Hip Labral Tear

A hip labral tear is an injury to the soft elastic tissue around the hip joint called the labrum. The hip joint is made of a ball and socket. The ball is the end of the thigh bone, also called the femur. This ball fits into the bowl-shaped socket in the pelvic bone, also called the acetabulum. Cartilage lines the socket to keep movement smooth and the joint cushioned. The labrum helps to hold the ball of the femur in place. When the this tears, it is called a hip labral tear.

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Hip labral tears can result from wear and tear or from an injury.

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Factors that can increase your chances of getting a hip labral tear include:

  • Wear and tear of hip joint from different activities, such as golf or softball
  • Traumatic injury to hip
  • Twisting injuries
  • Motor vehicle accident
  • Degenerative diseases like osteoarthritis
  • Femoroacetabular impingement syndrome (FAI)
  • Legg-Calve-Perthes disease
  • Hip dysplasia
  • Osteoarthritis
  • Slipped capital epiphysis
  • Capsular laxity/hip hypermobility

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Symptoms vary and can be mild, including:

  • Hip pain: sharp, deep, disabling
  • Locking or clicking of hip
  • Hip instability
  • Limited range of motion
  • Tenderness to touch
  • Groin, buttock, or thigh pain
  • Pain during activity

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Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will likely be referred to a specialist. An orthopedic surgeon focuses on bones and joints. Images may need to be taken of your hip. This can be done with:

  • Magnetic resonance imaging (MRI) arthrography
  • X-rays

An anesthetic may be injected to help diagnose this condition. If the pain gets better with the injection, the problem is in the joint which could be a labral tear.

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The goals and treatment plan for physical therapy management of a hip labral tear is specifically designed in accordance with individual patient symptoms.  the specific care plan will be comprehensive in nature and organized into three phases based on individual patient progression and response to treatment.

  1. Phase 1 of the protocol will consist of pain control, core stabilization, and range of motion.
  2. Phase 2 focuses on muscle strengthening, returning normal movement patterns, and initiation of sensory motor training.
  3. Phase 3 emphasizes advanced sensory motor training, with sport-specific and specific functional progression.  In addition, the physical therapist will provide specific education at each phase of the rehabilitation process and will work directly with the physician to achieve the goals.

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There are no known guidelines to prevent a hip labral tear.

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RESOURCES:
  • American Academy of Orthopaedic Surgeons

http://orthoinfo.aaos.org

  • Arthroscopy Association of North America

http://www.aana.org

CANADIAN RESOURCES:
  • Canadian Orthopaedic Association

http://www.coa-aco.org

  • Canadian Orthopaedic Foundation

http://www.canorth.org

REFERENCES:
  • Bharam S, Philippon MJ. Diagnosis and management of acetabular labral tears in the athlete. International SportMed Journal. 2008;9(1):1-11.
  • Burnett SJ, Della Rocca GJ, et al. Clinical presentation of patients with tears of the acetabular labrum. The Journal of Bone & Joint Surgery. 2006;88:1448-1457.
  • Hip Labral Tears. Arthorscopy Association of North America website. Available at: https://www.aana.org/VideoEducationLibrary/Articles/HipLabralTears/tabid/130/Default.aspx. Accessed May 6, 2013.
  • Hunt DH, Clohisy J, et al. Acetabular Labral Tears of the Hip in Women. Physical Medicine and Rehabilitation Clinics of North America – Volume 18, Issue 3 (August 2007).
  • O’Kane J. Anterior hip pain. Am Fam Physician. 1999 Oct 15;60(6):1687-1696. Available at:  http://www.aafp.org/afp/991015ap/1687.html Accessed May 6, 2013.

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