A labral tear is a fairly common injury of the hip, but it is easy to misdiagnose. Sometimes a patient receives treatment for another condition such as a hip flexor strain or tendonitis, and when the pain doesn’t improve, further investigation reveals a torn labrum.
The hip labrum is a thin layer of cartilage that lines the hip socket and cushions the joint. The labrum can be torn by trauma, such as a car accident or a collision during a contact sport. Tears can also result from repetitive stress, especially from the twisting motions common in ballet, softball or golf. The labrum can be also be damaged by a degenerative condition such as arthritis. Symptoms may include pain, stiffness, a clicking sound and a catching sensation in the hip.
Many people with labral hip tears have a positive impingement sign. This means that groin pain occurs after the following test: as you lie on your back, your knee is brought toward your chest until the angle between your thigh and torso is 90 degrees, and then your upper leg is moved in and toward the opposite shoulder while downward pressure is applied at the knee. Magnetic resonance arthrography with contrast can diagnose most hip tears. The most accurate diagnosis comes from arthroscopic surgery, in which a tiny camera is used to view the labrum.
Moderate cases can be treated with rest and physical therapy. A physical therapist can teach you exercises to improve hip strength and stability. Your therapist can also evaluate your movements and show you how to avoid the ones that stress the hip. Some patients may also benefit from corticosteroid injections. If the pain is severe or does not respond to physical therapy, arthroscopic surgery is recommended. The surgeon may remove the torn area or repair the cartilage with sutures.