Acetabular Labral Tear (Hip/Groin Pain)
Acetabular Labral Tears (Hip/Groin Pain)
The acetabular labrum is a ring of fibrocartilage and dense connective tissue that connects to the acetabulum, which is the socket in your pelvis/hip that attaches to your leg bone called the femur. The function of the labrum is to improve stability and decrease stress on the hip joint. The structure of the labrum is wider and thinner anteriorly, or front, of the hip and thicker posteriorly. Additionally, the upper front portion of the acebatalum (anteriorly/superiorly) has more free endings. Due to the front of the acebatalum being thinner and having more nerve endings/sensation compared posteriorly, people tend tear the anterior labrum more frequently and may report pain more often. Other than pain, other symptoms of labral tears include clicking, locking, and hip giving away.
One can injure their labrum from direct trauma or microtrauma from sports/daily tasks involving extremes range of motion/twisting. When torn, labral tears can cause a great deal of pain and increase difficulties with everyday activities such as standing, walking, or sitting. The best way to diagnose a labral tear other than arthroscopy (an invasive surgical procedure) is to perform an MRA, which is a form of an MRI. An MRA is like an MRI, however takes more detailed images of blood vessels. This is important because there is also only a blood supply to the outer 1/3 of the labrum, making it avascular (low blood supply). However, due to a low blood supply, the labrum may take time to heal since the cartilage can not receive nutrients, healing factors, or oxygen to aid in the healing process.
Depending on the extent of the injury, acetabular labral tears can heal on their own via exercise/therapy or surgical procedures. Physical therapy can assist with treating labral tears in a number of ways. Therapy can help manage acute pain, strengthen muscles surrounding the hip to help compensate for the decreased stability from a labral tear, improve circulation/blood flow, as well as perform clinical tests to help assist in diagnosing a tear and making recommendations for an MRA. Even if surgery ultimately becomes the only option to repair a tear, performing therapy prior to surgery will improve post-surgical results. The stronger/more flexible a person is going into a surgery, the stronger/more flexible they will be after the procedure. If a person has a acetabular labral tear, they should avoid sitting cross-legged, sitting on the edge of seat, and avoid hyperextension.
Disclaimer: This blog is for informational purposes only, please contact your doctor or physical therapist to fully evaluate your knee prior to make sure you are an appropriate candidate for therapy/surgery.