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Published on Jan 3, 2021 / # min read
Torn hip labrum symptoms and treatments, understanding what and where is your hip labrum, and treatments from strengthening and stabilizing with physical therapy to releasing your hip flexors
Hip pain and hip injuries can manifest in many ways. If you’re experiencing pain in your hips, it can often be difficult to know the root cause.
One of these causes may be a hip labrum tear.
A hip labrum tear might not always hurt at first, but over time you may start to notice a few differences in your hip mobility and ability to perform specific movements.
When you’re experiencing hip pain, you may be looking to find the one culprit - the too-soft mattress, the heavy grocery bags, the extra 50-miles on your bike. It’s important to remember that your hip structure is complex and has many moving parts that work together to create smooth, pain-free movement.
Understanding what your hip labrum is, where it is located, and what causes the labrum to become damaged over time is just as important as knowing how to treat it. You can then use this information to incorporate preventative care could help you avoid a hip labrum tear altogether. Or to help you spot potential hip labrum tear symptoms early on.
The hip labrum is a disc of cartilage that is strong and flexible enough to allow for the fluid movement of your hip joint. This durable cartilage rims the outer socket of your hip joint, deepening the joint surface and allowing for a wider range of motion. It also keeps the joint fluid in place. When the joint fluid is in the joint capsule, it reduces friction.
The hip labrum is located between the socket and the ball of your hip joint. It should cover the entirety of the ball and socket connection points on both hips, though everyone’s body is a little different. It then sits between these two bones to avoid direct contact with each other and protect them from friction when you are moving.
Beyond protecting the hip joint itself, the labrum helps to keep the ball and socket in correct alignment. You can think of your hip labrum cartilage as being like a rubber gasket. It keeps the joint’s ball and socket in place, and prevents damage during all of your movements.
Recognizing that you have a torn labrum can be difficult because hip labrum tear symptoms can present similarly to hip arthritis pain symptoms.
If you suspect you have a torn labrum, or even if you’ve just strained it, your iliacus muscle will likely be tight. And it’s the pain from this muscle - or the sensation of tight hips - that might be your first indication of a bigger problem in your hip joint.
Your iliacus muscle is one of the two muscles that make up your hip flexors. Paired with the psoas, the muscles are known as the iliopsoas. Together, the iliopsoas muscles are what bring movement and stability to your hips, thigh bones, and pelvic bone. They allow you to make everyday movements like going from standing to sitting position, or lifting your knee up to your chest.
Another job of the iliopsoas muscles is to stabilize your core and protect the ligaments and bones in your hip joints. Therefore, the muscles may contract or overcompensate when there is a problem, such as increased friction, misalignment, or a labral tear, causing increased tightness and pain in your hip flexors.
Still, in many instances, those that have experienced such a tear may not actually experience torn hip labrum symptoms or pain. It may take time for the pain to manifest in the hip, as the iliopsoas muscles attempt to correct the injury on their own.
Although you might not have all (or any) of the most common symptoms of a labral tear, they could present as one or more of the following:
The way hip labrum tear symptoms present can also depend on the type of labral tear it is: anterior or posterior.
Anterior labral tears are by far the most common type of labrum tear. Located in the front of the hip, this part of the labrum is thought to be easier to injure because of the lack of blood vessels in that area.
Posterior labral tears are less common than anterior tears partially because they are located on the back of the hip. While this joint area still moves frequently, there isn’t as much motion creating contact on the labrum cartilage in the back as there is in the front.
If a posterior labral tear occurs, it is because more stress is occurring in the back portion of the hip joint. This could be from frequently performing a repetitive motion like frequently squatting with weights or partaking in other squatting and lunging sports.
If you begin to experience these symptoms during activities that normally don’t cause pain or discomfort, it is time to seek the help of a professional.
As we mentioned, you may not always know you have a torn hip labrum. Symptoms are not always identifiable. But getting a proper diagnosis of any hip injury is important to ensure that you get the appropriate treatment.
