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Hip Labral Tear Physiotherapy
Hip labral tears happens when the labrum, which is a band of cartilage surrounding
the hip joint, is injured. Labral injuries can be caused by trauma,
such as a fall or a motor-vehicle accident, but most of the time, they are typically caused by
repetitive trauma to the hip joint.
Individuals who participate in
sports that require extremes of motion, such as
- figure skating
- repetitive twisting
- "cutting" like hockey or soccer
are most often diagnosed with labral tears. To
treat the symptoms associated with a labral tear, our senior physiotherapists
prescribe a combination of stretching and strengthening
activities to decrease irritation in the hip.
What is a Hip Labral Tear?
A hip labral tear occurs where there is damage to the labrum within
our hip joint.
The hip joint is where the thigh bone (femur) meets the
pelvis (Ilium). It is described as a ball-and-socket joint, and this particular joint design
allows the hip to move in several directions. The bony socket is
surrounded by a ring of cartilage called the labrum which serves to provide extra stability to the hip joint.
A labral tear results when a part of the labrum separates or is
pulled away from the socket. Most often, a labral tear is the result of
repetitive trauma to the hip, either due to running or repeated twisting
The consequences of repetitive stress can be magnified in a hip with
Hip impingement is a condition involving abnormal
bony contact between the hip's ball and socket joint. As the hip is moved into
specific positions, this bony contact occurs, placing additional stress
on the labrum.
Hip labral tears may result from a combination of several different variables, including:
- Bony abnormalities in the hip joint (hip impingement)
- Hip muscle tightness
- Hip muscle weakness
- Improper technique with repetitive activities
- Participation in sports that require distance running, or repetitive twisting and cutting
Once torn, the labral tissue in the hip does not have the ability to
heal on its own (reasons being it being a cartilage - no direct blood supply to heal quickly, and it being a joint so it will tend to reinjure due to movements at joints).
There are surgical procedures to remove or repair torn
labral tissue; however, treatment for a labral tear often begins with a
course of hip physiotherapy.
Nonsurgical treatment efforts are focused on addressing symptoms by
maximizing the strength and mobility of the hip to minimizing the stress
placed on the injured area. In certain cases, patients are able to
achieve a satisfactory level of activity even without surgery.
Surgical interventions are available to clean out the hip joint, and
repair or reconstruct the torn labral tissue. Following surgery,
patients will complete several months of physiotherapy to regain
function of the hip.
How Does a Hip Labral Tear Feel like?
Pain in the front of the hip or in the groin resulting from a hip
labral tear, can cause an individual to have limited ability to stand,
walk, climb stairs, squat, or participate in recreational activities.
Patients may experience:
- A deep ache in the front of your hip or groin, often described by
the "C sign." (People make a "C" with the thumb and hand, and place it
on the fold at the front and side of the hip to locate their pain.)
- Painful clicking or "catching" with hip movements. This creates the
feeling of something painful stuck in the hip or blocking hip motion.
- Pain that increases with prolonged sitting or walking.
- A sharp pain in the hip or groin when squatting.
- Pain that comes on gradually rather than with 1 specific episode.
- Weakness in the muscles surrounding the hip.
- Joint stiffness in the hip joint
How Is It Diagnosed?
Our senior physiotherapists will review your medical history and complete
a thorough examination of your hip, and possibly your lower back and
Remember, the goals of the initial examination are to
- assess the degree of
the injury and
- determine the cause and contributing factors to it
hip labral tear may be the result of a single injury, but most likely is
a condition that develops as a consequence of repetitive irritation in
We will assess the mobility and strength of your
hip, and may watch you walk, step onto a stair, squat, or balance on 1
leg. We will also gently touch the front, side, and
back of your hip to determine exactly where it is most painful.
We may also ask questions regarding your daily
activities—most importantly, activities that aggravate and relieve your
symptoms. We will also ask about your exercise
regimens and footwear, to identify other possible contributing factors
to your pain.
We may also refer you to an orthopedic physician
who specializes in hip injuries for diagnostic imaging (i.e., x-ray,
MRI). An x-ray helps to identify any bony abnormalities, such as hip
impingement that may be contributing to your pain. An MRI will help to
identify a labral tear.
what our senior physiotherapists can do
When you have been diagnosed with a hip labral tear, we will work with you to develop a plan to help achieve your
specific goals. To do so, we will select treatment
strategies in any or all of the following areas:
Many pain-relief physiotherapy strategies may be
implemented; the most beneficial with hip pain is to apply ice to the
area and decrease or eliminate specific activities for a certain length
We will help to identify specific
movements or activities that continue to aggravate the inside of your
We then will design an individual
treatment plan for you, beginning with a period of rest, and gradually
adding a return to certain activities as appropriate.
