What Is A Hip Labrum Tear? A Physical Therapist’s Guide

What Is a Hip Labral Tear? A Physical Therapist’s Guide

Hip pain can be frustrating, especially when it limits your movement, sleep, or ability to work out. One common cause of deep hip pain is a hip labral tear. It’s something I’ve seen in the clinic many times, and if you're reading this, you might be dealing with one yourself.

In this article, I’ll explain what a hip labral tear is, how it’s diagnosed, what causes it, and most importantly, what you can do to treat it and stay active.

What Is the Hip Labrum?

The hip labrum is a ring of cartilage that surrounds the rim of your hip socket, called the acetabulum. Think of it like a cushion or seal that deepens the socket, helps keep the ball of the femur (your thigh bone) in place, and provides joint congruency and stability for the entire joint.

This labrum also helps absorb shock and provides smooth movement when you walk, run, or rotate your hip.

What Is a Hip Labral Tear?

A hip labral tear is when that ring of cartilage becomes damaged, either frayed, torn, or detached from the rim of the hip socket. Tears can vary in size and location, and they’re more common than people realize.

Some people with labral tears feel deep hip pain or groin pain. Others may not have pain but feel clicking, catching, or limited range of motion.

How Is a Hip Labral Tear Diagnosed?

Diagnosis starts with a good clinical exam. A physical therapist or physician may perform specific tests to provoke symptoms or assess joint motion and strength.

However, the gold standard for diagnosis is usually MRI with contrast, known as an MRA (Magnetic Resonance Arthrogram). This imaging test uses dye to highlight the hip joint and labrum, making it easier to see if there’s a tear.

X-rays are sometimes used to rule out other bony issues, but they don’t show the labrum itself.

What Causes a Hip Labral Tear?

Labral tears can happen for a variety of reasons:

  • Repetitive hip motion: Activities like running, dancing, or kicking sports that take the hips into end-range positions can cause wear and tear over time.

  • Structural issues: Conditions like FAI (femoroacetabular impingement), where the bones of the hip don’t align properly, can pinch the labrum and lead to tearing.

  • Trauma or injury: A fall, car accident, or sports injury can cause an acute tear.

  • Degeneration: As we age, cartilage can weaken, making the labrum more prone to tearing.

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    Signs and Symptoms of a Hip Labral Tear

    The symptoms can vary, but common signs include:

    • Deep sharp pain in the front of the hip or groin

    • Pain aggravated with a combination of hip flexion (moving knee towards chest) and hip adduction (moving leg towards midline), and internal rotation.

    • Clicking, locking, or catching sensations when you move

    • Stiffness or loss of motion

    • Pain during twisting, pivoting, or prolonged sitting

    • Pain with end range hip flexion, like during squats and lunges

    • Pain with running, squatting, or changing direction

    Many people describe the pain as deep and hard to pinpoint, often felt during specific movements rather than all the time.

    How Do You Treat a Hip Labral Tear?

    Not all labral tears require surgery. Many people can manage them successfully with conservative treatment. Here’s how:

    1. Physical Therapy

    Physical therapy is one of the most effective first steps. Treatment often includes:

    • Strengthening the glutes, core, and surrounding hip muscles to support the joint

    • Improving mobility in stiff areas that may be overloading the labrum

    • Manual therapy to help with joint motion and tissue mobility

    • Activity modification to avoid aggravating positions or movements

    The goal is to reduce strain on the labrum, build strength, and improve movement patterns.

    2. Activity Modification

    Certain movements may worsen symptoms, especially in early stages. Common activities to avoid include:

    • Deep squats or lunges beyond your range

    • High-impact running or jumping (temporarily)

    • Prolonged sitting in a deep hip flexion position

    Modifying these movements doesn’t mean stopping everything, it means temporarily adjusting while your hip gets stronger.

    3. Injections

    In some cases, doctors may recommend a corticosteroid injection to reduce inflammation and help diagnose where the pain is coming from. This can be helpful but isn’t a long-term solution.

    4. Surgery

    If symptoms persist and conservative care hasn’t worked after several months, hip arthroscopy may be considered. This minimally invasive surgery allows the surgeon to clean up or repair the tear.

    However, most people I see benefit from rehab and avoid surgery altogether.

    Final Thoughts

    A hip labral tear can be frustrating, but it doesn’t mean your active life is over. With the right diagnosis and a good rehab plan, many people get back to training, running, and everyday activities without surgery.

    If you're dealing with deep hip or groin pain, don’t ignore it. Early evaluation and a smart rehab plan can go a long way in getting you back on track.

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