Hip Labral Tears
Your hip is a large ball and socket joint made up of your hip socket (acetabulum) and head of femur (thigh bone). The labrum is attached to your hip socket and has several functions including deepening the socket, acting as a shock absorber, lubricating the hip joint as well as increasing stability within the joint.
A labral tear is an injury to the aforementioned labrum. Studies have shown 22% of athletes with groin pain have a labral tear, as well as 55% of patients with mechanical hip pain. Although, various studies have also shown that there is a high percentage of the population who have labral tears and no symptoms.
Causes of Labral Tears
There are several ways labral tears can occur. These include:
- Direct injury or trauma such as falls or car accidents
- Repetitive microtrauma, including movements such as frequent rotation of the hip in ballet and soccer.
- Hip dislocation
- Extreme end range hip movement, such as the splits
Although, many cases of labral tears have no identifiable cause and are thought to be secondary to overuse and a buildup of microdamage over time. This is also due to the fact that the labrum has a poor blood supply and thus limited ability to heal.
Labral tears occur throughout the lifespan but your risk of having a labral tear increases with age. Those born with hip abnormalities such as shallow hip sockets (hip dysplasia) and femoral and/or acetabular anteversion or retroversion are at a higher risk due to the increased stress of the hip labrum.
Common Symptoms of Labral Tears
Symptoms of labral tears can vary from having no symptoms to a significant ache in the hip and groin region. Other symptoms include:
- The “C-sign” (pictured) is a classic complaint when describing the region of hip pain
- Pain in the front or back of the hip with or without related buttock pain
- Pain is often a dull ache with occasional sharp pain
- Clicking, locking and giving way of the hip
- Pain with prolonged walking or sitting, climbing stairs and/or pivoting
- Limited hip range of motion
Diagnosing a Labral Tear
Clinical examination- clinical assessment and diagnosis of a labral tear can be very difficult as the presentation and symptoms of a labral tear are very similar to many other hip pathologies. Your physiotherapist may suspect a labral tear based on your history and through physical tests and assessments, but they cannot definitively diagnose a labral tear without imaging.
Imaging- x-rays will show any bony abnormalities commonly associated with labral tears, such as hip dysplasia, but will not directly identify a labral tear. MRI’s and MRA’s provide more diagnostic accuracy for labral tears but the gold standard to diagnose and confirm a labral tear is a hip arthroscopy.
Physiotherapy- Physiotherapy cannot directly “fix” labral tears but the main aim of physiotherapy treatment is reduction of pain and improving function through strengthening of the muscles surrounding the hip, improving neuromuscular control around the hip and postural changes. A period of conservative management through physiotherapy is recommended prior to any surgical interventions.
Surgical- Should there be no changes in pain or function after 12 weeks of conservative treatment, referral to a specialist is recommended and surgery may be considered.
If you have hip pain or suspect you may have a labral tear please see your physiotherapist who will perform a thorough assessment and guide you through your rehabilitation. Click here to see our availabilities.