- Joint restriction / stiffness
Having a tight hip joint will place greater stress on the cartilage
and labrum. The best way to improve this is to use distraction
techniques to gently open and stretch the joint itself. Combine this with regular deep tissue massage to the
surrounding muscles helps blood flow and can increase mobility.
- Muscle tightness
Key muscles that pose a problem for the hip joint are the hip
flexors, the groin muscles (adductors), the deep hip rotators
(piriformis) and the tensor fascia latae (TFL). Trigger point therapy,
targeted stretches and self release, active release techniques, sports
massage and dry needling are all successful when dealing with muscle tightness.
- Pelvis/lumbar spine
Any changes to normal biomechanics in these areas will definitely affect the
hip joint. Both structures have many muscles that cross from one to the
other, which directly contributes to the way that the hip moves.
Pelvis rotation/twist is best fixed with manual mobilisation and
manipulation, followed by core stabilization and muscle strengthening. Lumbar spine
stiffness will also increase the demands on the hip, so regular massage and stretches can
really help offload that demand.
- Weak core
A weak core means poor stability.
It's akin to comparing running on sand as compared to firm ground. When you run on sand
you have no stability and every inch of muscle has to work harder, and your speed
and power will drop significantly as there’s no solid foundation from which to move
have shown that weak core muscles are a common factor in patients with
hip pain, often related to previous injuries or misfiring muscles.
Without these muscles helping to stabilize the area, the hip joint has
to cope with considerably more stress. Specific exercises to target the
transverse abdominus, the mulitifdus and the pelvic floor are often
recommended by our senior physiotherapists.
- Weak glutes
Our buttock muscles, aka glutes are a fascinating group of muscles, comprising of three
muscles in the buttock area. They serve to create power when we walk and
run. They create stability at the same time, and prevent a drop of the
opposite hip when walking and running.
Single leg squat and running
assessments will pick up any issues with weak glutes. When combined with
core strengthening, the hip joint and its labrum/cartilage are only
going to be healthier from all of the the hard work.
- Flat feet and ankle stiffness
People with fallen arches are more likely to have hip pain. As the
foot rolls in, the hip joint twists inwards slightly, compressing the
front of the joint. Added up over the thousands of steps we take each
day, an abrasive stress is only going to wear away at the labrum.
- Posture – Sitting and standing
Sitting compresses the front of the hip labrum and cartilage, and
when combined with crossing your legs, a dangerous situation can arise.
Fixing any issues ergonomically will help this
For example, if your
chair is too low then the hip joint will be more flexed, and this will
need to be corrected. Standing with all of your weight shifted to one
side will increase load on that particular hip joint.
At the same time, this coincides with muscles weakness in
your core and glutes, and is something that always needs fixing. Too
often, this is a problem with young mums who only hold and carry their
child on one hip.
- Movement re-education
Your back and hip may be
moving improperly, causing increased tension at the hip joint.
Self-stretching techniques may be applied to the lower body to decrease
tension and help restore normal motion in the back, hip, and leg.
are, however, certain hip motions to avoid following an injury to the
hip labrum. We will carefully prescribe exercises
that improve your range of motion, while protecting the area that has
the labral tear.
- Manual therapy
We may apply hands-on manual therapy
treatments to gently move your muscles and joints to decrease your pain
and improve motion and strength. These techniques often address areas
that are difficult to treat on your own.
- Muscle strengthening
Muscular weaknesses or
imbalances can be the cause or the result of hip pain. Based on your
specific condition, we will design a safe,
individualized, progressive resistance program for you, likely including
your core (midsection) and lower extremity.
You may begin by performing
strengthening exercises lying on a table, for example, lifting your leg
up while lying in different positions. You then may advance to doing
exercises in a standing position, for example, stepping on and off a
raised platform. We will choose what exercises are
right for you.
- Functional training
Once your pain, strength, and
motion improve, you will be able to safely transition back into more
demanding activities. To minimize tension on the hip, it is important to
teach your body safe, controlled movements.
Based on your own unique
movement assessment and goals, we will create a
series of activities to help you learn how to use and move your body
correctly and safely. We will also discuss specific
positions and activities that should be avoided or modified to protect
Now, it’s also important to note that hip labral injury that does not
always heal with conservative treatment. Some tears and degenerative
injuries in the hip joint have a limited ability to heal due to poor and limited
blood supply, and that is why this may indicate the need to consult with an orthopaedic
surgeon to understand potential surgery options. Avoiding this need for
surgery is the aim of all physiotherapy treatment programs.
Hip joint pain is a debilitating and complex injury, and patients
often leave it too long to have it fixed. For hip pain physiotherapy treatment to be as successful as it can be, it needs to be early on in the process.
In the end, we advise patients to listen to their body more. You need to trust what
your body is telling you before it’s too late and the full injury
process has set in.
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Phoenix Rehab Group works with specialist
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trained, qualified, experienced and passionate to provide high level of
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Commonly treated hand pain injuries includes
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See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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