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Thursday
Jan252018

What is a Hip Labral Tear?

The hip or acetabular labrum is a ridge of cartilage that runs around the rim of your hip joint socket. Its purpose is to make the hip socket deeper and more stable. The labrum can be torn from its attachment and cause pain, clicking or catching.

What Causes a Hip Labral Tear?
The labrum can tear for many reasons. Some people tear their labrum from falls or sporting injuries when your hip is forced into extreme positions. It can also be damaged by repetitive trauma in sports that require regular rotation of the hip -- like golf, soccer, hockey, and ballet. 
Studies show that up to 22% of athletes who complain of groin pain have a labral tear in the hip. However, almost 75% of cases of torn acetabular labrum have no known direct cause.

What are the Symptoms of a Labral Tear?
Some people experience no pain from a labral tear but most will feel pain or ache in their groin, over the lateral hip, or deep in their buttock region. Acetabular labral tears often cause a feeling of the leg "catching" or "clicking" in the hip socket as you move it. It may also feel like the hip is locking up. Some people get a feeling of giving way within the hip.

How is a Labral Tear Diagnosed?
Labral tears are diagnosed with a combination of symptoms, clinical signs for example restricted range of movement. It is difficult to get a specific diagnosis without a MRI or MRA (a special MRI looking at joints and requiring an injection into the joint) or by arthroscopic hip surgery.

How is a Labral Tear Treated?
Phase I - Reduce Pain & Protect Your Labrum
In most cases, you need to start treating your labral injury straight away by resting your hip and avoiding those aggravating activities. 

You should avoid sitting:
  • with knees lower than your hips.
  • with legs crossed or sitting on your legs so that the hip is rotated.
  • on the edge of the seat and contracting the muscles that flex your hips.
You should also avoid extending your hip excessively.

Phase II - Restore Flexibility & Strength
  • Have your biomechanics, joint and muscle function assessed.
  • Restore any limited joint range-of-motion.
  • Improve your soft tissue muscle length and resting tension.
  • Activate your deep stability muscles.
  • Progressively strengthen your intermediate and superficial muscles.
  • Enhance your proprioception and joint position sense.
Phase III - Return to Activity or Sport
  • Aim to improve your functional activities of daily living (ADLs) via goal focused exercises.
  • Graduate through a return to sport program that is specific to your needs.
  • Agility, speed, power, and sport-specific drills.
  • Modify your return to sport under the advice of your physiotherapist. 
  • Some labral tears can be treated conservatively but some will need hip surgery.
Hip Surgery for Labral Tears
A percentage of hip labral tears will require surgery to stop the pain and clicking. The procedure should also improve the hip joint integrity, which should reduce the future degeneration associated with labral tears. 
Surgery involves re-attaching the labrum and occasionally debriding (taking away the torn section) of the labrum. You will require post-operative hip rehabilitation under the guidance of your physiotherapist and surgeon to facilitate your safe return to sport.