What is a labral tear?
The labrum is a soft cartilage tissue that lies between the ball-and-socket hip joint that ensures bones glide smoothly past each other without touching. The hip is largely made up of the ball of the leg's femur bone located in the socket called the acetabulum.
The labrum attaches to the edge of the acetabulum, allowing for the femoral head to move freely without the two bones pressing against each other. The labrum also seals the femur within the acetabulum socket and keeps synovial fluid, which lubricates the joint, within the socket.
When a torn hip labrum occurs (whether it results in small tears, frays, or full tears), the labrum on the outer ring of the socket can rip away and the function of the hip joint becomes compromised.
A variety of activities can lead to a hip labral tear, whether a hard impact, fall, repetitive sports motions or with aging.
What are hip labral tear symptoms?
Pain is the most obvious torn hip labrum symptom. The pain can appear to come from the hip, groin, or buttocks area, depending on the location of the tear. Stiffness and a locking feeling in the hip are common symptoms of a hip labral tear along with a sharp catching feeling deep inside the groin region with pivoting.
Additional hip labral tear symptoms include:
- Stiffness accompanied by a limited range of motion of the hip
- Locking feeling that could also be a sharp catching pain sensation
- Instability when using the hip
- Pain intensified by athletic activity or sitting in low chairs
Learn more about the signs of a torn hip labrum. If you are experiencing symptoms of a hip labral tear, request an appointment with a specialist on Mass General Brigham's sports medicine team to diagnose and create a customized treatment plan for your injury. Same-day telehealth visits are often available to you.
Types of hip labral injuries
A labral tear in the hip can occur suddenly due to a sports injury or over time due to degeneration.
As commonly seen during sports, a traumatic injury to the hip can tear the labrum cartilage. These types of injuries can be contact or noncontact injuries. High-impact twisting or bending can overstress the cartilage and lead to a tear. Your labrum can also tear if you take a hard hit to the hip.
Chronic overuse of the hip, such as from a repeated sports-related motion, can cause the labrum to wear down. The labrum can also degenerate over time due to arthritis, which can be attributed to repetitive motions.
What causes a hip labral tear?
Common causes of a hip labral tear during athletic activity include:
- Sustaining a hard hit to the hip, whether by running into an opponent or falling on the ground
- A traumatic twisting of the hip
- Repetitive motion of the hip joint causing overuse
- Impingement syndrome of the hip caused by lumps or bumps about the hip that can tear the labrum over time
The most common sports with hip labral tears include soccer, ice hockey, golf, ballet, and football. Commonly an anterior hip labral tear is caused by repetitive motion, whereas posterior hip labral tears tend to result from an acute injury.
If not left to heal properly, a hip labral tear can cause further damage to the hip joint, including the loss of the cartilage coating of the ball and socket over time. Returning to activity before the labrum has fully healed risks escalating the injury and increasing the risk of arthritis developing within the joint.
Athletes should be in proper physical condition for their sport to decrease the risks of injury.
How are hip labral tears diagnosed?
A hip labral tear diagnosis can include a physical examination and imaging technology. A physical examination to diagnose hip labral tears often includes:
- Questions about the injury and extent of hip pain
- Comparing the injured hip with the uninjured hip to determine swelling and range of motion
- Movement testing to evaluate pain, range of motion, and stability
During a physical exam, your doctor will determine the severity of the injury and the possibility of additional damage. Imaging technology can further evaluate the labrum and hip joint. An X-ray can check the bones within the hip joint, and a magnetic resonance imaging (MRI) scan can evaluate the soft tissue in the joint, including the labrum. Both can be used to evaluate the entirety of the hip and rule out additional issues.
Hip labral tear treatment
Surgery may be required to repair a hip labral tear, although in many cases a doctor will recommend nonsurgical treatments including physical therapy to relieve pain from the tear.
While a hip labral tear won't fully heal on its own, the symptoms of a minor tear or injury can be relieved with nonsurgical treatments for a hip labral tear. Typically, rest, activity modification, over-the-counter anti-inflammatory drugs, and physical therapy are recommended. Physical therapy aims to strengthen and stretch hip muscles to better support the joint and relieve pain. Therapy may also teach an athlete the proper hip movements during activity to help alleviate pain.
A steroid injection may be prescribed to reduce pain and inflammation.
Minimally invasive arthroscopic surgery can repair a tear in the labrum by either stitching the tear together, using healthy tissue from elsewhere in the body to reconstruct the labrum, or removing damaged pieces of labrum.
In more severe cases, a surgeon may perform hip replacement surgery to improve movement.
Hip labral tear recovery time
Recovery time following a tear to the hip labrum depends on the extent of the injury. Those with a tear not requiring surgery may experience symptom relief within a couple of weeks following rest. The tear won't heal fully without surgery, so additional treatment and rest could be required.
Athletes will start rehabilitating almost immediately following hip labral tear surgery. Working with a physical therapist can improve strength and mobility. Full recovery from hip labral tear surgery could take four to six months.
Learn about the differences in torn hip labrum recovery between male and female athletes.
Preventing hip labral tears
A strong hip joint and proper warm-up can help limit the risk of a hip labral tear. Tips for further hip injury prevention include:
- Strengthening the hip through exercises and stretching
- Ensuring you are fit enough for your activity of choice
- Properly warming up and stretching before activity
- Improving your athletic technique to reduce the risk of abnormal twisting or bending
Learn more on how athletes can prevent hip injuries from one of Mass General Brigham’s sports medicine specialists.
FAQs
No, a hip labral tear will not heal on its own. Nonsurgical treatments can relieve pain and symptoms, but full healing requires surgery.
An untreated labral tear in the hip will continue to cause pain and additional symptoms to the patient. It will increase in severity and lead to additional injury and arthritis that will require further medical attention.
Walking with a labral tear in the hip could cause additional pain. Typically, doctors advise resting the hip and limiting activity, such as walking.
A shot of cortisone (steroid) will not heal a torn hip labrum. It may relieve pain in the hip for days, weeks, or sometimes months, but it does not have a long-lasting benefit. Some patients may overuse a torn labrum in the hip following pain relief, leading to further damage over time.
An MRI is effective at detecting a torn hip labrum. A visual examination during arthroscopic surgery can better determine the extent of the tear.
