The labrum is an important cartilage ring that promotes stability and shock absorption in the shoulders and hips. It is attached to the outer rim of the shoulder socket and helps keep the ball of the shoulder in place. The labrum performs that same function in the hip socket. When it gets torn it is referred to as a labral tear. In some cases, a labral tear occurs as the result of an injury, but it may also develop over time due to the aging process, kind of like wrinkles on the inside.
The symptoms of a shoulder labral tear can include:
- Pain at the top of the shoulder
- Pain deep inside the shoulder
- An increase in pain when the arm is turned inward
- Pain that worsens when the arm moves from a backward to forward position
- Pressing on the shoulder does not worsen the pain as it originates from deep inside
If a person is suffering from a hip labral tear, the following symptoms may occur:
- A limited range of motion or stiffness in the hip
- A clicking, catching or locking sensation in the hip
- Pain that worsens with prolonged walking or sitting
- A sharp, stabbing pain in the groin or hip while squatting
- Weakness in the muscles that surround the hip
- Feeling as if something is preventing hip movement or is stuck in the hip joint
Pain in the groin or hip can often be described through a C-sign, in which an individual makes a C shape with the hand and places it on the hip to demonstrate the location of the pain. Although the symptoms for a shoulder or hip labral tear are quite different, the diagnostic procedure for each type of tear is the same.
While a clinician may order an X-ray to identify potential bones issues (e.g., abnormalities, fractures) that may be contributing to the pain, an MRI is required for an accurate labral tear diagnosis.
It is important to note that imaging is not required to start your recovery. Many individuals have labral tears without having any symptoms and most individuals with a labral tear will recover with conservative care like physiotherapy. Imaging is important if recovery is not as expected or function is not improving and therefore surgery is being considered.
If on assessment, a primary care practitioner (family doctor, physiotherapist, sports physician, etc.) suspects a labral tear, people with mild to moderate pain may start rehabilitation with a physiotherapist who will assess the strength, mobility, and function, of the affected joint. The comprehensive assessment will entail a thorough history of the mechanism of injury, a physical examination of the joint if tolerated, and some specific tests to determine how well the joint can tolerate loads. Furthermore, a physiotherapist will evaluate your daily activities, sports regimens, or work-related tasks that may be aggravating the tear in order to suggest activity modification that will improve the symptoms and provide pain relief.