Labral Tear of the Hip

Ouch! The soccer player limps off the field after a sucessful goal. The football player notices his hip “locks up” ever since the tackle two Sundays ago. The young mother of three has recurrent pain in her groin a month after a car accident, despite a checkup by her family doctor.

What do these people have in common? They are all suffering a labral tear of the hip, an often-unrecognized condition.

Put simply, the labrum is elastic tissue that lines the hip socket where the ball of the thighbone fits into the hip. The labrum is filled with nerve fibers, often creating pain when the area is injured. Symptoms of a labral tear include:

• Radiating pain in the groin or front of the hip

• Pain that is worsened with sitting (because the hip is flexed)

• A sensation of the hip being “locked up”

• A hip that “gives way”

• Limited range of motion in one hip

Occasionally, a labral tear is present without noticeable symptoms. Over time, the injured hip becomes unstable, placing extra load on the surrounding muscles. Osteoarthritis can set in, causing further damage. Physicians recognize two main causes of labral tears:

• A sudden traumatic injury, such as that from a car accident, fall, or a sports impact

• A repetitive injury, such as high flex kicking or lower body rotation. These actions twist the hip and can lead to a labral tear due to degeneration over time.

While labral tears can occur in anyone, hockey, football, baseball, soccer and golf players – both professional and amateur – are at increased risk. A quick trip to the family doctor may not yield a labral tear diagnosis, and the individual may spend a few weeks treating a suspected “muscle strain” without relief.

A specialist should examine the injured hip, check range of motion, and order an x-ray, MRI or magnetic resonance arthrography (MRA) as needed. Once a labral tear is diagnosed, a variety of treatment methods may be employed, depending on the severity of the condition. Rest may be prescribed if the hip area is inflammed. Non-steroidal anti-inflammatory medicines, such as naproxen or ibuprofen are useful. A corticosteroid and/or local anesthetic injection may be given in some cases.

Arthroscopic surgery uses a tiny camera and tools inserted into an incision. Loose pieces of torn labrum may be removed, or they may be sewn back together. Many athletes, both professional and weekend warriors, can return to the field following succesful treatment for a labral tear.