- 1 1. What are hip labral tears?
- 2 2. What are the types of hip labral tears?
- 3 3. What are the risk factors and causes of hip labral tears?
- 4 4. What are the symptoms of a hip labral tear?
- 5 5. How is a hip labral tear diagnosed?
- 6 6. Can a labral tear heal on its own?
- 7 7. What are the recommended treatments for hip labral tears?
- 8 8. Do labral tears always need surgery?
- 9 9. What is the outlook for a patient with a hip labral tear?
- 10 10. When should I consult a doctor about a hip labral tear?
- 11 In summary…
- 12 A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic Insurance
Good hip mobility isn’t just useful for athletes or those with active lifestyles. Everybody needs strong hip muscles to support the pelvis and core, which serve as a strong foundation for our legs and arms. It’s the hip muscles that make it possible for us to move, run, walk, and jump.
A large percentage of the body’s weight is centred on muscles that are connected to the hip. Hence, these muscles need to be flexible and strong to withstand daily use and recover faster from injuries.
But what happens if we have hip pain? Hip pain can occur due to a plethora of reasons, including a hip labral tear. In this blog, we’ve rounded up everything you need to know about hip labral tears, and when to seek medical help for it.
1. What are hip labral tears?
The hips are made of three structures — bones, muscles, and nerves. Each of these plays a pivotal role in mobility and stability.
In anatomy and physiology, the term “labrum” refers to a brim or edge, which is the tough cartilage found around the hip’s acetabulum or socket.
The labrum works by facilitating the hip’s range of motion, helping the thigh to rotate in all directions. Also, it helps align the hip’s ball and socket properly and contains the synovial fluid inside the hip joint capsule.
Additionally, it keeps the bones in place as you move and keep the joint fluid inside to ensure frictionless and painless motion.
In a nutshell, the hip labrum provides support, stability, and flexibility to the joint. When it becomes damaged, it can take a toll on the alignment, range of motion, and synovial fluid of the hip joint — causing pain and making it difficult for us to move.
Meanwhile, labral tear is an injury to the labrum caused by degenerative issues, injury, or structural problems.
- Hip labral tears are common in people between the ages of 8 and 72 years old. On average, it occurs mostly in the fourth decade of life.
- Women are more likely to suffer from hip labral tears than men.
- The prevalence of labral tears with hip or groin pain is 22 to 55 percent.
- Labral tears in the hips were found more often in younger patients than labral tears caused by degenerative issues in the older population.
2. What are the types of hip labral tears?
The severity of hip labral tears may depend on the extent of the tear — it can have tiny tears due to gradual wear on the labrum, or larger ones that cause the labrum to separate from the socket bone. Larger labral tears may be due to trauma or injury.
There are two major types of labral tears, which are caused by different motions. Anterior labral tears, the most common type, are found at the front of the hip and are usually caused by repetitive pivoting or twisting motions. A posterior labral tear, on the other hand, affects the back of the hip. It’s the less common type and traumatic injuries are the common causes.
3. What are the risk factors and causes of hip labral tears?
The hip labrum is prone to a traumatic injury from the shearing forces that happen when you pivot, twist, or fall. Hip labral tears can be caused by many factors, including:
Trauma to the hip is a major cause of labral tears. These traumatic injuries may stem from vehicular accidents, falls, or high-impact sports, including football, hockey, golf, and soccer.
Some conditions that cause abnormal hip movement may cause hip labral tears. For instance, femoroacetabular impingement (FAI), wherein the femoral head does not fit into the socket properly, causes long-lasting movement limitations and groin pain.
In Asians, the incidence of posterosuperior tears is higher due to a tendency toward hyperflexion or squatting motions.
Further, slipped capital femoral epiphysis (SCFE) is a condition among adolescents wherein the growth plate becomes damaged. As a result, the femoral head stays in the cup of the joint while the femoral body is shifted — which could lead to labral tears, as well.
Degenerative health conditions
Joint degeneration and childhood disorders, including Legg-Calve-Perthes disease, can also increase the risk of hip labral tears. . Also called Perthes disease, this rare condition happens when the ball-shaped heat of the femoral head temporarily loses its blood supply. When this happens, the femur or thigh bone collapses, causing irritation and swelling.
Another example is osteoarthritis, a chronic condition wherein the cartilage in the pelvis or hip joint gradually wears away over time. As this happens, the cartilage becomes rough and causes friction between joints.
Hypermobility or Laxity
Capsular laxity caused by injury, collagen disorders, and repetitive motions can weaken some parts of the capsule, which leads to instability and increased force distribution on the labrum.
Hip dysplasia happens when the hip socket doesn’t fully cover the ball portion of the upper femur or thigh bone. In this case, the hip joint becomes partially or completely dislocated. This can lead to joint hypermobility and labral compression.
