A hip labral tear involves the ring of cartilage (labrum) that follows the outside rim of the socket of your hip joint. In addition to cushioning the hip joint, the labrum acts like a rubber seal or gasket to help hold the ball at the top of your thighbone securely within your hip socket.
Athletes who participate in such sports as ice hockey, soccer, football, golf and ballet are at higher risk of developing a hip labral tear. Structural abnormalities of the hip also can lead to a hip labral tear.
What Is a Labral Tear?
The labrum is a rim of soft tissue or fibrocartilage that surrounds the acetabulum (hip socket). The labrum adds to the stability of the hip by deepening the socket and protects the joint surface. The labrum can tear as the result of an injury, but is more often related to FAI. The labrum can also tear when there is arthritis in the hip, as a part of the overall degeneration of the joint. When there is a labral tear due to arthritis, treatment is usually geared towards treating the arthritic joint as a whole.
What Are the Symptoms of a Labral Tear?
Labral tears often cause pain in the groin or front of the hip during physical activity or with deep flexion (bending) and rotation of the hip. Some individuals with labral tears of the hip will also have clicking or a sense of catching deep within the hip during certain activities.
How Are Labral Tears Diagnosed?
Most hip pain that lasts more than a few days should be evaluated by a physician. The diagnosis of a labral tear is usually made by a detailed examination by your sports medicine physician. To verify the diagnosis, a specialized MRI of the hip, called an MRI arthrogram, is done. X-rays are also commonly taken to evaluate the bony structure of the hip, which is sometimes abnormal in people with labral tears.
Many hip labral tears cause no signs or symptoms. Occasionally, however, you may experience one or more of the following:
- A locking, clicking or catching sensation in your hip joint
- Pain in your hip or groin
- Stiffness or limited range of motion in your hip joint
When to see a doctor
Seek medical attention if symptoms worsen or don’t improve within six weeks.
The cause of a hip labral tear may be:
- Trauma. Injury to or dislocation of the hip joint — which can occur during car accidents or from playing contact sports such as football or hockey — can cause a hip labral tear.
- Structural abnormalities. Some people are born with hip problems that can accelerate wear and tear of the joint and eventually cause a hip labral tear.
- Repetitive motions. Sports-related and other physical activities — including the sudden twisting or pivoting motions common in golf or softball — can lead to joint wear and tear that ultimately results in a hip labral tear.
A hip labral tear may predispose you to develop osteoarthritis in that joint in the future.
Hip labral tears are often associated with sports participation. If your sport puts a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises. Try to avoid loading your hip with your full body weight when your legs are in positions at the extreme ends of your hip’s normal range of motion.
Nonsurgical Treatments for Hip Labral Tears
Hip labral tears can sometimes be treated with nonsurgical treatments. Below are some of the most common.
- Rest. Limited activity is advised to control discomfort, including the activities that bring on hip pain.
- NSAIDs. Taking non-steroidal anti-inflammatory drugs, such as aspirin or ibuprofen, for a limited period may reduce inflammation and pain in the hip area.
- Injections. A doctor may recommend local anesthetic fluid injections directly into the hip joint, called an intra-articular injection, if the pain is not alleviated from other measures. A corticosteroid may be added to the injection depending upon the level of hip pain and any other existing hip problems.
- Physical Therapy. A licensed physical therapist can provide an individual treatment plan. The plan may focus on strengthening the buttocks, thigh, and back, while also improving hip stability. Physical therapy for hip labral tears is considered a safe but under-studied treatment.9 Individuals should consult their doctor before beginning any physical therapy regimen.10
Surgical Treatment for Hip Labral Tears
If nonsurgical treatments are not recommended, or if they have been tried and do not relieve the hip pain, surgery may be suggested. The type of procedure that will be performed is dependent upon the severity of the tear.
Most surgical options for labral repair are minimally invasive, using a tool called an arthroscope. The arthroscope is about the size of a pencil and equipped with a tiny television camera, allowing the surgeon to view and repair the damaged labrum without having to make a large incision.
