A labral tear of the hip is an injury of the hip labrum. This tough, crescent-shaped cartilage structure lines the rim of the hip socket (called the acetabulum), which is located in the pelvic bone. Also known as the acetabular labrum, this should not be confused with the labrum of the shoulder, which is a similar structure called the glenoid labrum.
The hip is a ball-and-socket joint, where the head of the femur (thighbone) forms a "ball" that inserts into a "socket" called the acetabulum, which is located in the pelvis. The ball and socket are each covered with smooth articular cartilage. The labrum is an additional, specialized piece of cartilage that runs along the rim of the socket to provide a suction seal and stability to the hip joint, absorbing shock and distributing pressure during hip motion. The hip labrum may become torn or even detached from the acetabular socket for a variety of reasons.
A torn labrum can be caused by:
People with other conditions of the hip can be especially susceptible to labral tears. These include:
Hip labral tear symptoms can include:
Labral tears are difficult to diagnose, partially because of the many muscles and other structures that are near the hip joint. They are often misdiagnosed as common groin strains and it is not uncommon for the diagnosis to be missed for many months after the labrum is torn.
A sports medicine physician or orthopedist will conduct a physical exam and consider your symptoms. If your doctor thinks you may have a torn labrum, he or she will order imaging of your hip. This may include X-rays, but an MRI of the hip is the best way to confirm the diagnosis.
Some people who have a labral tear experience no symptoms and do not need specific treatment.
However, if you have persistent pain from a labral tear, you may get sufficient relief from a physical therapy regimen. Anti-inflammatory pain medications such as NSAIDs (ibuprofen, naproxen) can be used to decrease inflammation around the labrum and provide pain relief.
In conjunction with your doctor, a rehabilitation professional (physical therapist) will determine an appropriate set of exercises to get you back on your feet, pain-free.
If you have a severe tear or if nonsurgical treatment won't provide adequate relief, your doctor may recommend hip arthroscopy. This type of arthroscopic procedure is usually done on an outpatient basis and uses small incisions (1/2 cm) around the hip with specialized instruments to either debride (clean) or remove the injured labrum, or reattach it to the socket. After the surgery, you will be discharged on crutches and use them for 2 to 6 weeks. This length of time is determined on a case-by-case basis. Postsurgical physical therapy will improve your range of motion and muscle strength around the hip.
Whether you are treated surgically or nonsurgically, recovery from a torn hip labrum can take up to six weeks. Depending on the extent of the injury, competitive athletes may return to their sport sometime between 2 and 6 months.
Click the image below for an interactive diagram of a torn hip labrum.
Read about conditions and issues related to labral tears of the hip.