Hip anatomy
The hip is the largest weight-bearing joint in the body with complex anatomy and biomechanics. It is a ball and socket joint. The ball is the upper end of the thigh bone (femur) that fits into the socket (acetabulum) in the pelvis. The acetabulum is lined with articular cartilage that allows the joint to glide easily and offers a wide range of motion. The inherently strong hip joint is fortified with strong ligaments and muscles that form the hip joint capsule to stabilize the joint.
The labrum is a strong ring of cartilage on the rim of the acetabulum that performs several functions: it forms a strong seal to firmly hold the head of the femur in the socket, it deepens the socket, it helps the ball of the joint to move smoothly and easily, and it provides hip joint stability and a wide range of motion.
What causes a labral tear?
A labral tear can result from:
- structural problems such as FAI which affects how the ball and socket fit together. FAI is a common source of labral tears especially in young athletes
- hip trauma from high impact sports like football and ice hockey
- repetitive use trauma from sports like golf, soccer and ballet
- degenerative conditions like osteoarthritis
- hip dislocation can cause damage labrum
What are the symptoms of a labral tear?
A labral tear can cause sudden, significant pain and tenderness in and around the hip. The most common pain is deep groin pain that can spread to the buttocks or low back. Groin pain is pain in the crease where the leg meets the hip. 22% of athletes with deep groin pain have a labral tear. In some, the pain is activity related. Some people with a labral tear may have no symptoms, but most people will experience pain or discomfort that worsens with movement, sports and exercise. Other symptoms include hip stiffness, a clicking sound or locking sensation in the hip with movement, and a sense of instability.
Who is at risk?
Athletes who participate in sports that require repetitive twisting and pivoting like soccer, rugby, skiing, skating, horseback riding, ice hockey and football frequently suffer with labral tears.
Research reports that women suffer labral tears more often than men.
How is a labral tear diagnosed?
Most labral tears occur along with other hip injuries. Also, hip pain can be caused by problems inside the joint and also outside the joint. Dr. Joe Cooper will consider this while he reviews your medical history including evidence of any hip injuries. He will conduct a physical exam testing range of motion and inquire about your symptoms and when they started and what causes them. He will order x-rays to diagnose any anatomical problems like arthritis and FAI that can cause a labral tear. An MRI will reveal the details of the tear, its size and location. He may offer an injection of anesthetic into the joint to see if that relieves your pain. If so, the problem is inside the joint.
How is a labral tear treated?
Treatment depends on the severity of the tear. Labrum tears have no ability to heal on their own due to a poor blood supply. Nonsurgical treatment with over the counter anti-inflammatory medications, physical therapy may be tried. When symptoms fail to resolve, arthroscopic hip surgery will be necessary.
When you are suffering with groin or hip pain, contact an expert, Dr. Joe Cooper to schedule a consultation.
