One fairly common sports injury that can affect even the most seasoned of athletes is the labral tear which, if left untreated, can result in a lot of pain and stiffness in the hip joint. Having a basic knowledge of sports injuries such as this is something every athlete and sports-lover needs. That way, you can understand what should happen, what shouldn't and when it is necessary to seek expert help.
Mr Gurdeep Biring, Consultant Orthopaedic Surgeon at BMI The Chiltern Hospital and BMI The Shelburne Hospital, offers his insights on the labral tear, explaining the nature of the injury, what the treatment options are and what to expect with recovery.
What is a labral tear Injury?
Athletic hip injuries which cause disabling groin pain typically involve the labrum, which is a horse-shaped ring of fibrocartilage that follows the rim of the hip joint.
It acts like a washer and allows lubrication of the joint whilst creating a vacuum seal to keep the hip joint in place. Tears of the labrum can lead to pain and dysfunction.
These labral tears are usually associated with other abnormalities of the hip joint, which can cause impingement of the labrum.
Are there any symptoms we should be aware of?
Athletes describe experiencing labral tear pain in the groin and hip region with episodes of locking, catching or clicking. Their movement can often be restricted and stiffness can often set in. Certain movements such as flexing and rotating the hip inwards can also cause intense discomfort.
What tests are necessary to diagnose a labral tear?
A plain x-ray of the pelvis will identify bony abnormalities; however the gold standard test is a high resolution MRI scan which will define the labrum and any injuries to the articular cartilage. Sometimes a contrast MRI may also be necessary.
What treatment is required?
Athletes with symptomatic labral tears should undergo non-operative treatment in the first instance; this can include activity modification, anti-inflammatories and a short course of physical therapy. If the symptoms don’t settle down in four weeks then assessment by an Orthopaedic Surgeon with an interest in hip injuries should be considered. Hip injections may also be considered at this stage.
When would someone require surgical treatment?
Athletes with persistent symptoms that are not settling and which have persisted for longer than six weeks may require Hip Arthroscopy. This is a key-hole procedure which allows a camera and instruments to be inserted into the hip joint, enabling the labrum to be repaired or debrided, and any structural abnormalities to be assessed and treated.
Following surgery is a return to sport possible? And how long will recovery take?
For those people where a labral tear is identified early, and where appropriate treatment with arthroscopic intervention has been administered, then favourable outcomes and return to sport is achievable.
Rehabilitation is very important and depends both on the extent of the injury and treatment of any associated structural abnormalities. Typically you can expect recovery to take up to 12 weeks.