Hip Labral Tear Exercises that Can Help Speed Up Your Recovery

What Is a Labral Tear?

According to the Cleveland Clinic, your hip joint is composed of a ball (the femoral head) and a socket (the acetabulum), allowing it to move in many different directions. The socket is lined by a ring of tissue (cartilage), also known as the labrum, which serves several different purposes:

• Deepens the socket and creates a seal or suction that keeps the ball portion of the hip joint secure in the socket, adding to the joint's stability
• Assists in helping the femoral head to smoothly move on the acetabulum without pain or restriction
• Absorbs the forces to which the hip joint is exposed when you walk, run or move about

In some people, the labrum can begin to tear — a portion of the cartilage pulls away from the bony socket of the hip. This can occur for a number of reasons, including trauma to the leg, degeneration over time or as a result of a structural abnormality within the joint itself.

The Best Hip Labral Tear Exercises

Early on in your recovery, it's best to start with gentle, pain-free exercises. Initially, these movements should focus on strengthening the muscles in the back and outside of the hip. Activating these areas helps minimize the strain on labrum on the front portion of the joint.

1. Glute Bridge

This exercise is an easy way to activate the gluteus maximus, a large muscle in the back of your hip.

2. Clamshell

The clamshell exercise exercise targets your gluteus medius, a muscle on the outside of the thigh that supports the pelvis and hip joint. You can add a resistance band around your knees to increase the intensity of the exercise as your recovery progresses and you get stronger.

3. Fire Hydrant

This unique exercise activates multiple muscles, including the abdominals and the hip external rotators.

4. Banded Side Step

This is another effective way to strengthen the hip abductor muscles on the outside of your hip using only a resistance band. If this is too easy, try lowering the level of the resistance band to your ankles.

5. Donkey Kick

This distinctively named exercise helps increase the strength in your glutes and support the back of your hip joints. You can also perform this move standing while facing a counter and leaning your arms against it.

6. Side Plank

Lie on your side with your forearm on the floor underneath you and your legs stacked on top of each other. Keeping your knees straight, push up through your forearm as you lift your hip off the floor.

After 1 or 2 seconds, lower your hip back down again. If this is too challenging, try the same movement with your knees bent.

Is Walking OK With a Torn Hip Labrum?

As long as you've consulted with your doctor, orthopedist or physical therapist, walking can be a perfectly safe way to facilitate your recovery. In fact, movements like standing and walking might actually feel better when you have a torn labrum, depending on the location of the tear.

If you experience mild pain that influences your regular gait, you may also want to incorporate specific exercises to improve walking with a limp.

2. Piriformis Stretch

Your piriformis muscle is lies deep behind the gluteus maximus in your butt and helps you rotate your hip. Tightness in this muscle, which sits near your sciatic nerve, can throw off the mechanics of the hip and alter your movement at the joint, according to the Cleveland Clinic.

If you'd like, you can use a towel hooked around your affected ankle instead of using the opposite leg to guide your stretch.

3. Butterfly Stretch

The butterfly stretch helps target the muscles on the inside of the hip near your groin and inner thigh (called your adductor muscles). Poor flexibility in these structures can cause the hip joint to tighten.

If it's more comfortable, you can sit on a small pillow or do this stretch while lying down.

Warning

If you have attempted to stretch and strengthen your hips, and you paid close attention to the exercises to avoid, and you still have symptoms, you may need to speak to your doctor. Further treatment like formal physical therapy, an injection into the hip joint, or even surgery may be necessary.

Hip Labral Tear Exercises to Avoid

Regular stretching and strengthening is important; however, there are several torn hip labrum exercises to avoid, specifically those that incorporate twisting or strain the hip flexors.

This can include exercises like a knee-to-chest stretch, deep squats or lunges. It can also mean that activities like sitting or crossing your legs are irritating.

Is Cycling Good for a Hip Labral Tear?

Because of the position the cycling requires of your hips, cycling isn't good for a hip labral tear. As you pedal, you must bring your knee up, putting your hip into excessive flexion. Then, you apply force in this position as you press down and around.

This, combined with the full range of motion of the hips, creates a potentially painful situation that can further aggravate your torn labrum.

What Are the Symptoms of Hip Labral Tears?

In some cases, a hip labral tear causes no symptoms at all. However, this isn't always the case. One of the most common complaints in people with this condition is soreness or pain, particularly a deep ache in the front of the hip or groin.