The risk factors of labral tears in the hip include:
- Problems with muscle length, joint mobility, posture, neuromuscular control, and muscle performance
- Abnormal boney hip morphology
- Lower crossed syndrome
- Structural abnormalities
- Pre-existing hip conditions
- Athletes in sports where the hip is repeatedly flexed, or may experience a sudden impact on the hip — hockey players, soccer players, dancers, golfers, football players, cross country athletes, track and field athletes, and rugby players.
4. What are the symptoms of a hip labral tear?
A labral tear can cause pain and instability in the hips. Patients frequently present with anterior (frontal) hip and groin pain. The less common areas of pain include the lateral thigh, anterior thigh, knee, and buttocks.
Aside from pain, other signs and symptoms of a hip labral tear include:
- Stiffness of the hip joint
- Limited range of motion of the hips
- Locking, clicking or a “giving way” sensation in the hip
- Inability to flex the hip beyond the right angle
- Hip instability
- Unequal leg lengths
5. How is a hip labral tear diagnosed?
Hip labral tears can go undiagnosed due to the overlap of symptoms with other hip problems such as hip bursitis, hip flexor tendonitis, and other soft tissue injuries.
To land a diagnosis, a sports medicine physician or an orthopaedic surgeon will perform a physical exam. The doctor will also ask for your specific symptoms.
Some of the most commonly used diagnostic tools are X-rays to detect abnormalities in the shape and alignment of the hip bones, and a magnetic resonance imaging (MRI) scan to get a better picture of the soft tissues, including the labrum.
6. Can a labral tear heal on its own?
A hip labral tear won’t heal on its own, and if it’s left untreated, it will lead to ongoing and worsening pain.
However, if the tear is minor and does not cause much discomfort or pain, you can manage the symptoms without repairing the tear. It can heal in a few weeks with a round of physical therapy, pain relievers, and anti-inflammatory medicines.
If the symptoms do not resolve after 6 to 12 weeks of management or in severe cases, surgery is necessary to repair the torn labrum and restore its normal function.
7. What are the recommended treatments for hip labral tears?
When the labral tear is causing pain and discomfort, the orthopaedic surgeon will recommend nonsurgical treatment options to see if they will work.
Rest. Getting plenty of rest is important to prevent further damage to the labrum. Avoiding strenuous activities and modifying activities can help hasten hip labral recovery.
Pain relievers. Taking pain relievers and anti-inflammatory medicines can help relieve pain and inflammation.
Physical Therapy. Physical therapy can also help manage pain, correct movement patterns, recover your range of motion, and strengthen the muscles in your buttocks, back, and thigh.
Steroid injection. To ease symptoms such as swelling, doctors can inject steroids into the hip joint.
For severe tears or if the tear doesn’t respond to other treatments, surgery is recommended. For hip labral tears, the orthopaedic surgeon performs an arthroscopic procedure, a kind of minimally-invasive surgery that uses an arthroscope.
An arthroscope is a tiny fibre-optic tube with a camera. Also called a key-hole surgery, it has three types — arthroscopic labral debridement, arthroscopic hip labral repair, and arthroscopic hip labral replacement.
8. Do labral tears always need surgery?
Fortunately, not all hip labral tears require surgery. In mild cases, a combination of rest, avoiding activities that cause pain, physical therapy, and pain relievers can help relieve the symptoms.
In worse cases, surgery may be needed to repair a hip labral tear. If it’s left untreated, it can cause hip instability and mobility issues in the long run. Pain in the hip and groin due to hip labral tear can cause limited ability to stand, walk, squat, stand, or participate in physical activities.
9. What is the outlook for a patient with a hip labral tear?
Hip labral tears often remain undiagnosed for long periods. The key to the success of the treatment is to detect the problem right away. The long-term outlook of this condition depends on the severity of the labral tear.
For most patients who underwent hip arthroscopy, it may take 4 to 6 months to fully recover from surgery. Afterwards, they can go back to their previous physical activities.
Patients who follow the rehabilitation plan appropriately are more likely to get back to their normal activities faster.
10. When should I consult a doctor about a hip labral tear?
While hip pain isn’t usually life-threatening, it can take a toll on your life, and your ability to perform daily activities. Any pain in the hips that doesn’t go away after a few days must be assessed by a doctor.
Hip pain can take a toll on the body, especially if it’s chronic. One cause of hip pain is a labral tear, and if it’s left untreated, it can affect one’s quality of life. If you feel any pain in the hip or groin area, visit a doctor to help you plan a treatment regimen and get back to your normal life.
If you wish to learn more about the hip labral tear and other related concerns, you can book a consultation with A/Professor Andrew Dutton at (+65) 6836 8000.