A very common question in the physical therapy world is “should I get the surgery?” In some cases, surgery may be the only option for an injury… in other cases, the posture and/or alignment, the strength, and the flexibility of the client has a ton to do with the pain the patient is experiencing. In these cases, it is possible to improve posture via strength and alignment and it can be completely possible to live a very active life even with a tear. In this blog, we’re going to talk about a labral tear in the hip – this is a fairly common (and fairly undiagnosed) tear that can actually rehab really well with PT and the patient may never need surgery.
The labrum is a C-shaped piece of cartilage that lies in the hip joint and functions to provide added stability to the hip joint. A labral tear is when there is a tear in that cartilage, which can occur either in the anterior (front) or posterior (back) part of the labrum. Labral tears are common in people with excessive hip tightness or excessive hip weakness – both of which cause postural imbalances in the hip; distance athletes, and athletes who perform repetitive cutting or twisting.
You might be thinking, how can I NOT get surgery if the labrum is supposed to add stability to the joint and it’s torn? Well, we’ll tell you! Since sitting has become the new trend, our anterior hips get really tight and weak and actually pull the whole femur (thigh bone) forward in the hip joint, and our posterior hip muscles are often too weak (or at a mechanical disadvantage) to pull that femur back into place. This imbalance can lead to a pinching in the front of the hip; repetitive movements with an already pinched joint can lead to a labral tear. Many times, if the anterior hip muscles (hip flexors) are released and strengthened, and the posterior ones (the glutes, etc.) are strengthened and taught to fire effectively when they’re supposed to, balance can be restored to the joint and the pinch on the torn labrum eases up. Once the pressure is released from the tear, and as long as stabilization work is continued, it is quite possible to function healthfully, regardless of the tear.
Dr. Alexandra Terpos, DPT