Hip labral tear

Overview

Symptoms

Many hip labral tears cause no signs or symptoms. Some people, however, have one or more of the following:

• Pain in your hip or groin, often made worse by long periods of standing, sitting or walking
• A locking, clicking or catching sensation in your hip joint
• Stiffness or limited range of motion in your hip joint

When to see a doctor

Seek medical attention if symptoms worsen or don't improve within six weeks.

Causes

The cause of a hip labral tear might be:

• Trauma. Injury to or dislocation of the hip joint — which can occur during car accidents or from playing contact sports such as football or hockey — can cause a hip labral tear.
• Structural abnormalities. Some people are born with hip problems that can accelerate wear and tear of the joint and eventually cause a hip labral tear.
• Repetitive motions. Sports-related and other physical activities — including long-distance running and the sudden twisting or pivoting motions common in golf or softball — can lead to joint wear and tear that ultimately result in a hip labral tear.

Complications

A hip labral tear can make you more likely to develop osteoarthritis in that joint in the future.

Prevention

If the sports you play put a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises.

Diagnosis

Your doctor will take a history of your discomfort. During the physical exam, your doctor will move your leg, and especially your hip joint, into various positions to check for pain and evaluate your hip's range of motion. He or she might also watch you walk.

Imaging scans

A hip labral tear rarely occurs in isolation. In most cases, other structures within the hip joint also have injuries. X-rays are excellent at visualizing bone. They can check for fractures and for structural abnormalities.

An MRI can provide detailed images of your hip's soft tissues. A contrast material might be injected into the hip joint space to make a labral tear easier to see.

Anesthesia injection

Hip pain can be caused by problems within the joint or outside the joint. Your doctor might suggest injecting an anesthetic into the joint space. If this relieves your pain, it's likely that your problem is inside your hip joint.

Treatment

Treatment depends on how severe your symptoms are. Some people recover with conservative treatments in a few weeks; others need arthroscopic surgery to repair or remove the torn portion of the labrum.

Medications

Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), can relieve pain and reduce inflammation. Pain can also be controlled temporarily with an injection of corticosteroids into the joint.

Therapy

A physical therapist can teach you exercises to maximize hip range of motion and hip and core strength and stability. Therapists can also teach you to avoid movements that put stress on your hip joint.

Surgical and other procedures

If conservative treatments don't relieve your symptoms, your doctor might recommend arthroscopic surgery — in which a fiber-optic camera and surgical tools are inserted via small incisions in your skin.

Depending on the cause and extent of the tear, the surgeon might remove the torn piece of labrum or repair the torn tissue by sewing it back together.

Complications of surgery can include infection, bleeding, nerve injury and recurrent symptoms if the repair doesn't heal properly. A return to sports can take weeks to months.

Preparing for an appointment

Your family physician might refer you to a doctor who specializes in hip disorders or sports medicine.

What you can do

Make a list that includes:

• Detailed descriptions of your symptoms and when they began
• Other medical problems you've had
• Activities that might contribute to your hip pain
• All medications, vitamins and other dietary supplements you take, including doses
• Questions to ask the doctor

What to expect from your doctor

Your doctor may ask:

• Where exactly does it hurt?
• Are you aware of what you were doing when it started?
• Does anything make the pain better or worse?