Hip labral tear

Overview

A hip labral tear involves the ring of cartilage (labrum) that follows the outside rim of the socket of your hip joint. In addition to cushioning the hip joint, the labrum acts like a rubber seal or gasket to help hold the ball at the top of your thighbone securely within your hip socket.

Athletes who participate in such sports as ice hockey, soccer, football, golf and ballet are at higher risk of developing a hip labral tear. Structural abnormalities of the hip also can lead to a hip labral tear.

Illustration showing hip labral tear — Hip labral tears are more common in people who play certain sports or who have structural abnormalities of the hip. If conservative treatments don't help, your doctor may suggest surgery to remove or repair the torn labrum.

Symptoms

Many hip labral tears cause no signs or symptoms. Occasionally, however, you may experience one or more of the following:

A locking, clicking or catching sensation in your hip joint
Pain in your hip or groin
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 may 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 the sudden twisting or pivoting motions common in golf or softball — can lead to joint wear and tear that ultimately results in a hip labral tear.

Complications

A hip labral tear may predispose you to develop osteoarthritis in that joint in the future.

Prevention

Hip labral tears are often associated with sports participation. If your sport puts a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises. Try to avoid loading your hip with your full body weight when your legs are in positions at the extreme ends of your hip's normal range of motion.

Diagnosis

During the physical exam, your doctor will move your leg, and especially your hip joint, around in various positions to check for pain and evaluate your hip's range of motion. He or she may also want to watch you walk.

Imaging scans

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

Detailed images of your hip's soft tissues can be provided through magnetic resonance imaging (MRI). A contrast material may be injected into the hip joint space to better define a labral tear if one exists.

Anesthesia injection

Hip pain can be caused by problems within the joint or outside the joint. Your doctor may 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 choices will depend on the severity of your symptoms. Some people recover with conservative treatments in a few weeks, while others may require arthroscopic surgery to repair or remove the torn portion of the labrum.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs), 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 strength and stability. Therapists can also analyze the movements you perform that put stress on your hip joint and help you avoid these forces.

Surgical and other procedures

If conservative treatments don't relieve your symptoms, your doctor may 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 may cut out and remove the torn piece of labrum or repair the torn tissue by sewing it back together.

Preparing for an appointment

While you may initially consult your family physician, he or she may refer you to a doctor who specializes in hip disorders or sports medicine.

What you can do

You may want to write a list that includes:

Detailed descriptions of your symptoms
Information about medical problems you've had
Information about the medical problems of your parents or siblings
All the medications and dietary supplements you take
Questions you want to ask the doctor

What to expect from your doctor

Your doctor may ask:

Where exactly does it hurt?
When did the pain start?
Did anything precipitate it?
Does any activity make the pain better or worse?

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