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Hip pain can be the result of a number of different issues. However, many of the most common causes of hip pain are age related. So if you are under 40 years old and experiencing hip pain then you may have difficultly identifying the cause of the pain.
One possible cause of hip pain in younger people could be a hip labral tear, another cause might be a hip impingement. This is also sometimes called an acetabular labral tear. In some cases, this can be debilitating and significantly impact your daily life.
Labral tears in the hip are often associated with sports and physical activities, such as golf, football or hockey. These types of activities involve sudden movements, such as twisting, rotating or pivoting motions, which can result in injury to the cartilage (labrum) that lines the socket of your hip joint.
Potential causes include:
- Direct trauma – you may have injured or dislocated the hip joint as a result of a bad fall, a car accident, or a contact sport. This injury can lead to a labral tear.
- Bone abnormalities – you may have been born with hip problems, such as bone spurs, which can cause greater-than-usual wear and tear on the hip joint. This eventually results in a labral tear.
- Repetitive motions – wear and tear on your hip joint may be exacerbated by some of your physical activities and sports, particularly where sudden twisting or pivoting movements occur. This can result in a tear.
Your hip consists of a ball-and-socket joint, where the top of your thigh bone (femur) sits inside the socket of your pelvis (this is known as the acetabulum). The acetabular labrum is the band of cartilage that sits around the rim of your hip socket. It acts as a cushion to your hip joint.
In addition to this cushioning effect, the hip labrum also acts like a rubber seal to help hold the ball at the top of your femur securely within the socket. When this band of cartilage is damaged, a labrum tear can occur.
These tears can be painful and disruptive to your lifestyle, and in some circumstances they can increase the risk of developing osteoarthritis. Symptoms for labral tears aren’t always apparent, but you may experience any of the following:
- Pain in your hip or groin.
- Stiffness in your hips.
- Limitations in hip movements.
- Feeling unsteady on your feet.
- A grinding sensation when you rotate your hip outwards.
- A clicking or locking sensation in your hip joint.
Your doctor will normally refer you to hospital for a hip labral tear test. These diagnostic tests will be performed by medical professionals and usually involve a labral tear hip MRI scan to identify the precise location of the tear.
After diagnosis of a labral tear, your consultant will suggest a variety of non-surgical treatments. The consultant will take into consideration various lifestyle factors, such as what sports you play, to identify any areas that may put a strain on your hips.
Initially, you will likely be advised to limit any stress placed on your hips. This may mean reducing physical activity and avoiding placing your full body weight on the affected hip.
Medication, such as paracetamol and ibuprofen, can offer some labral tear pain relief. In addition, pain killers may also help with reducing inflammation.
Strength and flexibility exercises can also help to condition the surrounding muscles. A physiotherapist will be able to advise you on these exercises. They will then guide you through suitable exercises, so you feel comfortable and confident performing them in your own home.
If the non-surgical measures outlined above have little or no success, you may be advised to have a hip arthroscopy (keyhole surgery).
There are two main objectives of this type of arthroscopic surgery: ·
- treat you quickly, so that you are not in pain any longer ·
- restore function and stability to your hip, so that you can carry on enjoying life as quickly as possible.
A hip arthroscopy is a common procedure, usually carried out under general anaesthetic. Hip labral tear surgery usually lasts around 30 minutes to two hours. Normally, you will be allowed to leave hospital on the same day as the operation or the following morning if the procedure is performed in the evening.
During arthroscopic hip surgery, the surgeon will make a small incision into your hip in the soft tissue. Then a small, flexible tube about the length and width of a drinking straw is inserted into the hip joint. This tube is called an arthroscope. The arthroscope contains a light source and digital camera that sends images to a video screen or your surgeon’s eyepiece. This allows the surgeon to see inside the joint. The surgeon will then use a set of small, specialist tools to repair the torn labrum. Using small metal or plastic ‘anchors’ and a sterile thread, the surgeon will reattach the torn labrum to the hip socket.
Once completed, the surgeon will close the wound with stitches or surgical staples.
Following surgery, a physiotherapist will help to stand and take your first steps without putting any undue weight on the operated hip. They will show you have to use a walking aid, such as elbow crutches or a walking frame.
The physical therapist will also take you through a course of hip labral tear exercises that will help to strengthen your muscles and get you walking unaided as soon as possible. You may be shown how to use a variety of physiotherapy equipment, such as a resistance band.
Hip labral tear rehabilitation exercises are a vital to help you on the road to a full recovery. These may include a series of hip labral tear stretches to help you build flexibility and return a full range of motion to your hip.