- Arthroscopic labral debridement. This technique involves trimming or smoothing the area of the labrum that is torn, usually performed through an arthroscopic procedure. This procedure may be recommended if the surgeon believes that a frayed labrum is causing symptoms or could cause future symptoms.
- Arthroscopic hip labral repair. This may be recommended when the labrum has separated from the bone. During a labral repair, the doctor will reattach the torn labrum to the hip’s socket (acetabulum) using small metal or plastic “anchors” and sterile thread.
- Arthroscopic hip labral replacement. Labral replacement, sometimes called labral reconstruction, may be recommended when the labrum is too damaged to repair.
- Labral replacement uses a graft (tissue from another part of the body or from a donor) to completely replace the torn labrum. This is a relatively new procedure and not considered standard practice. Physicians report promising outcomes11 but no large, long-term studies are currently available.
Arthroscopic surgery cannot always be performed. Bony abnormalities (such as those seen in hip impingement) or other hip conditions may make it difficult for a surgeon to access the hip joint with an arthroscope. In these cases, a doctor may suggest an open surgical procedure that requires dislocating the hip.
- Surgical hip dislocation. In this approach, an “X” incision is made in the skin over the hip joint, and the femoral head is dislocated from its socket. This procedure provides a full view of the hip and is designed so that the surgeon can repair or replace the torn labrum and address other existing conditions, such as hip impingement.
Recovery time and long-term effects of the surgery will depend on many factors, including the type of damage that was present in the hip as well as the patient’s age. The general rule is that weight-bearing is limited for 4 to 6 weeks and a custom rehabilitation protocol should begin soon after the procedure. Many people can eventually return to their usual, normal activities. Others may need to change from high-impact to low-impact activities, such as switching from running to cycling.12
If pain persists after these surgical interventions have been performed, a doctor may suggest hip arthroplasty, or hip replacement, as a next step.
It is becoming more common for sports injuries to be treated with regenerative medicine, such as platelet-rich plasma or stem cell injections. Clinical studies on the use of regenerative medicine for hip labral tears have been relatively small with mostly inconclusive results. Large-scale studies are needed to determine how exactly regenerative medicine fits into hip labral tear treatments.
Other things to consider
If you have a Hip Labrum Tear, you don’t need to resort to invasive surgery. Most Hip Labrum “Repair” procedures actually involve cutting away torn sections of your tissue. Avoid surgery and heal your tissue with conservative treatment.
Hip Labral Tears often cause severely reduced motion of the hip joint. You may have difficulty climbing stairs, crouching down low, walking, or even standing.
You can heal your Hip Labrum Tear and regain your mobility. All you need is the right treatment. You need to rest your hip and stimulate healthy blood flow.
Ice Wraps bring nutrient-rich, oxygenated blood to your hip. This increase in blood flow works to actively heal your damaged tissues. Blood flow is the most critical element in rapid recovery. Unfortunately, an injured Hip Labrum at rest often has very restricted blood flow. While physical activity stimulates blood flow, it can also lead to re-injury and a lengthened recovery time. They’re designed to speed up the healing process while you’re at rest. This means you can receive the additional blood flow you need to heal and avoid re-injury at the same time.
Points to remember during deep tissue massage for hip pain: Massage for Labrum Hip Tear
- Identify the specific points or the trigger points which are the painful “knots” on the hip joint.
- To do this, you should lie down in a supine position keeping your back straight.
- Using one finger, gently apply pressure on the areas surrounding the hip joint.
- Try to distinguish the trigger points. Once they are identified, using your fingertips, gently massage these points. Avoid putting excessive pressure. Start with mild or gentle pressure and slowly increase the pressure as far as bearable.
- The trigger points should be massaged slowly in single directional strokes.
- Slowly increase the massage frequency and its duration.
Benefits of Massage for Hip Pain Relief
Massage for Labrum Hip Tear helps in breaking down the adhesion’s in the hip regions thereby reducing pain and restoring normal hip joint mobility. During the early stage of the massage therapy, the individuals may feel pain and discomfort, which will gradually subside as the frequency of the massage therapy increases.
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