What is a Labrum / Labral Tear?
The acetabular labrum is a ring of specialized cartilage resting on the edge of the bony socket (acetabulum) of the hip joint. The function of the labrum is to deepen the socket and provide a “suction seal” to the hip joint. Tears of the acetabular labrum are becoming more commonly recognized.
Hip labral tears can be due to a single acute traumatic event. Acute labral tears usually result from a sports injury, fall, or accident. They are commonly associated with sudden, twisting maneuvers that cause immediate pain in the hip.
More commonly, however, labral tears are degenerative in nature. Degenerative labral tears are chronic injuries that occur as a result of repetitive wear and tear over time and can be seen in the early stages of hip arthritis. The most common cause of degenerative labral tears is a condition known as femoroacetabular impingement (FAI).
Treatment for labral tears consists of activity modification, physical therapy, and anti-inflammatory medications. If these measures are unsuccessful, the labrum can be debrided or repaired using a minimally invasive arthroscopic technique.
Femoroacetabular Impingement (FAI)
Femoroacetabular impingement (FAI) is a subtle abnormality of the shape and anatomy of the hip that can lead to repetitive micro-injury to the hip joint. Over time, this repetitive trauma can lead to hip labral tears and is thought to be a major cause of hip arthritis.
Normally, the ball and socket of the hip joint are shaped so that the ball (femoral head) moves very smoothly inside the socket (acetabulum). The socket should be just the right size to hold the ball in place. Femoroacetabular impingement occurs when either the ball or the socket is not shaped just right, leading to abnormal contact between the bones and soft tissues of the hip. In femoroacetabular impingement, the bone of the femoral head butts up against the bone and cartilage rim (labrum) of the hip socket. This is where the term “femoroacetabular impingement” comes from.
Femoroacetabular impingement is caused by one of two different mechanisms:
- Cam-type impingement – In this situation, the ball of the hip joint is not as round as it should be. Typically, there is extra bone present at the front of the femoral head, which bumps into the socket and labrum when the hip is flexed or bent up.
- Pincer type impingement – In this type of impingement, the hip socket covers too much of the femoral head. This can be because the socket is too deep or because it is tipped forward more then it should be (acetabular retroversion). Again, the front of the hip socket will come into contact with the femoral head sooner than it should be leading to impingement.
The symptoms of femoroacetabular impingement are similar to the symptoms of people with hip labral tears. Most people feel pain in the groin, which can radiate to the buttock. The pain can be worse with activity but can also be aggravated by prolonged sitting. Twisting movements are also frequently painful. Some people may feel a catching sensation in the hip, as well.
Activity modification and anti-inflammatory medications can sometimes improve the symptoms of femoroacetabular impingement. The only way to truly fix the problem, however, is to restore the normal shape of the hip joint. In many cases, this can be done through minimally invasive arthroscopic surgery. This involves reshaping the bone of the femoral head or hip socket and repairing tears of the labrum through 2 or 3 small incisions. In more complex deformities, surgery through a larger open approach may be necessary.
Massaage for Labral Tears
The deep tissue massage technique comprises using deep pressure along with slow strokes on the affected areas. A hip labral tear involves the ring of cartilage (labrum) that follows the outside rim of the socket of your hip joint.
Can physical therapy heal a labral tear?
Some labral tears can be managed with physical therapy; in severe cases, surgery may be required to repair the torn labrum.
Your physical therapist can also assess the severity of your injury based on your response to treatment. If you find yourself feeling improvements within three months of physical therapy, chances are your labral tear can be managed without surgical intervention.
What happens if a labral tear goes untreated?
If left untreated, acetabular labral tears may become a mechanical irritant to the hip joint, which can increase friction in the joint and speed the progress of osteoarthritis in your hip.
*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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