form with that one.

• Stand near a wall, chair, or counter for balance if needed
• Grab a loop band and put it around both your legs approximately mid-calf
• Stand tall with good posture and the abs tight as you shift your weight into one foot
• Bring the free leg straight behind you as you extend the hip and squeeze the butt, taking care not to lean forward with your trunk and keeping the ankle bent
• Return the leg to the starting position
• Next, bring your leg straight out to the side while keeping your kneecap and toes pointing straight forward, avoid any sideways leaning with your trunk
• Again, return the leg to the starting position
• Finally, bring your leg straight in front of you into hip flexion before returning to the start position
• Alternate between these 3 motions 10 times 
• Repeat on both legs for 2-3 sets on each

If you are making progress with this exercise and want to make it harder, doing the moves without balance assistance or even standing on a foam pad is possible. Additionally, you can add more functional movement with your band such as side-ways walking or exaggerated forward walking (known as monster walks).

9. Psoas March

Keeping the core strong is an essential part of hip recovery, especially since most hip muscles play multiple roles in stabilizing the hip in addition to the pelvis and low back. This exercise addresses core and hip strength at once while minimizing hip aggravation.

• Start by lying on your back with the knees bent and feet flat on the floor
• Wrap a loop resistance bandaround the feet so that the band goes under the arches
• Make sure your back is flat and stabilized against the floor by tightening the abs
• Lift both feet of the ground so that your hips and knees are both flexed to approximately 90 degrees to start
• Now, start to extend one leg forward as you push your foot into the resistance band
• Go as far as you can comfortably while keeping good form
• Alternate pushing each leg forward
• Repeat for 10 repetitions on each leg for 2-3 sets total 
• If this move is too hard to control or there is pain, lift the legs higher toward the ceiling or start without a band
• To make the exercise harder, bring the legs closer to the ground

Since a squat is a move we all do everyday to get up and down from chairs and other low surfaces, being able to squat with adequate hip strength and coordination is important. This move also incorporates the hip abductors and rotators too for a great combo move. Don’t force any range of motion that causes hip pinching or pain.

• Grab a loop band and wrap it around your legs just above the knees
• Stand with the feet hip width apart and knees directly over the toes (not collapsed inward)
• Do a mini squat by bending your hips and knees 
• Keep the butt back as if to sit in a chair, back flat, and weight centered in the feet (not in the toes)
• While holding this squat position, activate the outside of the hips by pushing out against the band to subtly externally rotate the hips (knees move away from each other)
• Repeat this small hip motion 10 times for 2-3 sets total
• You can increase the depth of your squat and repetitions as tolerated 

Balancing on one leg is a great way to strengthen the hips. It is also a very functional move since single leg balance is required for basic everyday moves like walking and running.

• Stand near a chair, wall, or counter for balance safety as needed
• Choose your level of difficulty by the surface you will be standing on- either a on the ground or a softer surface like a foam balance pad or even balance disc
• Shift your weight into one leg as you lift one foot off the ground to balance
• Attempt to hold for 30+ seconds for 2-3 sets on each leg
• To increase your balance challenge, reduce the amount of assistance from your arms, stand on a more challenging surface, or even add head or arm movements

Movements to Avoid with Hip Pain

When recovering from a hip labrum tear, there are a few certain moves that may exacerbate your symptoms or even cause a bigger tear. Try to avoid these movements as much as possible while you are in the healing process to prevent any unnecessary setbacks. As you recover, talk to your doctor about clearance for higher level activities.

• Any movement that elicits an increase in hip pain (outside of general discomfort) or any other abnormalities
• Movement that requires a combination of internal rotation and flexion- as it will cause anterior hip impingement (pinching of the acetabulum)
• Deep flexion activities; such as end range squatting
• End range hip extension
• Jumping, running, or other high impact activities
• Pivoting or cutting during sports activities 
• Heavy leg lifting

Tips for Performing Exercises

Now that you have a good idea of where to start with your exercise program, here are some tips for optimizing it  to minimize downtime and feel your best.

• Pair your exercise program with other activities that promote healing and pain relief- such as massage, heat, and electrical stimulation

• Pay close attention to your posture and hip positions with daily activities and sleep to avoid unnecessary aggravation.

  Tips for Hip Pain at Night

• If you’re feeling unsure about your exercise program, physical therapy is always a great option- a physical therapist can guide you with a personalized treatment program for maximizing the recovery process

  Physical Therapy for Hip Labral Tear

• Always use your symptoms as a gauge for when to modify or progress your exercise program, daily activities, and sports

Recovering from a Hip Labral Tear

Having an understanding of what to expect and what exercises will help you stay on track as you heal will give you the best results. Plus, properly treating your labrum tear from the start will reduce your risk of future problems like articular joint damage and hip arthritis. Always talk to your sports medicine doctor or physical therapist about any concerns you have about your hip. If your symptoms aren't getting better, suddenly get worse, or are limiting your daily activities, get in touch with your trusted medical professional immediately for further medical advice.

Sources:

https://www.runnersworld.com/health-injuries/a29425202/hip-labral-tear/#:~:text=Monster%20Walk%20(Forward%20and%20Lateral)&text=Place%20a%20resistance%20band%20just,repeat%20on%20the%20other%20side.

https://www.impactphysicaltherapy.com/physical-therapy-for-hip-labral-tear/

https://www.livestrong.com/article/188528-what-are-some-exercises-for-hip-labral-tear-recovery/

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