Recommended Treatments for a Hip Labral Tear

There is a range of treatments to treat pain from a hip labral tear and promote healing. Depending on the severity of the tear, surgery may be recommended right away. In other cases, surgery will be recommended only after non-surgical interventions have been tried.

General treatments for hip labral tears include:

• Non-surgical treatments: considered for mildly inflamed or frayed labrums with the potential to heal and/or become less painful
• Surgical treatment: recommended for moderate to severe tears and for some types of mild tears associated with underlying hip conditions, such as hip impingement

For some people, labral tear pain tends to return after non-surgical care when all physical activities are resumed, and in such cases, surgery is an option.

Goals of Treatment for Hip Labral Tear

Treatments for labral tears in the hip aim to:

• Relieve excessive stress on the labrum and prevent further damage
• Reduce hip, groin, knee, and/or buttock pain
• Strengthen the muscles, tendons, and ligaments in the pelvis, buttock, and thigh
• Improve range of motion in the hip joint
• Enable participation in physical activities and/or sports

Early treatment of a hip labral tear is associated with better outcomes.

Non-Surgical Treatments for Hip Labral Tears

Non-surgical treatments for managing pain from mild labral tears include:

• Rest and activity modification. Resting and limiting strenuous physical activity reduces stress on the labrum and decreases inflammation in the hip joint. Depending on the severity of the tear, activity modification is recommended for 2 weeks or more.
• NSAIDs. Taking non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, for a limited period helps reduce inflammation and pain in the hip area.
  Some NSAIDs are not suitable for all patients due to the potential risk of gastric irritation and/or bleeding and cardiac problems. To avoid these risks, consulting a physician before taking these medications is advisable.
• Heat therapy. Applying a dry or moist heat pack near the hip joint relieves labral pain by reducing muscle tension and spasms. Heat therapy is useful before starting an exercise, sport, or physical activity.
  A clean cloth or towel must be placed between the heat pack and the skin to avoid skin damage, and application time should be limited to 20 minutes with a break of at least 2 hours before reapplying the heat pack.
• Ice therapy. Placing an ice or cold pack near the hip joint reduces labral pain by calming inflammation and swelling around the hip. Ice therapy is effective in reducing activity-related soreness after participating in exercise, sports, or physical activities. 
  Ice packs should not be placed directly to the skin. A towel or other protective barrier must be used between the cold pack and the skin and application time should be limited to 20 minutes with a break of at least 2 hours before reapplying the ice pack.

• Physical therapy. A physical therapy treatment plan is generally advised for mild labral tears.²Groh MM, Herrera J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med. 2009;2(2):105-117. doi:10.1007/s12178-009-9052-9^,3Su T, Chen GX, Yang L. Diagnosis and treatment of labral tear. Chin Med J (Engl). 2019;132(2):211-219. doi:10.1097/CM9.0000000000000020 Physical therapy focuses on improving hip stability and strengthening the muscles in the buttocks, thighs, and pelvis. 
  The treatment is typically divided into 4 stages:

  • Stage 1: reduce inflammation and pain, stabilize the trunk, and correct posture
  • Stage 2: restore a normal range of motion in the hip and associated joints
  • Stage 3: restore strength and function of the hip and associated joints
  • Stage 4: activity or sports-specific retraining

  See 5 Best Stretches and Exercises for Hip Labral Tears

• Intra-articular injection. If hip pain is not alleviated through the above treatments, an intra-articular injection may be considered. For some people, these injections help decrease pain, improve function, and promote progression in physical therapy. 
  There are 2 types of intra-articular injections:
  • Corticosteroid injection. Cortisone, a type of corticosteroid, helps relieve inflammation, and the medication may be combined with a local anesthetic for additional pain-relieving effects.
  • Platelet-rich plasma injection. Ongoing research supports the use of platelet-rich plasma (PRP) therapy to heal damaged hip labrum cartilage.⁴De Luigi AJ, Blatz D, Karam C, Gustin Z, Gordon AH. Use of Platelet-Rich Plasma for the Treatment of Acetabular Labral Tear of the Hip: A Pilot Study. Am J Phys Med Rehabil. 2019;98(11):1010-1017. doi:10.1097/PHM.0000000000001237 Platelet-rich plasma is derived from the patient's blood and contains plasma with a higher concentration of platelets than is found in normal blood. These cells may stimulate the formation of new cartilage in some individuals.⁵Drengk A, Zapf A, Stürmer EK, Stürmer KM, Frosch KH. Influence of platelet-rich plasma on chondrogenic differentiation and proliferation of chondrocytes and mesenchymal stem cells. Cells Tissues Organs. 2009;189(5):317-326. doi:10.1159/000151290
    When used in conjunction with physical therapy and exercise, PRP may reduce hip pain and improve function in those with hip labral tears.⁴De Luigi AJ, Blatz D, Karam C, Gustin Z, Gordon AH. Use of Platelet-Rich Plasma for the Treatment of Acetabular Labral Tear of the Hip: A Pilot Study. Am J Phys Med Rehabil. 2019;98(11):1010-1017. doi:10.1097/PHM.0000000000001237

If these treatments fail to relieve hip labrum pain or if the symptoms get worse, surgery is recommended.

