What’s a Hip Labral Tear?

If you’re an athlete and you’ve started to notice activity-related groin pain – particularly in the crease where the hip meets the leg – you may have a hip labral tear. Now you're probably wondering: What is that?

A hip (acetabular) labral tear is damage to the ring of cartilage (called the labrum) in the hip socket, which causes pain with sport activities.

Sometimes people get hip labral tears from falls or other actions, but often patients do not recall a specific injury. “One of the most common causes – particularly in young people and athletes – is a condition called femoroacetabular impingement (FAI),” Ian Rice MD, of the TriHealth Orthopedic and Sports Institute, explains.

FAI refers to a process by which a misshapen hip joint gradually leads to breakdown of the labrum and cartilage in the joint, causing pain and dysfunction. This may eventually lead to premature osteoarthritis. This process typically unfolds over months to years.

Hip labral tears are more common in sports that involve a lot of cutting, like football, basketball and soccer. However, wrestlers and gynmasts are also commonly affected.

While hip labral tears don’t usually cause abrupt, excruciating pain, like an ACL (anterior cruciate ligament) or shoulder labral tear would, studies show they’re more common than you’d think: Up to 22 percent of athletes who complain of groin pain have a hip labral tear. 

Young athletes typically only feel pain when they are playing their sports, but as the tear progresses, pain occurs with basic activities like walking or rising out of a chair.

If you're wondering whether a hip labral tear should keep you from playing, Dr. Rice recommends a common sense approach. "If you reach the point where you can't be effective in your sport, or the pain is so intense you are no longer enjoying your activities, then it's time to have it addressed."

To find out if you have a labral tear, see an orthopedic hip arthroscopy expert who has the proper knowledge and skills to address this highly specialized area in orthopedic sports medicine. "Treatment of hip labral tears is a small niche in sports medicine orthopedic surgery," Dr. Rice explains. "Even among surgeons who perform other hip surgery, such as hip replacement, very few perform hip arthroscopy for labral tears. Your primary care doctor can help you find the right surgeon and receive the best care possible."

A workup typically includes X-rays and may require additional testing such as an MRI or procedures (injections, for example) to confirm the diagnosis or rule out other problems.

From there, your doctor may prescribe activity modification, anti-inflammatory medications, and possibly physical therapy, depending on the severity.

If those treatments fail, surgery may be necessary: “Labral tears and a misshapen hip joint are structural problems, and severe cases require a structural solution – hip arthroscopy surgery.” Dr. Rice explains.