Hip labral tears are a common source of hip pain and groin pain, particularly in active people, and they are often misunderstood. This guide explains what hip labral tears are, the symptoms to look for, what causes them, and how they are treated, including when physiotherapy is enough and when surgery is considered. Understanding the labrum, and its relationship with hip impingement, is the place to start.
Written by Ffion Thomas, Physiotherapist at BeFit Training Physiotherapy, Coogee.
What Is the Hip Labrum?
The labrum is a ring of cartilage that lines the rim of the hip socket, the acetabulum. It deepens the socket, helps hold the ball of the joint, the femoral head, in place, and acts like a seal that supports the way load is shared across the joint. When the labrum is torn, that seal and stability can be affected, which is where hip labral tears start to cause symptoms.
Because the labrum sits deep in the joint, hip labral tears can be difficult to pinpoint without a proper assessment, and the symptoms overlap with several other causes of hip pain.
Symptoms of Hip Labral Tears
The symptoms of hip labral tears vary from person to person, and some tears cause very little at all. When symptoms are present, the most common include:
- Deep hip pain or groin pain, often described as being felt inside the joint
- A catching, clicking or locking sensation in the hip
- Pain that worsens with deep hip flexion, such as squatting, sitting for long periods or getting in and out of a car
- A feeling of the hip giving way or lacking stability
- Stiffness or reduced range of motion
Groin pain is one of the most characteristic features of hip labral tears, though the same pattern can come from other conditions, which is why assessment matters before assuming the labrum is the cause.
What Causes Hip Labral Tears?
Hip labral tears can develop in a few different ways, and often more than one factor is involved.
Hip Impingement
One of the most common contributors is hip impingement, also called femoroacetabular impingement. This is where extra bone on the femoral head or the socket rim leads to abnormal contact during movement, which can gradually wear or tear the labrum over time. Hip impingement and hip labral tears frequently occur together, and addressing the impingement is often part of managing the tear.
Repetitive Movement and Load
Sports and activities involving repeated deep hip flexion, twisting or rapid change of direction can load the labrum heavily. Dancers, footballers, hockey players and runners are among those who more commonly develop hip labral tears through repetitive load.
Structural Factors
The shape and orientation of your hip joint can make hip labral tears more likely. Conditions such as hip dysplasia, where the socket provides less coverage over the femoral head, place greater demand on the labrum to stabilise the joint, which can lead to tearing over time.
Injury
Less commonly, a single traumatic event such as a fall, a heavy tackle or a sudden twist can tear the labrum directly.
How Are Hip Labral Tears Diagnosed?
Diagnosing hip labral tears starts with a detailed assessment of your history and symptoms, followed by physical tests that load the hip in specific positions to reproduce your hip pain or groin pain. Because the symptoms overlap with hip impingement, hip dysplasia and other conditions, a physiotherapist will also look at how your hip moves and how much strength and control you have around it.
Imaging, usually an MRI, can confirm hip labral tears and show associated features such as hip impingement. It is worth knowing that labral changes show up on imaging in many people who have no pain at all, so a scan finding is interpreted alongside your symptoms rather than on its own.
How to Treat Hip Labral Tears
Most hip labral tears are managed without surgery, at least to begin with. Treatment is guided by your symptoms, your goals and what is driving the tear, rather than by the scan alone.
Physiotherapy and Strengthening
Physiotherapy is usually the first-line treatment for hip labral tears. The aim is to reduce the load going through the labrum by building strength and control around the hip, particularly the glutes and deep hip stabilisers, and by improving how you move. Addressing any underlying hip impingement or control issues often settles symptoms without the labrum itself needing repair.
Activity and Load Modification
Adjusting the activities that aggravate your hip pain, at least in the short term, gives the joint a chance to settle. This does not usually mean stopping activity altogether, but modifying the positions and loads that provoke symptoms while you build capacity.
When Surgery Is Considered
If symptoms do not settle with a well-structured course of physiotherapy, or where there is significant hip impingement or structural involvement, surgery may be considered. That decision sits with an orthopaedic surgeon, and even where surgery is performed, physiotherapy afterwards is central to a good outcome.
Frequently Asked Questions
What does a hip labral tear feel like?
Hip labral tears often cause deep hip pain or groin pain, sometimes with a catching or clicking sensation, and pain that worsens with deep hip flexion like squatting or prolonged sitting. Some people also feel the hip is unstable or giving way.
Can hip labral tears heal without surgery?
Many hip labral tears are managed well without surgery. Physiotherapy focused on strength, control and load management can settle symptoms effectively, particularly when any underlying hip impingement is addressed. Surgery is considered when conservative treatment does not resolve the problem.
What causes hip labral tears?
Common causes include hip impingement, repetitive loading through sport, structural factors such as hip dysplasia, and less commonly a single traumatic injury. Often more than one of these contributes to the tear.
Should I keep exercising with a hip labral tear?
Usually yes, but with modification. Avoiding the specific positions and loads that provoke your hip pain, while building strength around the joint, is generally more helpful than stopping altogether. A physiotherapist can guide what to adjust.
How BeFit Can Help
If you are dealing with hip pain or groin pain and think it might be a labral tear, our general physiotherapy team can assess your hip, work out what is actually driving your symptoms, and build a treatment plan around it. No referral is required.
Related Reading
For more on hip health, see our guide to the hip pain journey, and our piece on how hip anatomy shapes squat performance, which explains how the shape of your hip joint influences movement.
Book an Appointment
Book an appointment at BeFit Training Physiotherapy. No referral needed.
BeFit Training Physiotherapy Edgecliff
Ground Floor, 287-289 New South Head Road, Edgecliff NSW 2027
Phone: (02) 9327 7749
BeFit Training Physiotherapy Coogee
Shop 1/2 Byron Street, Coogee NSW 2034
Phone: (02) 7205 2805
