You may have read in the news that Lady Gaga has called off her tour due to a labral hip tear. This is a fairly common injury that I see routinely in my practice and is most likely a result of her very active lifestyle.
The labrum is a piece of cartilage that wraps around the hip socket and helps stabilize the hip joint. The most common cause of labral tears is Femoral Acetabular Impingement (FAI). Which means the thigh bone (Femur) pinches on the hip socket (Acetabulum) and causes trauma to the labrum (which attaches to the outer rim of the Acetabulum), which can result in the labrum tearing. There are multiple factors that contribute to FAI, but we believe it occurs primarily from a combination of hereditary abnormalities, traumatic events, and activity related injuries. For instance, there is a much higher incidence of FAI and labral tears in athletes, particulary football players, hockey players, and soccer players than in the general population.
Even if you are not involved in these types of high impact sports, labral hip tears are common injuries found in young, active people. They can be found in kids as young as 14 and in adults in their elder years. We tend to see them more in the younger population (14-45), because this is the time period that people tend to be the most active. Many elderly patients will have labral tears, but will not show symptoms because of their decreased activity level.
Although some people with labral tears may never require fixation, it is much more common that the tear requires surgery, particularly when seen in a young, active patient. Surgery is often necessary in order to return to full function and activity/sport.
The initial treatment for labral tears is typically a short period of rest and anti-inflammatory medication. The usual recommended time period of inactivity is 6-12 weeks. This can sometimes be supplemented with an intraarticular injection of steroid to calm the acute inflammation down following injury. If conservative measures fail to provide the desired relief, surgical repair is the treatment of choice. Labral hip tears are most commonly fixed arthroscopically, although open procedures do exist. Patients typically require one night in the hospital and 2-4 weeks on crutches. Full recovery, in particular return to sport, is usually possible within 4-6 months.
Although some of the causes of FAI may be unavoidable and in a patient’s “deck of cards”, prevention is always a key component in any injury. I typically recommend being very diligent in stretching before participation in any sport or prolonged activity. Another key component, particularly in females, is developing and maintaining a strong and stable core. Core strength and gluteal strength are key components in the prevention of all hip injuries, including labral tears.
Dr. Casey D. Taber is a board certified orthopaedic surgeon who has completed additional fellowship training in sports medicine. He treats patients aged 14 years and up for conditions of the shoulder, hip, knee and any sports-related injury. His special interests include hip arthroscopy for FAI and labral hip tears. To schedule an appointment with Dr. Taber, please call 210.281.9595.