Hip pain and painful snapping inside the hip, or groin region are frequent disabling injuries amongst athletes, particularly those involved in sports that require repetitive pivoting or squatting. The evolution of physical therapy diagnostic techniques as well as arthroscopic surgical interventions for the hip have allowed for more effective diagnosis and management of the cause of this pain.
Chronic symptoms of pain in the front of the hip, or less often in the buttocks, along with catching or clicking in the hip are often associated with diagnoses such as acetabular labral tears. The labrum in this instance refers to cartilage which lines the rim of the hip socket and helps with hip stability and joint health. Traumatic isolated labral tears are rare (about 5% of cases).
For most patients, the injury has been due to specific repetitive wear in combination with individual anatomical contributions. Some patients may exhibit signs of having loose ligaments, or excessive range of motion in the hips; while others may demonstrate a specific lack of motion which may contribute to an impingement injury. The term impingement in this case describes the improper impact between the femur (ball) and the acetabulum (socket), or Femoral-Acetabular Impingement leading to injury other structures such as the labrum, usually in the front of the hip.
How do you treat a labral tear?
Once the causes of the injury are identified, patients can have immediate benefit from education on lifestyle, postural, and activity modification to reduce inflammation and further injury. Conservative treatment through physical therapy can be an effective option, particularly for those whose symptoms are caused by decreased stability of the hip. This will include exercises to increase core and hip muscle strength as well as an assessment of posture and the timing of muscle activation with movements of daily life. In severe cases, the application of arthroscopic surgical techniques has facilitated relatively consistent resolution function and/or sporting activity in both recreational and elite athletes.
i Martin RL, Kelly BT, Philippon MJ. A classification system for labral tears of the hip [abstract]. J Orthop Sports Phys Ther. 2005;35:A23.