Understanding Hip Labrum Tears: Symptoms, Causes, And Treatments

Hip labrum tears can cause significant discomfort, impacting daily activities and overall mobility. This condition affects the labrum, a soft tissue ring stabilizing the hip joint, leading to pain and restricted movement. 

Although commonly experienced by athletes, dancers, and individuals with active lifestyles, hip labrum tears can occur in anyone. Factors such as repetitive movements or underlying structural issues can contribute to this injury. Recognizing symptoms early and exploring treatment options can be crucial for managing hip labrum tears and preventing further complications.

How The Hip Labrum Ensures Stability In The Hip Joint

The hip labrum is a cartilage ring that lines the acetabulum’s outer edge (the hip joint socket). This structure is crucial to maintaining the hip’s stability and function. By creating a seal around the acetabulum, the labrum helps secure the head of the femur (thighbone) within the joint, promoting smooth movement and reducing friction between the bones.

The labrum also helps distribute pressure evenly within the hip joint during activities like walking, running, and twisting, contributing to overall joint stability and flexibility. Its cushioning properties allow for a broader range of motion while protecting the joint from wear and tear by increasing stability.

What Is A Hip Labrum Tear?

A hip labrum tear occurs when the cartilage that lines the rim of the acetabulum becomes damaged. This type of injury can develop gradually due to repetitive stress or suddenly due to trauma, such as a fall or direct impact. 

A tear in the hip labrum can lead to pain, a feeling of instability in the hip joint, and a reduced range of motion. The severity of symptoms varies; some individuals experience mild discomfort while others face significant challenges in their daily activities.

Types Of Labral Tears

Hip labral tears can occur in different regions of the labrum, each affecting the hip joint in distinct ways. The location of the tear often influences the symptoms experienced and the activities that may aggravate the condition. The two primary types of labral tears are anterior tears and posterior tears. 

Understanding these variations can help identify the nature of the injury and determine the proper treatment approach.

• Anterior tear: An anterior labral tear occurs in the front part of the hip joint. This is the most common type of hip labral tear, often associated with repetitive hip flexion and rotation, such as running or sports like soccer and hockey. Anterior tears can lead to pain in the front of the groin or hip area, especially during movement.

• Posterior tear: A posterior labral tear occurs in the back part of the hip joint. Although less common than anterior tears, posterior tears are often associated with activities that involve sudden impact or twisting movements, such as football or gymnastics. This type of tear can cause discomfort or a catching sensation deep in the buttock or along the back of the hip.

Common Hip Labrum Tear Symptoms You May Experience

A hip labrum tear can present with a variety of symptoms, although in some cases, there may be no noticeable signs. Common symptoms include locking, clicking, or catching sensations in the hip joint, pain in the hip or groin area, and stiffness or limited range of motion in the hip joint.

It is important to note that labral tears can occur without causing pain. Many hip labrum tears do not produce any symptoms. If pain is present, it may be due to other conditions, such as sacroiliac (SI) joint dysfunction, pinched nerves in the lower back, or issues with the hip girdle muscles, ligaments, or tendons.

• Catching or Locking Sensation – A hip labrum tear may cause locking, clicking, pain in the hip or groin, stiffness, or limited motion. However, many cause no symptoms, and pain may stem from SI joint issues, pinched nerves, or muscle imbalances. 
  
• Front-of-Hip Pain – Pain in the front of the hip may result from hip flexor strain, labral tears, or joint inflammation. It may cause stiffness, discomfort with movement, and difficulty with activities such as walking or climbing stairs. Read More About Front-Of-Hip Pain.
  
• Loose Hip Joint – A loose or unstable hip joint may be caused by ligament laxity, previous injury, or joint degeneration. Accompanying symptoms may include discomfort, clicking sensations, and a feeling of the hip slipping or giving way during movement. Read More About Loose Hip Joints.
  
• Butt Pain – Pain in the buttocks may stem from muscle strain, nerve compression (such as sciatica), or joint dysfunction. Accompanying symptoms may include aching, sharp pain, or numbness, sometimes radiating to the lower back or legs. Read More About Butt Pain.

Causes Of A Torn Hip Labrum

A torn hip labrum can result from various factors, from everyday activities to specific physical conditions. Understanding the underlying causes is essential to help prevent and manage this injury. 

Below are some common causes that can lead to a torn hip labrum, each contributing to the breakdown of cartilage in different ways:

• Structural issues: Conditions that cause abnormal hip movement can lead to hip labral tears. In femoroacetabular impingement (FAI), the head of the femur doesn’t fit into the socket properly, leading to long-lasting groin pain and movement limitations. FAI can affect individuals at any age and is a common cause of hip labrum tears. Without treatment, it may progress to osteoarthritis.

• Trauma: Traumatic injuries, such as falls, car accidents, or direct impacts, can force the hip into unnatural positions, resulting in a labral tear. Athletes in contact sports like ice hockey, football, and soccer are at higher risk for such injuries.