In most cases, a physical diagnosis will include a variety of orthopedic tests, communication about your medical history, a rundown of your current fitness routine, a history of your past injuries (if any), and a general physical assessment.
It’s important to share all this because labrum tears are common with serious athletes that use their hip joints repetitively and aggressively. Participating in sports like dance, gymnastics, hockey, or soccer requires very specific hip movements and rotations. This can put extra stress and pressure on the hip joint itself, as well as extra strain on your iliopsoas muscles.
These labral tears can also be caused by hip joint abnormalities, such as hip dysplasia. The way your ball and socket fit together could result in added friction or pressure in specific areas, leading to damage and tears later in life.
Doctors and physical therapists alike will test for a labral tear in much the same way. During a physical examination, they will measure joint strength, flexibility, and range of motion. They’ll be checking to see if there is any obvious swelling and listen to your feedback about which movements are causing pain in your hip flexors, legs, lower back, and pelvic region.
If there is obvious pain for the patient when testing for these things, it can be a strong indication that the ball and socket of the joint are not adequately protected.
A standard test that doctors use to determine whether a labrum tear has occurred or not is called the FABER test. FABER stands for flexion, abduction, and external rotation. This specific test puts the hip joint into a position to expose anterior labral tears.
The FABER test works by having you lay on your back with straight legs. Then, you put one leg in a figure-4 position.
Your physical therapist or doctor will gently apply pressure to the knee of the bent leg. If there is groin pain on the side of the bent leg, it could be a hip labrum tear symptom. It is an indicator that there is a problem in your hip muscles, such as your iliopsoas muscles, or that there could be a joint injury.
Once you have identified torn hip labrum symptoms - and determined that your hip pain is indeed being caused by a torn hip labrum - now is the time to address it.
Repairing cartilage is a difficult task for the body, but it is not impossible.
The most common treatments for hip labrum tears include injections, anti-inflammatories, rest, and physical therapy. I always recommend that you begin with the least invasive treatment, opting for natural solutions such as rest and physical therapy that focuses on releasing and stabilizing your iliopsoas muscles. Only if those are unsuccessful should you move on to more aggressive treatments.
Depending on the severity of your pain and the other torn hip labrum symptoms you’re experiencing, a doctor may recommend an anesthetic fluid injection for pain management.
By mitigating some pain, you can integrate other movements and physical therapy.
However, this type of intra-articular injection is most often recommended if the pain and other hip labrum tear symptoms cannot be alleviated by a different treatment measure.
Another common treatment is the use of anti-inflammatory medication, generally non-steroidal, to help control your hip labrum tear symptoms. Like the injection, this is meant to mitigate pain to allow for continued treatment of other kinds as opposed to being a complete solution in itself.
These non-steroidal anti-inflammatory drugs should also bring down the swelling caused by the friction and irritation of the damaged hip joint.
One of the best treatments for doing away with hip labrum tear symptoms is simply to rest for a while. This can be hard to do if you are an athlete, but giving your body time to heal is essential.
In most cases, though, this doesn’t mean all activities have to halt.
Many patients who experience hip labrum tear symptoms are only recommended to stay away from painful activities. So, if running is causing you pain, but walking isn’t, a doctor may recommend that you stop running for a short period of time to let the labrum rest and avoid pain.
You should also be incorporating very light stretches or movements designed specifically to release your hip muscles, which may reduce or eliminate hip flexor pain and restore natural alignment in your hips and pelvis.
Working closely with a physical therapist is a great treatment option for almost any type of hip pain, especially a labrum tear. A physical therapist can come up with individualized treatment plans that will help you to improve strength and stability in your hip joints.
Many physical therapists focus strictly on labrum hip tear exercises that help you build up the muscles surrounding your hips like the iliopsoas muscles, glutes, abdominals, and back muscles. Improving muscle strength in these areas is a proven way to help stabilize the hip joint and protect it from future damage.
When a part of the hip structure is damaged, especially a part so integral to movement like the labrum, your muscles tend to try and pick up the slack and support the hip more intensely. With hip labrum tears, we often see this happening with the iliopsoas or hip flexor muscles.