This can make things like walking, running, crouching and going up and down stairs difficult. It can also limit your range of motion, causing stiffness within the hip joint itself.

Does a Torn Hip Labrum Hurt All the Time?

Surprisingly, a hip labral tear does not always cause pain. A May 2015 study in ‌The Bone and Joint Journal‌ found labral tears in more than 38 percent of young adult participants, with none of them reporting any pain.

What Causes a Labral Tear?

Tears in the hip labrum can occur for a number of reasons. Sometimes, bony irregularities in the femoral head or acetabulum can cause higher amounts of contact and strain on the labrum. This is called femoral acetabular impingement, or FAI, and can lead to the labrum ultimately tearing.

According to the Cleveland Clinic, repetitive or high-impact activities can also be the cause. If you regularly experience this type of force, whether at work or while playing sports or exercising, you might be more susceptible to tears due to the increased stress on the labrum.

Finally, some labral tears can be attributed to simple degeneration or wear and tear. Osteoarthritis of the hip, which causes the cartilage to break down, can make the labrum more susceptible to fraying and tearing. This is worse in people with obesity, as the extra weight increases the stress on the joints in the legs.

What Aggravates a Hip Labral Tear?

Depending on where exactly the tear is and how severe it is, there are several things that can irritate or worsen a torn labrum:

• Sitting with legs crossed
• Crouching down
• Walking up and down stairs
• Running
• Cycling
• Doing lunges or squats
• High-impact activity
• Bringing your knees into your chest
• Doing any movement that twists your hips inward or outward

How Are Labral Tears Diagnosed?

While your symptoms can help your doctor diagnose a labral tear, imaging is the only way to be sure. The most accurate way to determine whether you have this issue is to get a magnetic resonance angiography (MRA), a version of an MRI that uses dye to visualize your blood vessels.

X-rays can also be helpful in diagnosing FAI or osteoarthritis, which can cause the tearing to happen in the first place. CT scans are usually not effective at visualizing a hip labral tear and aren't frequently used.

How Long Does It Take to Recover From a Hip Labrum Tear?

For labral tears that do not require surgery, two to four months of physical therapy may be needed before you can fully return to your previous activity levels.

This time frame is significantly extended if arthroscopic hip labral repair surgery is required. While every surgeon has their own protocol, it's not unusual for the entire rehabilitation process to take five to six months.

Following surgery, the hip labral tear treatment is typically divided into four phases, according to a May 2016 review in ‌Sports Health‌.

• ‌Phase 1‌ lasts about three weeks and focuses primarily on diminishing your pain, protecting the area that was operated on and preventing your muscles from getting weaker.
• ‌Phase 2‌ is spent slowly restoring your strength and range of motion, while also correcting any lingering abnormalities in your walking pattern.
• ‌Phase 3‌, which can last four more weeks, continues to emphasize strength, while also working on your balance and overall endurance.
• ‌Phase 4‌ reintroduces running and other impact activities after about 12 weeks.

What Can You Do to Help Heal a Torn Labrum?

In addition to the gentle stretches and strength exercises listed above (and anything else your physical therapist recommends), you can also manage any pain from a labral tear with ice and/or over-the-counter medications like Ibuprofen, per Johns Hopkins Medicine.

Do I Need Surgery for a Torn Labrum?

While arthroscopic hip labral repair surgery may be required in some cases, not everyone with a torn labrum needs it.

In a 2018 review in the ‌Journal of Sport Rehabilitation‌, patients who were diagnosed with hip joint disorders, like a labral tear, improved with conservative treatment, such as activity modification, strengthening labral tear hip exercises and the use of pain medication.

Although a labral tear will not physically heal itself, improving your flexibility and strength while avoiding aggravating movements may allow you to resume your normal activities without surgery.

Warnings and Precautions

If you have questions about the pain in your hip or if it's failing to improve with exercise, be sure to speak to your doctor. They'll be able to properly diagnose your condition and help you feel your best again.

How Do You Sit With a Hip Labral Tear?

If your regular sitting position causes pain from your hip labral tear to flare up, there are a few adjustments you can make.

The general idea, however, is to prevent your hips from coming into too much flexion (bringing your knees toward your torso). Think about keeping your knees lower than your hips while seated.

• Avoid low chairs, opting for higher chairs instead
• Tilt your seat base downward (front points to the floor)
• Sit on a wedge cushion (tall part under your butt)
• Recline your seat back slightly

Read more on: livestrong