What is the hip labrum and how is it injured?
The labrum of the hip has a similar function as the labrum in the shoulder. It is a cartilage ring around the socket portion of the joint that adds suction, stability, and absorbs shock and load. A traumatic injury can cause a labral tear but it can also be torn through repetitive stress. This stress can commonly happen over time in a hip joint that is more oval shaped rather than spherical, which is how some people are built. Labral tears are also very typically seen along with hip osteoarthritis. About ¾ of labral tears are not associated with any known specific event or cause, with the underlying origin thought to be repetitive microtrauma. Athletic activities that involve repetitive pivoting motions while weight bearing have been associated with damage to the acetabular labrum. Specific sporting activities, such as soccer, hockey, golf, and ballet, have been linked to labral abnormalities, because they require frequent external rotation of the hip. Although labral tears can be present for long periods before being diagnosed, once a labral tear is present there is loss of congruity between the femoral head (ball) and the acetabulum (socket). Therefore, the earlier the diagnosis is made, the better.
Symptoms of a hip labral tear include:
- Clicking of the joint
- Joint stiffness/reduced range of motion
- Groin pain, commonly with sitting long periods of time
- Giving way
Precise diagnosis of a labral tear usually requires an MRI with an injection of contrast dye (an MR arthrogram).
Depending on how functionally limiting the symptoms of a labral tear are, surgery may or may not be indicated. Conservative treatment is performed in 3 phases:
- Pain control, core stabilization, correction of abnormal joint movement
- Muscle strengthening, range of motion, sensory motor training, correcting muscle imbalances
- Sport specific functional progression
The main goal is optimizing alignment of the hip joint and creating a muscle balance around the hip and pelvis. While healing and rehabilitating, limiting pivot motions, analyzing and retraining gait, and checking foot motion is important.
The author of this article is Jenny Donohoe, PT from Athletico – Andersonville.