OVERVIEW

Where is the acetabular labrum located?

The acetabular labrum is located within the hip joint, forming a fibrocartilaginous ring attached to the rim of the bony acetabulum.

The hip joint is a typical ball-and-socket joint composed of the femoral head and acetabulum. The acetabular labrum enhances stability by deepening the acetabulum and narrowing its opening, ensuring a better fit between the femoral head ("ball") and the acetabulum ("socket").

Additionally, the acetabular labrum plays roles in proprioception, sealing the joint cavity, and protecting articular cartilage.

What is an acetabular labral tear?

An acetabular labral tear is a condition caused by trauma, specific movements, or joint degeneration, leading to symptoms such as groin pain, hip joint locking, leg weakness during walking, and difficulty bearing weight.

Acetabular labral tears are a common cause of anterior hip pain, with a prevalence rate of 22%–55% ^[1].

Conservative treatment is the first-line approach. If symptoms persist or the tear is severe, surgery may be recommended.

SYMPTOMS

What are the symptoms of a labral tear in the hip?

1. Groin pain and stiffness, which may radiate to the outer hip, front of the thigh, or buttock;
2. Increased pain during weight-bearing activities, squatting, or hip flexion and rotation movements;
3. Pain typically develops gradually (due to repetitive microtrauma) or occurs suddenly after a traumatic event (e.g., a fall or hip dislocation from a car accident causing a labral tear);
4. Clicking, popping, or a sense of instability in the hip during walking;
5. Altered gait, limping, or a dropping of the pelvis on the opposite side.

CAUSES

How does a labral tear of the hip occur?

1. Trauma: This is the most common cause. Hip dislocation or injury due to car accidents, falls, or other trauma often leads to a labral tear.
2. Specific sports: Certain sports that require rapid hip rotation, excessive flexion, or extensive movement place excessive stress on the hip joint. Repeated microtrauma can lead to labral wear and tear, such as in soccer, hockey, ice hockey, golf, ballet, and running.
3. Age: The risk of labral tears increases with age. Up to 96% of elderly individuals have labral tears.
4. Hip joint disorders: Hip impingement and hip instability are major contributing factors.

Who is most prone to labral tears of the hip?

Labral tears are more common in individuals whose hip joints endure repetitive stress, particularly athletes, including long-distance runners, ballet dancers, golfers, ice hockey players, soccer players, and hockey players.

DIAGNOSIS

When should you go to the hospital for a labral tear?

A labral tear is usually not life-threatening but can significantly impact daily life. If the pain is severe, persistent, and severely affects functions like walking, climbing stairs, or squatting, the patient should seek medical examination and treatment.

Which department should you visit for a labral tear?

• Sports Medicine, Rehabilitation Medicine, or Orthopedics in hospitals;
• Sports rehabilitation centers.

Is imaging necessary for diagnosing a labral tear?

Yes.

Diagnosing a labral tear requires combining patient symptoms with imaging findings. MRI is the preferred imaging method for detecting labral tears. If acute fractures, stress fractures, or dislocations are suspected, an X-ray should be performed.

TREATMENT

Can a labral tear of the hip heal on its own?

No, it cannot heal on its own, but conservative treatments such as rest, activity modification, exercise therapy, and physical therapy can improve function.

What is the prognosis for a labral tear of the hip?

Treatment outcomes depend on the severity of the injury and the treatment plan:

• Conservative treatment cannot repair a torn labrum but can relieve pain and improve function. Exercise therapy, in particular, enhances muscle flexibility, strengthens muscles, and balances joint forces, helping maintain hip joint health. Conservative treatment is the first choice for labral tears. Patients with minor tears may return to training after conservative treatment.
• If conservative treatment fails, surgery can repair or remove damaged tissue to reduce pain, restore joint function, and prevent or delay osteoarthritis. With systematic rehabilitation, patients typically return to pre-injury activity levels within 4 to 6 months post-surgery.

How should a labral tear of the hip be treated conservatively?

Conservative treatment is the first-line approach, with surgery considered if it fails ^[2].

The goals of conservative treatment are to reduce pain, improve function, and correct muscle imbalances. When the affected leg matches the healthy leg in strength, range of motion, and movement control, young patients can resume sports, and older patients can regain daily function.

Conservative treatments include:

• Medication: Under a doctor's guidance, anti-inflammatory pain relievers (e.g., ibuprofen) or intra-articular corticosteroid injections may be used.
• Exercise therapy: Restores normal joint mobility, strengthens muscles, corrects gait, and improves hip movement patterns to enhance trunk stability and reduce dynamic hip valgus (details below).
• Manual therapy: For patients with joint restrictions or muscle/fascia tightness, joint mobilization or soft tissue techniques (e.g., massage, myofascial release) can help.
• Physical therapy: Cold therapy for acute pain; ultrasound or electrotherapy for chronic cases to accelerate metabolism, promote healing, relieve muscle spasms, and reduce pain.

