If your hip labrum is torn due to a sports injury, your surgeon may recommend labral repair to treat it. Labral repair is a type of surgery that aims to reverse damage to the labrum.
The labrum is the thick cartilage that lines the rim of the hip socket or acetabulum. It helps keep the femoral head, the top of the thigh bone, in place within the hip socket, keeping them aligned. Additionally, the labrum protects the hip joint, provides it with stability and aids in shock absorption.
If the labrum is torn, it can result in symptoms such as:
- Limited range of motion in the hip
- Pain in the hip or groin
- A locking, clicking, or grinding sensation with movement
- Hip instability
However, in some people, labral tears present no symptoms, highlighting the importance of regular physical examinations and screenings for athletes.
Depending on the severity of the injury, a labral tear could sideline an athlete for a long time. Fortunately, most cases of labral tears can be repaired. Timely and appropriate treatment may restore the range of motion to the hip, manage pain, and help an injured athlete return to physical activities sooner.
Below, we explore labral injury causes, what labral surgery entails, and how soon after treatment you can play sports.
Labral Tear Treatment Options
There are several therapies used to treat labral tears. Which one a surgeon prescribes depends on factors such as the type of labral tear and the severity of the damage.
Medical professionals generally classify hip labral tears according to location:
- The anterior labral tear is the most commonly diagnosed type of hip labral tear. It occurs at the front of the hip joint and is typically caused by repeated pivoting or twisting that results in overuse. Athletes who play sports requiring these movements, like hockey, ballet and football, may be particularly at risk for anterior labral tears.
- Another cause is femoroacetabular impingement (FAI), a structural condition where the hip bones are not normally shaped due to extra bone growth. FAI causes the femoral head and the hip socket to place additional pressure on the labrum. This results in friction, which can result in a hip labral tear.
- Posterior labral tears, which occur at the back of the hip, are less common than anterior labral tears. They are typically caused by traumatic injuries, such as those resulting from playing high-impact or contact sports, falls and accidents.
If you have been diagnosed with a hip labral tear, your healthcare provider will consider the type of tear, its severity, your symptoms and your wellness goals to prescribe treatment. Your care plan may include one or more of the following approaches:
Nonsurgical interventions may be appropriate if your symptoms don't affect your quality of life and ability to play sports. If you do experience pain, limited range of motion and other symptoms that impact your athletic skills, or if medication and physical therapy aren't helpful, your surgeon may recommend surgery.
However, it's important to note that hip labrum tears do not heal with self-care and rest. Nonsurgical treatments only help with symptoms. The only way to repair the damage to the hip labrum and ensure lasting results is through surgery.
- Over-the-counter pain medication: Pain relievers like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen and ibuprofen may help with short-term pain management. It's essential to take OTC pain medication as directed by your physician and to not take NSAIDs for more than 10 days in a row. If you need long-term pain management options, consult your physician for other options.
- Corticosteroid Injections: These are injected directly into the hip joint to treat pain and, importantly, inflammation. The femoral head can move more smoothly and painlessly within the hip socket because of the reduced swelling. How long the effects of corticosteroid injections last varies from patient to patient. Some individuals experience pain relief for several months or years; for others, the effects are gone within a few weeks.
- Physical Therapy: A physical therapist can teach patients exercises to strengthen the hip muscles. Stronger hip muscles provide support to the hip joint, allowing patients to move with less pain.
For severe cases or if symptoms do not get better after conservative treatment, your care provider may recommend surgery. If an underlying condition has caused your hip labral tear, your surgeon will also address it to help prevent the injury from recurring. For instance, if FAI is the cause of your hip labral tear, your surgeon will reshape the hip bones. This can often be done during the same procedure.
There are two types of surgery available to treat labral tears. These are:
Hip Labrum Repair Surgery
If your healthcare provider determines that the hip labrum can be repaired, they may recommend hip labrum surgery. This is an outpatient, minimally invasive procedure involving an arthroscope, a special camera that resembles a long, thin tube that is connected to a video monitor.
The surgeon will insert the camera into an incision in the treatment area to be able to see the torn labrum and the hip joint. Guided by the video monitor, the surgeon can see the injured area and use special surgical tools to treat it.
The surgeon may create additional small incisions to allow access to the tools. They then repair the torn hip labrum by implanting suture anchors.
Hip Labral Reconstruction
If the hip labrum is severely torn or if the hip labrum keeps getting reinjured after treatment, the surgeon may recommend surgery to rebuild it. This procedure may be done via arthroscopic or open-surgery approaches. The latter is rarely used and typically only if the tear is very large or the patient's hip anatomy is unusual.
Like arthroscopic hip labral repair, arthroscopic hip labral reconstruction is an outpatient procedure. However, if the reconstruction is done through open surgery, the patient may need to stay at the hospital for two to five days after the procedure.
Recovery Timeline for Returning to Sports
It typically takes up to six weeks for the repaired labrum to heal and reattach to the rim of the hip socket. However, returning to sports will take several months of physical therapy and rehabilitation.
Recovery time for labral surgery depends on several factors, including the severity of the tear and the type of surgery performed. Large tears take longer to heal, and patients who have undergone less-invasive arthroscopic procedures will typically be able to recover faster than those who have undergone open surgery.
Additionally, it is crucial for patients to follow their care provider's rehabilitation plan. Doing so will help with healing and hasten their return to sports. Here is a general recovery timeline for athletes who have undergone hip labral tear repair or reconstruction:
Zero to Four Weeks
For the first two weeks after labral surgery, the patient will need to use crutches to get around. Afterward, they can start putting some weight on their hip and walk slowly for short distances.
If you had open surgery, your staples would be taken out two to three weeks after the procedure.
During this period, your surgeon may advise you to start a physical therapy routine under the guidance of a licensed physical therapist. Your PT may introduce you to passive range of motion exercises (PROM), massage and gentle stretches to help decrease inflammation and strengthen the muscles supporting the hip.
Four to Twelve Weeks
With the approval of your orthopedic time, you can increase the frequency and intensity of your range-of-motion, rotating and strengthening exercises.
In most cases, patients who have had labral repair surgery can start performing sports-specific exercises three months after surgery. However, starting slowly and with care is essential, as the hip can be reinjured with too much or too vigorous physical activity.
Patients may be able to return to sports six months to one year after surgery.
If you have had or are planning to have labral surgery, it's best to work with your surgeon and care team to develop a rehabilitation plan aligned with your athletic goals. They will monitor your progress, adjust your treatment plan when necessary, and provide you with guidance to ensure a speedy and successful recovery.
Returning to Sports: Best Practices
Returning to sports after surgical treatment for a labral tear should be gradual. While you may want to get back in the game as soon as possible, it's essential to exercise patience and focus on gentle progression.
Exerting too much physical activity too fast can result in re-injury. Instead, work with your physical therapist and begin with low-impact exercises, increasing the frequency and intensity of your routine over time. Following your care team's recommendations will help prevent re-injury and facilitate healing.
Personalized Labral Repair Treatment Plans for Athletes
American Hip Institute (AHI) offers cutting-edge, minimally invasive treatments for patients with hip labral tears. We have treated countless professional athletes using innovative approaches that help restore the functionality of their hips so they can return to playing sports.
Contact us to book an appointment today.