In the pelvis, there is a ring of cartilage that surrounds the pit forming the hip joint, thereby widening and deepening the articular surface. This is called a “labrum”. Since the hollow part of the pelvis is called the acetabulum, it is also called the “acetabular labrum”. A similar structure is also present in the shoulder, the “glenoid labrum” in the shoulder.
Apart from cushioning the labrum joint, it provides a socket for the head of the thigh bone to sit and not come off easily. Tears of the labrum cartilage caused by trauma or structural reasons are called labral tears or labral tears.
Labrum tears often do not cause any symptoms. However, sometimes it can cause locking in the hip, a feeling of being stuck, pain in the hip and groin, stiffness in the hip joint and decrease in the range of motion, and walking difficulties. If you have such complaints and do not decrease in a few weeks, you can consult a physical therapy and rehabilitation (FTR) or orthopedic doctor.
Labrum tear may predispose to the development of hip calcification (osteoarthritis).
Why Does It Happen?
Direct damage or dislocation of the hip joint as a result of a trauma such as a traffic accident, fall or sports injury can lead to a tear of the labrum. Some individuals are structurally more prone to labrum injury due to the shape of the bone. In hip impingement syndrome , the difference in the shape of the thigh bone and pelvis can lead to joint obstruction and labrum damage in normal movements. Games such as golf, softball, hockey, and ballet that require excessive rotation and bending of the hip can cause wear and tear in the labrum over time.
Those involved in sports that put a lot of weight on the hips should exercise regularly to keep their muscles strong and flexible. When the hips are positioned at the limit of the normal range of motion during sports, loading with the whole body weight should be avoided.
The diagnosis is suspected by medical history and physical examination. In the examination, the movement of the hip joint in various directions is evaluated. Other problems may accompany a hip labrum tear. While X-ray film enables the evaluation of bones, MRI (MR) imaging provides visualization of soft tissues such as muscles, tendons, including the labrum, and edema. MRI is usually required to make a definitive diagnosis. Sometimes a local anesthetic injection may be given to see if the pain is really caused by problems in the hip joint. If the pain disappears when painkillers (anesthetics) are injected into the hip with a needle, then the problem is really inside the hip.
Treatment may be physical therapy or surgery, depending on the severity of the problem.
The first step is to avoid movements that increase pain. Sitting with your legs crossed or sitting on the floor with your legs crossed are movements that strain the labrum.
Mild complaints may improve in a few weeks with physical therapy. Pain medications may be prescribed for short periods of time. These drugs also suppress edema and inflammation . Inflammation can also be reduced by injecting cortisone into the joint . In physical therapy, exercises are applied to normalize hip movements, stretch and strengthen the muscles. Exercises that strengthen the core muscles, increase the sense of balance and joint position are also helpful. Various physical therapy devices can be used to reduce pain, reduce muscle spasm, and strengthen muscles.
If the symptoms do not decrease with physical therapy, surgery may be required. The surgery is performed with the arthroscopic (closed) method. The torn part of the labrum can be removed or sewn together. Physical therapy may be required for returning to normal life and sports after surgery.