Hip Labral Tears
Hi everyone, in todays blog we are going to be discussing hip labral tears. The hip joint is made up of the femoral head of the femur and the acetabulum of the pelvis. Like the shoulder it is a ball and socket joint, but much more stable due to the greater depth of the socket.
The articular cartilage within the hip joint is known as the labrum. Its role is to increase the surface area of hip joint, act as a cushion against loading and provide passive stability to the joint by acting like a seal to hold the head of the femur in place.
Further stability is provided by ligaments (iliofemoral, pubofemoral and ischiofemoral ligament) and muscles (quadriceps, gluteals, hamstrings).
The hip has the ability to move into 6 directions:
1. Flexion – bending forward
2. Extension – straightening backwards
3. Abduction – leg moving away from body
4. Adduction – leg moving across body
5. External rotation – foot pointing outwards
6. Internal rotation – foot pointing inwards
A labral tear is diagnosed when part of the labrum is either torn or pulled away from the socket. Once the labrum is torn, it does not have the ability to heal due to its very poor blood supply.
Labral tears can occur from sporting injuries when your hip is forced into extreme positions, trauma (such as a dislocation), falls and most commonly repetitive movements in sports that require twisting or pivoting movements. It may also occur secondary to other conditions such as osteoarthritis of the hip.
Symptoms of a hip labral tear may include the following:
1. Pain in the groin or lateral hip
2. Clicking, locking or a catching sensation with hip movements
3. Gradual onset of pain – without mechanism of injury
4. Limited range of movement or stiffness when moving the hip
5. Pain when squatting or with prolonged sitting
Hip labral tears can be treated either conservatively or with surgery. The severity of the tearing and level of pain and disability will generally dictate if surgery is necessary. Surgery should always be seen as a last resort as removing the labrum greatly increases the risk of developing hip osteoarthritis.
A conservative treatment approach should be overseen by an allied health practitioner and follows the process of reducing pain then restoring range of movement to the hip joint followed by restoring strength and stability.
A treatment plan would consist of releasing any tightness or spasm in the surrounding musculature using dry needling or soft tissue techniques, mobilising the hip and lumbar spine to restore movement as well as a structured strengthening program to increase stability and support to the hip. Should conservative management be unsuccessful then surgery could be considered.
Unfortunately, hip labral tears are difficult to predict and thus hard to prevent. However, they are more common in people who participate in regular sport so trying to avoid loading the hip joint at the end of range and maintaining flexibility, alignment and strength through the hip and low back can help reduce your risk.
A good set of simple mobilizing and stretching exercises to perform before and after sports includes:
1. Knee Rolls:
Lying on your back with knees bent and arms stretched out. Rock your knee’s from side to side 50 times (25 each way).
Start with small movements and gradually increase the range until your knee’s are touching the ground.
2. Low Back Stretch:
After you have finished the knee rolls straighten out the bottom leg and roll the top leg over it. keep the shoulder on the ground until you feel a comfortable stretch through the low back.
Hold x 15 secs and repeat x 2 each side.
3. Hip Flexor Stretch:
Starting in a kneeling lunge position. Keep the back knee fixed on the ground and lunge forward onto the front leg. Place both hands on the front knee and gently push your shoulders backward until you feel a comfortable stretch through the front of the hip.
Hold x 15 secs and repeat x 2 each side.
So that’s a brief overview of hip labral tears, if you experience any of the symptoms or discomfort as described above, seek advice from your healthcare practitioner as soon as possible.
If you have any questions or comments, feel free to email us at firstname.lastname@example.org and we’ll happily answer them for you. If you are suffering with hip pain and want relief today, call us on (08) 9486 8653 and we will arrange an appointment for you.