• Degenerative osteoarthritis: Osteoarthritis is a chronic condition involving joint cartilage degeneration. Cartilaginous structures such as the labrum erode over time, making them more prone to tearing. Advanced age and excess body weight can increase a person’s risk of developing osteoarthritis.

• Repetitive motions: Repetitive twisting or rotational movements from activities such as running or soccer can gradually wear down the labrum, causing microtraumas that may lead to tears over time.

Diagnosing Hip Labrum Tears

Diagnosing a torn hip labrum typically involves a combination of a physical exam, patient history, and imaging tests. A physician will begin by discussing symptoms and assessing the hip’s range of motion, looking for signs such as pain, stiffness, or clicking sounds. During the physical exam, specific movements may be used to pinpoint discomfort and identify instability in the hip joint.

Imaging tests like MRI (magnetic resonance imaging) are often recommended to confirm the diagnosis. An MRI with contrast dye can provide detailed images of the hip joint, highlighting any damage to the labrum. In some cases, an X-ray may also be ordered to rule out bone abnormalities or structural issues that could contribute to the symptoms. 

These methods help physicians accurately diagnose the presence and severity of a hip labrum tear, guiding the development of a customized treatment plan that addresses the patient’s needs. 

Conventional Treatment Options

Conventional treatments for hip labral tears aim to improve mobility and reduce pain. Here are some common options:

• Medications: Pain relievers and anti-inflammatory drugs may help reduce swelling and pain associated with a hip labral tear.
  
• Physical Therapy: A structured program of exercises may strengthen the hip muscles, improve flexibility, and improve the muscular stability of the hip, which takes the pressure off of the labrum.
  
• Surgery: Surgery is typically only recommended for severe tears that don’t respond to conservative treatments. Surgical options include:
  • Arthroscopic Hip Labral Repair: This procedure involves reattaching the torn labrum to restore stability in the hip joint.
  • Arthroscopic Labral Debridement: This surgical approach removes damaged or frayed tissue to alleviate pain and improve hip function.
  • Arthroscopic Hip Labral Replacement: For severely damaged labrums, this procedure replaces the torn tissue with a graft to restore proper joint function.

• Hip Labral Tear Surgery: Hip labral tear surgery involves repairing or removing damaged cartilage in the hip socket. It may be done arthroscopically to support joint stability and manage pain from labral injuries. Read More About Hip Labral Tear Surgery.

Risks Of Hip Labrum Surgery

Hip labrum surgery carries certain risks, and outcomes can vary. Additionally, surgical “cleanup” of a labral tear—which involves removing part of the labrum—may increase the risk of joint degeneration and osteoarthritis over time. 

This underscores the importance of considering all treatment options and thoroughly discussing risks with a physician in the licensed Regenexx network before proceeding with surgery.

Can You Treat Hip Labrum Tears Without Surgery?

If you’ve been told that a labral tear is causing your hip pain and that surgical repair is your only solution, it is important to consider less invasive alternatives. Treatment options extend beyond surgery.

Physicians in the licensed Regenexx network use interventional orthobiologics to treat hip labrum tears without surgery. Whether a hip labral tear results from an acute injury or a degenerative condition, the Regenexx approach can help reduce pain and may support the body’s natural healing processes. 
This non-surgical approach aims to provide a less invasive alternative to traditional surgeries, with the potential for shorter recovery times and fewer complications. Customized treatment plans may incorporate one or more of the following orthobiologics:

Regenexx-SD Injectate

Procedures using Regenexx-SD injectate include a patented protocol that utilizes Bone Marrow Concentrate (BMC), which contains the patient’s own mesenchymal stem cells. The cell processing for a Regenexx-SD injectate routinely achieves 20x concentration— above what non-Regenexx cell processing can achieve.

Regenexx-SCP Injectate

Procedures using Regenexx-SCP injectate represent a supercharged version of platelet-rich plasma (PRP). In this process, blood is drawn, then processed to isolate the platelets and growth factors. The growth factors are then purified, concentrated, and injected into the hip area using imaging guidance for precision. Regenexx-SCP injectate provides a higher concentration of growth factors than typical PRP procedures. 

Regenexx-PL Injectate

Procedures using Regenexx-PL injectate are a highly specialized derivative of platelet-rich plasma (PRP) with a faster and more concentrated release of growth factors compared to typical PRP.  The PL injectate is often combined with other orthobiologics such as PRP and bone marrow concentrate.

Before And After Procedure MRI Images

Look at the outcomes of a patient who opted for a Regenexx approach (vs. surgery).

Scroll to the right to view the MRI of the hip before treatment and to the left to see the post-treatment outcome. The BEFORE image highlights a torn labrum  (visible as the triangle-shaped space inside the dashed yellow circle). 

The AFTER image shows the area appearing almost uniformly dark, which indicates either no visible tear or a marked improvement in the appearance of the tear.