Hip Labral Tears: Why They Hurt, What Scans Show, and What Rehab Involves - Camberwell
- Emma Glynn
- 6 days ago
- 5 min read
By Emma Glynn - The Hip & Knee Physio
Quick summary
A hip labral tear can cause sharp groin pain, catching, clicking, or a sense of instability, especially during deep squats, pivoting, or prolonged sitting. It’s commonly seen in both active individuals and older adults. While MRI can confirm a tear, it’s not always needed early. Most people start with structured physiotherapy before considering more invasive options.
What is a hip labral tear?
The labrum is a ring of cartilage that lines the hip socket (acetabulum). It deepens the socket, improves joint stability, and helps distribute load. A labral tear occurs when this cartilage ring becomes frayed or detached, either due to trauma, overload, or hip morphology (e.g., FAI or dysplasia) (Kalisvaart & Safran, 2011).
While labral tears can be painful and functionally limiting, not all tears cause symptoms and many are found incidentally on imaging in people with no pain (Register et al., 2012).
Common symptoms of a hip labral tear
Patients with a symptomatic labral tear may describe:
Groin pain or deep hip ache, often intermittent
Clicking, catching, or a sense of the hip “giving way”
Pain with sitting, getting out of a car, or twisting
Reduced hip rotation or flexibility
Weakness or apprehension with sport or stairs
Symptoms can be sharp, stabbing, or a deep dull ache. For athletes, labral tears may present as groin pain that doesn't settle with rest, or as recurrent hip tightness.
Why do labral tears happen?
Labral tears typically develop due to:
1. Structural factors
Conditions like femoroacetabular impingement (FAI) or hip dysplasia place abnormal forces on the labrum, increasing shear stress during movement (Philippon et al., 2007).
2. Overuse or overload
Repetitive pivoting, running, or deep flexion (e.g., squats, lunges) can wear down the labrum over time, particularly if muscle strength or movement control is suboptimal (Nepple et al., 2012).
3. Trauma
A fall, tackle, or abrupt twist may cause an acute tear, though this is less common than gradual degeneration.
Do I need a scan?
Imaging is not always necessary at the first sign of hip pain. However, it may be considered if:
Pain persists beyond 6–8 weeks of rehab
There's mechanical catching, locking, or instability
Other diagnoses (e.g. stress fracture, arthritis) need exclusion
MRI arthrogram remains the gold standard to visualise labral pathology, though standard MRI can be helpful. However, scans must always be interpreted in context: labral tears are also found in pain-free hips, especially in those over 40 (Register et al., 2012).
What’s the difference between a labral tear and hip arthritis?
Both can cause groin pain, stiffness, and reduced hip rotation. However:
Feature | Labral Tear | Hip Osteoarthritis |
Age group | Often 20s–50s | Often 50s+ |
Pain onset | Activity-related, mechanical | Gradual, stiff in morning |
Range of motion | Painful end-range flexion/rotation | Globally reduced |
Imaging | Labral damage, may show FAI | Joint space narrowing, osteophytes |
What does physiotherapy for labral tears involve?
In many cases, physio-led rehab is the first line, particularly for mild-to-moderate symptoms without clear mechanical locking (Griffin et al., 2016).
Goals include:
1. Settling pain and irritability
Load modification (e.g. avoiding deep squats, long sitting)
Anti-inflammatory strategies (guided by GP if needed)
2. Strengthening hip support muscles
Gluteus medius, glute max, deep rotators and core
Movement pattern retraining (e.g., avoiding hip drop or knee collapse)
3. Controlled mobility
Gradual progression through pain-free ranges
Avoid aggressive stretches that shear the labrum
4. Return to sport/activity
Progressive load exposure
Criteria-based return, not time-based alone
In some cases, persistent or severe labral tears may be referred for surgical consultation, often for arthroscopic labral repair, particularly in young athletes or those with mechanical symptoms. Post-operative rehab is crucial for recovery and return to sport (Domb et al., 2014).
What can you do this week?
Track what aggravates your symptoms (e.g. squats, sitting)
Modify high-load positions (avoid deep hip flexion or twisting)
Begin gentle glute activation (e.g. side-lying clams, bridge)
Stay active within pain-free limits (e.g. walking, cycling)
If pain persists >2 weeks or worsens, book a physiotherapy assessment
FAQs
Can a labral tear heal without surgery?
Some tears settle well with rehab, especially if they’re small and don’t cause mechanical locking (Griffin et al., 2016).
Can I exercise with a labral tear?
Yes, many people can continue modified training while symptoms are managed. Guidance from a physio is key.
Do cortisone injections help?
They may reduce inflammation short term, but won’t “heal” the tear. They're typically used selectively.
Is hip clicking always a labral tear?
No, other structures like the iliopsoas tendon can also cause snapping or clicking.
What if I also have lower back or SIJ pain?
Hip, spine and SIJ often interact - a thorough assessment is important to determine the source.
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The content provided on this website is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.
While The Hip and Knee Physio strives to present accurate and up-to-date information, we do not guarantee results or outcomes based on the information provided. Any exercises, strategies, or recommendations featured on this site should not be considered a personalised treatment plan.
Always seek the advice of a qualified healthcare provider before starting any exercise program, particularly if you are experiencing pain, injury, or a pre-existing medical condition.
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References
Domb, B. G., Stake, C. E., Finley, Z. J., & Botser, I. B. (2014). Arthroscopic labral reconstruction is superior to segmental resection for labral tears: a matched-pair comparison. American Journal of Sports Medicine, 42(1), 122–130. https://doi.org/10.1177/0363546513510143
Griffin, D. R., Dickenson, E. J., O'Donnell, J., Agricola, R., Awan, T., Beck, M., ... & Martin, H. D. (2016). The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. British Journal of Sports Medicine, 50(19), 1169–1176. https://doi.org/10.1136/bjsports-2016-096743
Kalisvaart, M. M., & Safran, M. R. (2011). Hip instability treated with arthroscopic capsular plication. Knee Surgery, Sports Traumatology, Arthroscopy, 19(10), 1683–1687. https://doi.org/10.1007/s00167-011-1604-y
Nepple, J. J., Philippon, M. J., & Campbell, K. J. (2012). The hip fluid seal—Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip fluid pressurization. Knee Surgery, Sports Traumatology, Arthroscopy, 20(4), 703–709. https://doi.org/10.1007/s00167-011-1614-9
Register, B., Pennock, A. T., Ho, C. P., Strickland, C. D., Lawand, A., Philippon, M. J. (2012). Prevalence of abnormal hip findings in asymptomatic participants: A prospective, blinded study. American Journal of Sports Medicine, 40(12), 2720–2724. https://doi.org/10.1177/0363546512462124