A hip labral tear is an injury to the labrum, which is the cartilage that forms a cup-like structure around the edge of the hip socket (the acetabulum) in the hip joint.
The labrum helps stabilise the ball-and-socket joint by deepening the socket and providing a cushion for the bones.
A tear in the labrum can occur due to:
- Repetitive movements or activities that stress the hip joint, such as in athletes or people involved in activities like running, dancing, or kicking.
- Trauma, such as a fall or a direct blow to the hip.
- Hip impingement (a condition where there is abnormal contact between the ball of the hip joint and the socket).
- Age-related degeneration that leads to wear and tear of the labrum over time.
The signs and symptoms of a hip labral tear can vary depending on the severity of the tear, but common ones include:
Pain
- Groin pain: This is the most common location for pain with a hip labral tear. It may be sharp or dull and can worsen with movement, especially activities that involve twisting or rotating the hip.
- Outer hip pain: Some people experience pain on the outside of the hip, around the hip joint.
- Deep ache: You might feel a deep ache inside the hip or groin, which can be exacerbated by certain positions or activities.
Clicking, Catching, or Locking
- Some people describe a sensation of the hip “catching” or “locking” while moving. This can happen when the torn part of the labrum moves or shifts within the joint.
Limited range of motion
- A labral tear can lead to stiffness in the hip joint, limiting how far you can move your leg in certain directions. This is particularly noticeable when performing activities like bending or rotating the hip.
Pain with Specific Movements
- Activities such as sitting with crossed legs, squatting, running, or any motion that involves rotating the hip may exacerbate the pain. You might also notice pain when getting in and out of a car, or climbing stairs.
Swelling
- In some cases, there might be mild swelling around the hip joint, although this is less common than the other symptoms.
Weakness
- Some people with hip labral tears experience weakness in the hip or leg muscles due to pain, or because the joint isn’t functioning as effectively.
Pain After Prolonged Sitting or Activity
- You might notice increased discomfort after sitting for a long time (e.g., in a low seat or with your legs crossed) or after physical activity that puts stress on the hip.
running with a labral tear
Running with a hip labral tear can be challenging and depends on the severity of the tear and how your body responds to activity.
Things to keep in mind:
- Pain and Discomfort: If you experience pain, discomfort, or a feeling of instability when running, it’s a sign that the tear may not be well-supported by the joint, and running could cause more harm. It’s important to listen to your body.
- Impact on Healing: Running, especially long distances or high-impact running, could slow down healing or increase inflammation, especially if you’re not following a proper rehabilitation plan.
- Type and Severity of the Tear: If the tear is mild or moderate, you might still be able to run with some modifications, such as reducing intensity. If the tear is severe, it could significantly limit your range of motion and make running difficult or impossible without pain.
- Physical Therapy: A physical therapist can help with exercises to strengthen the muscles around the hip joint and improve flexibility, which may help with stability and reduce pain. This might allow you to gradually return to running.
- Alternative Exercises: If running becomes too painful, low-impact exercises like swimming, cycling, or using an elliptical machine might provide a good cardiovascular workout without the stress on your hip.
Ultimately, it’s important to balance activity with proper rest and treatment. If running is causing significant pain or worsening your symptoms, it may be time to take a break and focus on rehabilitation and strength work in the gym.
treatment
The treatment can vary depending on the severity of the injury, the patient’s age, activity level, and overall health. Treatment options generally fall into two categories: non-surgical and surgical.
Non-Surgical Treatment (conservative management)
Rest and Activity Modification:
- Avoid activities that aggravate the hip, such as running, squatting, or prolonged sitting.
- Low-impact activities like swimming or cycling may be recommended to maintain cardiovascular fitness while reducing strain on the hip.
Physical Therapy:
- Strengthening: Focus on strengthening the muscles around the hip joint, especially the gluteal muscles, to provide more stability to the joint.
- Stretching: Stretching exercises can help improve flexibility and reduce strain on the hip joint.
- Mobility exercises: To improve range of motion and relieve stiffness in the hip.
Corticosteroid Injections:
- In some cases, a corticosteroid injection into the hip joint can help reduce inflammation and provide pain relief. This is typically considered when symptoms persist despite other treatments.
Surgical Treatment (if conservative measures fail)
If symptoms persist despite non-surgical treatments, or if the labral tear is severe, surgery may be recommended. The two main types of surgeries for a labral tear are arthroscopic surgery and hip replacement (in extreme cases).
Arthroscopic Surgery:
- Arthroscopy is a minimally invasive procedure where small incisions are made, and a tiny camera (arthroscope) is used to view the hip joint.
- Labral Repair: If the tear is repairable, the surgeon may reattach or stitch the torn labrum.
- Labral Debridement: If the tear cannot be repaired, the surgeon may trim or remove the damaged portion of the labrum.
- Femoroacetabular Impingement (FAI) Treatment: If hip impingement is contributing to the labral tear, the surgeon may also reshape the bones of the hip joint to improve joint mechanics and reduce further stress on the labrum.
- The goal of surgery is to stabilise the joint and relieve pain, which can often result in significant improvement in function.
Post-Treatment Rehabilitation
- Whether you have conservative treatment or surgery, rehabilitation is key to recovery. It typically includes:
- Physical therapy to regain strength, range of motion, and function.
- Gradual return to activity as symptoms improve, starting with low-impact exercises and advancing as tolerated.
- Monitoring symptoms and making sure any movements that caused pain before aren’t reintroduced too quickly.
When to Consider Surgery:
Surgery is usually considered when:
- Non-surgical treatments do not relieve symptoms after several months.
- The pain and limitations significantly affect daily activities or sports.
- The tear is causing instability or severe dysfunction in the hip joint.
It’s crucial to follow the recommendations of your healthcare provider and work closely with a physical therapist to ensure the best outcome from your treatment plan.
If you experience any of these symptoms, especially if they persist or worsen over time, it’s important to see a healthcare provider for a proper diagnosis. They may perform physical exams, imaging tests (like an MRI), and other evaluations to confirm the presence of a labral tear and recommend appropriate treatment.
If you are unsure if you have a hip labral tear then an assessment with our Physiotherapy & Injury Rehab could help with a diagnosis and if you are recovering from one, we can help with a treatment and recovery plan.