Since the hip flexors engage with nearly every hip movement, it makes sense that a tight hip flexor often correlates with a labrum tear. Keep in mind that this can be both a torn hip labrum symptom, and a cause of a labrum tear.
A tight iliacus muscle can begin to pull your hip out of alignment, which directly opposes what the labrum does. One of the labrum’s jobs is to keep your hip joint aligned and in place.
So, with the extra pull of each movement, your labrum will be experiencing far more pressure than usual. Over time, this can lead to the cartilage wearing down and eventually tearing.
On the other hand, if you’ve experienced a trauma of some kind that tore your labrum, you may not notice any hip labrum tear symptoms until the iliopsoas muscle tightens more. This occurs because the iliopsoas is compensating for an imbalance of some kind in the joint structure.
Whatever the cause of the muscle tightness, one thing is for sure, if you have a hip labrum tear, more often than not, your hip flexors will be tight too.
And, to find long-lasting pain relief, you need to make sure to release your hip flexors.
Knowing your hip anatomy and how your body is meant to work together in unison makes it easier to understand where your hip pain is coming from. Living with and treating a hip labrum tear comes with many symptoms that often disguise themselves as arthritis or other issues.
Once you’ve been diagnosed, and treatment begins, it can be helpful to start looking at other contributing factors, such as your tight iliopsoas muscles.
Treating the iliopsoas muscles is two-part. There is the psoas, which can be massaged along the connecting point of your inner thigh and pelvis. But the iliacus muscles can be relatively difficult to release. It connects to the internal side of your hip bone and requires a precise angle and amount of applied pressure. Therefore, it is nearly impossible to reach with an average massage ball, foam roller, or your own fingers.
A skilled physical therapist is trained on iliacus muscle release, but you can’t do this effectively alone between sessions or as a preventative measure.
There is one self-massage option, though. The Hip Hook by Aletha is the only tool designed to reach the precise point where your iliacus connects to your pelvic bone, using body weight to apply the right amount of pressure.
It’s safe to use as a part of your daily routine. And, as your iliopsoas loosens, you’ll likely experience less pain, less tightness in your hip flexors, and less stress will be put on the cartilage of your hip joints.
Once you have rebalanced your hip joints, strengthened them through physical therapy, and given your hips the rest they need, any hip labrum tear symptoms you have been experiencing should decrease and may even disappear. And if you feel that familiar hip flexor tightness or hip pain start to flare up, you can easily use your Hip Hook at home.
If you’d like more information on targeted hip stretches and exercises, or would simply like a deeper understanding of your hip labrum, iliopsoas muscles, and the many other components of your hip joints, check out my book: Tight Hip, Twisted Core.
Armed with all your new knowledge, you’ll surely be able to kick your hip labrum tear symptoms to the curb.
Common symptoms of a torn hip labrum include: limited mobility and pain-free range of motion in the hip joint; pain in the hip or groin area that typically worsens with extended periods of inactivity; and sensations like clicking, locking, or a feeling of catching when moving the hip joint through certain ranges of motion.
No, the torn labral tissue inside the hip joint will not heal on its own and can only be repaired or removed through surgery. However, the first course of action is typically some form of physical therapy because surgery is not always necessary to improve the symptoms of a torn hip labrum.
A torn hip labrum can be caused by several different things, including: structural misalignments of the hips and pelvis that increase friction within the hip joint, trauma or injury to the hip, or degenerative health conditions of the hip.
Tight hip flexors (like the iliacus and psoas) can pull the pelvis forward into an anterior rotation, which reduces the space available within the hip socket for the hip to move through certain ranges of motion. This can increase friction inside the hip, where the soft tissues (like the hip labrum) experience gradual wear and tear until this injury develops.
While a torn hip labrum cannot heal itself, there are other alternatives that you can try for pain relief before resorting to surgery. Using a combination of muscle release along with other corrective stretching and strengthening exercises can help to improve the alignment and range of motion within your hip joints, and may also help to reduce your pain.