Overview
A hip labral tear involves a ring of cartilage (labrum) that surrounds the outside rim of the hip joint socket. The labrum not only acts as a cushion for the hip joint but also helps to keep the ball at the top of the thighbone securely within the hip socket. This condition commonly occurs in athletes who participate in sports such as ice hockey, soccer, football, golf, and ballet. Structural problems of the hip can also lead to a hip labral tear. Symptoms include pain in the hip or groin, a locking, clicking, or catching sensation in the hip joint, and stiffness or limited range of motion in the hip joint.
Understanding the disease
Symptoms
Symptoms of a hip labral tear may include pain in the hip or groin, a locking, clicking, or catching sensation in the hip joint, stiffness, or limited range of motion in the hip joint. However, many hip labral tears cause no signs or symptoms. If symptoms worsen or do not improve within six weeks, it is recommended to seek medical attention.
Risk Factors
The risk factors for developing a hip labral tear include participating in sports that put a lot of strain on the hips, such as long-distance running, ice hockey, soccer, football, golf, and ballet. Structural problems of the hip, including dysplasia (a socket that doesn't fully cover the ball portion of the upper thigh bone), a shallow socket, and femoroacetabular impingement (extra bone in the hip), can also contribute to the development of a hip labral tear. Trauma or injury to the hip joint can also cause a hip labral tear.
Development
Hip labral tears can develop due to several reasons, including:
- Trauma: Injury to or dislocation of the hip joint, which can occur during car accidents or from playing contact sports like football or hockey, can cause a hip labral tear.
- Structural problems: Hip issues present at birth, such as a shallow socket or dysplasia (where the socket doesn't fully cover the ball portion of the upper thigh bone), can accelerate joint wear and tear and eventually lead to a labral tear. Extra bone in the hip, called femoroacetabular impingement (FAI), can also cause pinching of the labrum, which may result in tearing over time.
- Repetitive motions: Sports-related and other physical activities, such as long-distance running, sudden twisting or pivoting motions common in golf or softball, can lead to joint wear and tear, ultimately resulting in a hip labral tear. It's important to note that many hip labral tears cause no signs or symptoms. Some people may experience pain in the hip or groin, a locking, clicking, or catching sensation in the hip joint, stiffness, or limited range of motion in the hip joint. If you experience these symptoms or if your symptoms worsen or don't improve within six weeks, seek medical attention.
Assessment and Diagnosis
Triage
You should seek medical attention if you experience symptoms of a hip labral tear, such as pain in the hip or groin, a locking, clicking, or catching sensation in the hip joint, or stiffness or limited range of motion in the hip joint. Additionally, if these symptoms worsen or do not improve within six weeks, it is recommended to consult a doctor.
Diagnosis
To diagnose a hip labral tear, your healthcare provider will likely take a history of your discomfort and perform a physical exam. During the physical exam, the provider will move your leg and hip joint into various positions to check for pain and evaluate your hip's range of motion. They may also watch you walk. Imaging scans, such as X-rays or magnetic resonance arthrography (MRA), may be used to provide detailed images of your hip's soft tissues and help identify a labral tear. In some cases, your healthcare provider may suggest an anesthetic injection into the joint space to help determine if the problem is within the hip joint.
Management and Treatment
Treatment
Treatment for a hip labral tear depends on the severity of the symptoms. For some individuals, conservative treatments like rest, modified activities, and physical therapy may be enough to relieve pain and promote recovery in a few weeks. Conservative treatment options may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen or naproxen sodium can help reduce pain and inflammation.
- Physical therapy: A physical therapist can teach you exercises to increase your hip's range of motion, build hip and core strength, and help you avoid movements that put stress on your hip joint.
- Activity modifications: Modifying your daily activities and exercises to reduce stress on the hip joint can help alleviate pain and promote healing. However, if conservative treatments don't provide sufficient relief, your healthcare provider may recommend arthroscopic surgery to repair the torn labrum. Surgery may involve removing the torn portion of the labrum or sewing the torn tissue back together. It's essential to discuss the potential risks and benefits of surgery with your healthcare provider. Remember to follow your healthcare provider's advice on the best treatment plan for your specific case.