See 6 Activities to Avoid with a Hip Labral Tear

Surgical Treatment for Hip Labral Tears

If surgery is considered, the goal is to conserve as much of the labrum as possible and preserve its natural rubber seal effect around the hip socket (acetabulum).

There are open surgeries and minimally invasive procedures for treating the hip labrum. The recommended approach depends on the type and severity of the labral tear and the presence of other underlying hip conditions.

Patients are discharged the same day or the next day after surgery if minimally invasive procedures are used. If open surgical techniques are used, a hospital stay of 2-4 days is necessary.

An orthopedic surgeon performs hip labral surgeries, and a multidisciplinary team comprised of a physiatrist, physical therapist, and primary care physician is typically involved in the pre-and-post surgical processes.

Minimally invasive surgery for hip labral tears

Most surgical options for labral repair are minimally invasive and use a tool called an arthroscope. An arthroscope is about the size of a pencil and is equipped with a tiny camera, allowing the surgeon to view and repair the damaged labrum without having to make a large incision.

Minimally invasive procedures are used when the problem is limited to the labral tissue and the rest of the hip joint is intact.

• Hip labral repair is indicated when the labrum separates from the bone. The procedure involves reattaching the torn labrum to the hip’s socket using small metal or plastic “anchors” and sterile thread. See Hip Labrum Repair Surgery: Issues to Consider
• Hip labral debridement is indicated for small labral tears and involves trimming or smoothing the tear by cutting or debriding the labral tissue.
• Hip labral replacement, also called labral reconstruction, is a less common procedure used when the natural labrum is severely damaged or in an irreparable condition. Labral replacement uses a graft (tissue from another part of the body or a donor) to completely replace the torn labrum. 
  This surgery is relatively new and not considered standard practice, and the success data for this surgery is limited. See Hip Labral Reconstruction: Surgical Steps and Recovery

Labral repair surgery is preferred over labral debridement because it preserves more labral tissue.³Su T, Chen GX, Yang L. Diagnosis and treatment of labral tear. Chin Med J (Engl). 2019;132(2):211-219. doi:10.1097/CM9.0000000000000020

Labral debridement provides effective pain relief in the short term, but over time, the hip joint loses its rubber seal effect due to loss of natural labral tissue and there’s a risk of future hip instability and pain.³Su T, Chen GX, Yang L. Diagnosis and treatment of labral tear. Chin Med J (Engl). 2019;132(2):211-219. doi:10.1097/CM9.0000000000000020

Hip labral repair surgery is associated with the most favorable outcomes and has a success rate of 68% to 82% in the short and long term.⁶O’Connor FG, Wilder RP, Nirschl R, eds. Running Medicine. Second edition. Healthy Learning; 2014.

Open surgery for hip labral tears: Surgical hip dislocation

Sometimes, an arthroscopic procedure is not possible to treat labral tears. For example, the presence of bony abnormalities, such as overgrown bone in hip impingement, makes it difficult for a surgeon to access the hip joint with an arthroscope. In such cases, an open procedure is performed where the knobby head of the thigh bone (femur) is dislocated from the hip’s socket for a full view of the hip joint, enabling the surgeon to repair or replace the torn labrum and address other existing conditions, such as hip impingement.

Recovery after Hip Labrum Surgery

It takes several weeks to months to fully recover from a hip labral surgery.

The recovery process and surgical success varies for each individual and depends on several factors such as the:

• Type of surgical procedure
• Skill of the surgeon
• Patient’s underlying condition
• Patient’s age and overall health
• Rehabilitation protocol and post-surgical care

As a general rule, weight bearing is limited for 4 to 6 weeks after surgery and a custom rehabilitation protocol begins soon after the procedure.

Most individuals return to their usual, normal activities or sports after a course of physical rehabilitation. Rarely some individuals need to change from high-impact to low-impact activities, such as switching from running to cycling.

If hip pain persists after labral surgery, the patient’s orthopedist may suggest hip arthroplasty or hip replacement as a next step.