Labral tear: hip and shoulder
What is labral tear?
Firstly, labrum is a strong fibrous tissue which surrounds the shoulder and the hip joints providing it with depth and stability. Particularly in the hip, it also provides shock absorption and force distribution. Labral tear, is literally a tear to the labrum which, depending on the severity and location, may cause a significant dysfunction and discomfort of the joint.
What causes a labral tear?
There are few reasons why you might experience a labral tear. One of the most common reasons is when you sustain a slip and fall injury. Although the reasons are the same for hip and shoulder, below we will give some specific examples for both joints.
Shoulder:
- Repetitive strain injuries: these can be caused by a sporting activity requiring lots of overhead motion such as racket sports (tennis, softball, squash) and swimming.
- Dislocation: shoulder dislocation which might occur during a sporting activity such as rugby or boxing.
- Abnormal bone growth: abnormal bone growth might occur from birth or due to a traumatic injury, particularly to the rotator cuff tendon, causing it to calcify. Abnormal bone growth results in a bone spur which, during the shoulder movement, rubs onto the labrum eventually causing it to tear.
Hip:
- Repetitive strain injuries: these can be caused by sports involving a lot of repetitive movements and pivoting such as running, cycling, football, rugby, hockey and more.
- Trauma: trauma can be caused during a sporting activity or a fall.
- Dislocation.
- Abnormal bone growth: just like in the shoulder, if the bone growth is abnormal, it will result in the bone spur rubbing onto the labrum eventually resulting in a tear.
Symptoms of labral tear?
Labral tears have several specific symptoms:
Shoulder:
- Pain at night. Depending on the severity, you might not be able to sleep on that side.
- Grinding, popping or catching deep in the shoulder during movement.
- Loss of strength.
- Reduced range of movement.
- Pain while doing any type of overhead activity.
Hip:
- Stiffness of the hip joint. Feels like it does not move very well.
- Pain in the hip or groin area.
- Reduced range of motion of the joint.
- Locking, clicking or catching sensation during hip movement.
- Hip might feel weak.
Can I exercise with a labral tear?
This very much depends on the severity of the tear and what activity you desire to do. This applies for both, hip and shoulder. Generally, you should be able to do some form of exercise, however, you will have to be careful not to aggravate the area and ensure that the exercises performed are pain free, otherwise you might make the tear worse. For example, if you love playing tennis and your shoulder hurts while serving or smashing, unfortunately, you will have to adapt your game so that you could avoid any of these shots. It might be more tricky when it comes to the hip. For instance, if you like cycling but it causes you pain, only alternatives would be going to a gym and using a recumbent bike, which allows the hip to move at a bigger angle, or change it to running, brisk walking or cross-training.
What should be avoided if I have a labral tear?
Ensure that any movement or exercise that you desire to do does not cause any pain or other symptoms in the affected area. Forcing the action and pushing through the pain will very likely worsen the tear and increase the dysfunction of a joint.
Conservative management of labral tear:
When it comes to conservative management of labral tears, it very much depends on the severity and location of the tear in the hip and the shoulder. Labrum has a poor blood supply, hence, meaning that, if a tear is significant, it will not heal on its own. However, there are few conservative treatment approaches which might help you to manage the symptoms and maintain a good quality of life:
Manual therapy: will help to release the tension of the surrounding muscles and might help to manage the ache/pain that you are experiencing. This might involve massage and joint articulation techniques.
Exercises: strengthening exercises might help you to strengthen the musculature around the affected area so that the joint is stronger and has more support.
Surgical management of a labral tear:
If conservative approach is ineffective, arthroscopy can be used. During the arthroscopy, a surgeon might trim and smoothen the torn labrum which is causing the pain. If possible, the surgeon might attempt to attach the labrum back to its origin with a plastic anchor, or, if necessary, the surgeon might also shave off any abnormal bone growth which may have caused or contributed to the labrum tear.
We hope this information was useful for you. If you have any questions about it or about our treatments, please contact us. We are only a 3 minute walk away from Angel Station. We are always happy to help.
References:
https://link.springer.com/content/pdf/10.1007/s12178-009-9052-9.pdf
https://www.charbonnier.ch/pdf/publications/73.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953303/pdf/najspt-02-241.pdf