Can heat therapy be used for a labral tear of the hip?

It depends:

• Avoid heat therapy within the first 3 days after injury or 3–7 days post-surgery, as it may worsen bleeding and swelling. Cold therapy (e.g., ice packs) is recommended during this phase.
• Heat therapy is suitable during the chronic phase or after the acute post-surgical period. It improves blood circulation and metabolism, easing symptoms. Pre-stretching heat application (using heating pads, warm towels, etc.) enhances effectiveness.

How can I relax the muscles around a hip labral tear at home?

For patients with tight or shortened muscles/fascia around the pelvis, manual release or massage can relieve stiffness.

At-home tools like foam rollers can achieve similar effects to professional therapy. Common tight muscles include the iliopsoas, rectus femoris, hamstrings, iliotibial band, and tensor fasciae latae. Self-release techniques (using a tennis ball, massage ball, or foam roller):

• Iliopsoas release with a massage ball:
  Link: Iliopsoas self-release with a ball
• Rectus femoris foam rolling:
  Link: Quadriceps foam rolling
• Hamstring foam rolling:
  Link: Hamstring foam rolling
• Iliotibial band foam rolling:
  Link: IT band foam rolling
• Tensor fasciae latae release with a ball:
  Link: TFL self-release with a ball

What exercises improve mobility for a hip labral tear?

Stretching helps if muscle tightness or joint restrictions exist. However, avoid excessive stretching if limitations stem from bone-related issues (e.g., hip impingement, dysplasia, or femoral anteversion). Professional guidance is recommended.

• Iliopsoas stretch:
  Link: Iliopsoas static stretch B
• Rectus femoris stretch:
  Link: Quadriceps static stretch
• Hamstring stretch:
  Link: Hamstring static stretch
• Iliotibial band stretch:
  Link: IT band stretch
• Tensor fasciae latae stretch:
  Link: TFL stretch

What strength exercises help with a hip labral tear?

Weak muscles require strengthening. The gluteus maximus (power) and gluteus medius (stability) work with core muscles to stabilize the hip ^[3]. The gluteus medius is especially crucial for improving walking and weight-bearing.

• Glute bridge: Strengthens glutes and core
  Link: Glute bridge
• Clamshell: Targets gluteus medius and core
  Link: Clamshell
• Standing hip hike: Functional gluteus medius training
  Link: Standing hip hike
• Side plank: Enhances lateral core stability
  Link: Side plank
• Monster walk: Strengthens gluteus medius and lower body
  Link: Monster walk lateral movement

Is surgery necessary for a hip labral tear?

Initial treatment includes rest, immobilization, and physical therapy, with NSAIDs for symptom relief.

Surgery is recommended for recurrent pain, mechanical locking, or bone abnormalities causing impingement. Options include hip arthroscopy or open surgery, such as labral debridement, repair, reconstruction, or augmentation, depending on the tear.

DIET & LIFESTYLE

Does a labral tear of the hip require weight-bearing restrictions?

Yes.

Weight-bearing restrictions are necessary after a labral tear, meaning the patient should avoid placing full body weight on the injured leg. A cane or crutches can be used while standing or walking, with the duration of restrictions determined by medical advice. Post-surgery patients typically need activity modifications, including at least 6 weeks of restricted weight-bearing.

Can patients with a labral tear perform aerobic exercise?

Yes.

Patients can engage in low-impact aerobic activities that do not cause pain, such as cycling, walking, swimming, or using an elliptical machine. High-impact exercises or those requiring extreme hip twisting or hyperextension (e.g., running, skiing) should be avoided.

Aerobic exercise is crucial for maintaining cardiovascular health and preventing chronic diseases. Patients should continue exercising as long as it doesn’t provoke pain.

What lifestyle adjustments should patients with a labral tear make?

1. Seating posture: Avoid prolonged sitting; do not use deep/soft chairs or cross legs to prevent hip rotation.
2. Assistive devices: Use walkers, crutches, or canes (placed on the opposite side of the injured limb) if pain worsens or walking becomes difficult to reduce hip joint pressure.
3. Environmental modifications: Opt for higher chairs and adjust bicycle seats upward to avoid excessive hip flexion and reduce joint load.

PREVENTION

What are the preventive measures for acetabular labral injuries?

1. Perform preventive rehabilitation exercises daily, such as the previously mentioned hip joint and core strength training, as well as lower limb muscle flexibility exercises;
2. Elderly individuals should engage in balance training and lower limb strength training to prevent falls and reduce the risk of hip joint injuries.