The hip joint is the largest joint in the body and supports the whole weight of the body. It consists of a ‘ball’ positioned at the top of the thigh bone (femur) that sits inside a ‘socket’ (the acetabulum), which is part of the pelvis.
The labrum is a ring of strong, flexible cartilage that sits on the outer rim of the socket of the hip joint. It provides cushioning to the joint, acts like a rubber seal to help the fluid escaping from the joint and keeps the ball at the top of the thigh bone stay in the correct place. It also ensures smooth movement of the hip during all the activities we do each day. A hip labral tear occurs when there is damage to this labrum.
Symptoms of Labral Tears
In some cases, there may be no symptoms at all, at least initially or if the damage is minor. However, symptoms that do arise from labral tears include:
- Pain deep in the front of the hip or groin area, which can become worse during long periods of sitting, standing or walking, or by exercise.
- A clicking, locking or catching sensation in the hip joint.
- Stiffness or a lessened range of motion in the hip joint.
- Pain may also be felt in the back, thigh or buttocks.
- A feeling of instability, like the hip is going to collapse.
What Causes a Labral Tear?
The most common cause of a labral tear is Femoral Acetabular Impingement Syndrome (FAI) which is when there is a structural problem with the ball and socket. Excess bone on either of these parts of the hip joint can cause irregular contact between them. Because they don’t fit snugly together, it can cause pain and may contribute to an early onset of osteoarthritis.
Other common causes of this injury are when the hip joint is stressed while rotating, such as a dislocation, repetitive hip movement that leads to gradual wear and tear, trauma such as a car accident or developmental conditions like hip dysplasia.
Sporting activities can also cause hip labral tears and they are particularly noticed in athletes who perform repeated hip flexion and sudden impact movements, such as runners, golfers, ballet and football players.
How to Treat Labral Tears
It may be difficult to know exactly what is causing your hip or groin discomfort so if you have a nagging pain in that area it is advised to seek the help of a healthcare professional. A physical examination will assess any swelling and inflammation as well as the range of motion in the hip.
An x-ray will show any abnormalities in the shape of the bones or the alignment of the hip joint, as well as any arthritis that is present. An MRI may also be recommended to provide a detailed view of the soft tissues around the hip.
Once a labral tear has been confirmed, a treatment plan can be devised and may include any of the following.
- Rest is likely to be recommended, particularly from an activity that caused the injury.
- Physiotherapy to strengthen the area and remobilise the hip joint.
- Injections including intra-articular steroids, to reduce inflammation and pain.
- Non-steroidal anti-inflammatory medication, or oral analgesia.
- Surgery may be recommended and can be open surgery or done with an arthroscope.
Physiotherapy for Labral Tears
Physio is often incredibly effective in treating a labral tear and will help reduce pain and improve the function of the hip.
Your physiotherapist will begin by undertaking a thorough assessment of both hips to have a clear understanding of the injury. Melbourne Sports Physiotherapy have staff highly experienced in hip injuries and provide expert advice and treatment.
As the patient, you will receive detailed information on the diagnosis as well as practical advice on any necessary modifications to daily activities. Working to a rehabilitation plan that is specifically tailored to you, there will be a range of treatments that may include:
- Therapy to improve the stability of the hip.
- Strengthening the hip muscles to provide support to the area.
- Neuromuscular control and movement patterns, to make sure muscle movements are accurate.
- Proprioception exercises to monitor the body’s responses.
- Improving the mobilisation of joints as well as overall mobility.
- Balance and coordination training.
Physio can even assist with overall performance by targeting weaker areas, those that may have contributed to the labral tear in the first place. You will also be given advice on how to prevent further labral tears and how to manage any structural conditions.
The team at Melbourne Sports Physiotherapy want you to be up and moving, pain free, as soon as possible so don’t put up with hip pain for a single day longer. Give them a call to discuss your hip injury or book an appointment online.