Are you struggling with chronic hip pain that just won’t let up? You’re certainly not alone, and it can be frustrating to diagnose the cause of your pain. One potential culprit is a hip impingement, also known as a femoroacetabular impingement (FAI). However, closely related with similar symptoms is a labral tear.

Few issues are as interlinked and perplexing as hip impingements and labral tears. These two conditions, though distinct, share an intricate relationship that can leave individuals dealing with hip pain and discomfort searching for answers.

 

Understanding both conditions

A hip impingement is a condition where there is abnormal contact between the bones of the hip joint due to a deformity or misshaped bone. With this condition, the ball-shaped head of the femur (thigh bone) does not fit properly into the socket-shaped acetabulum (part of the pelvic bone). This causes the bones to rub against each other, leading to friction and discomfort.

There are three different types of hip impingements:

  • Cam impingement: Involving excess bone growth on the femur’s head, which can lead to impingement when the hip is flexed or rotated. This is the most common type of impingement.
  • Pincer impingement: An overgrowth of the acetabulum’s rim, which can cause the labrum (a ring of cartilage that lines the hip socket) to be pinched when the hip is moved.
  • Combined impingement: A combination of both cam and pincer impingements, where there are abnormalities on both the femur and acetabulum.

A labral tear entails the impairment of the labrum, a crucial ring of cartilage responsible for providing stability to specific joints within the body, such as the shoulder or hip. This condition may stem from various factors, including joint trauma or the repetitive strain incurred during sports and physical activities. However, labral tears are not solely attributed to external factors; they can also be associated with the presence of hip impingements.

 

The connection

Labral tears in the setting of hip impingements can be as high as 59%, according to an article from the National Library of Medicine. This is due to the abnormal shape and contact between the bones associated with a hip impingement, which can cause excess stress, friction and pinching of the labrum that potentially can lead to a labral tear.

However, while both conditions involve problems with the hip and can co-exist, they are still distinct in their own ways as a hip impingement refers to the structural abnormalities of the hip joint, and a labral tear involves damage to the cartilaginous ring in the hip joint.

 

Symptoms

Whether you have a hip impingement, a labral tear or a combination of both, the bottom line is that both conditions can cause pain and have overlapping symptoms such as:

  • Hip stiffness
  • Pain in the groin and front of the thigh
  • Limping
  • “Snapping” or “clicking” sound
  • Limited range of motion

 

Diagnosis and treatment

If you’re experiencing any of these symptoms, seek out an evaluation from an orthopedic specialist to determine if you may have a hip impingement, labral tear, or another medical condition involving your hip.

After reviewing your medical history and a physical examination of your hip, your physician will recommend further evaluation if necessary. Both hip impingements and labral tears can be detected using imaging studies, including an X-ray, MRI, or CT scan. In some cases, a diagnostic injection may be performed to help identify the source of pain.

If one or both conditions are detected, your physician will come up with the best treatment plan to suit your needs, depending on the severity of the condition and symptoms. For milder cases, conservative treatments may include physical therapy to improve hip strength and flexibility, as well as lifestyle modifications to reduce activities that enhance symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. In more severe cases, surgical intervention may be necessary. Hip arthroscopy is a minimally invasive surgical procedure often used to address both hip impingements and labral tears. During this procedure, the surgeon can reshape the hip joint to alleviate impingement and repair or remove the damaged labrum. Ultimately, the choice of treatment is personalized to each patient’s unique condition, with the goal of reducing pain, improving hip function, and enhancing overall quality of life.

At Mather, minimally invasive procedures to resolve the issue provide quicker recoveries and reduced postoperative discomfort. “We take a personalized approach to care and tailor each hip arthroscopy to individual needs, addressing specific concerns such as labral tears, hip impingement, or cartilage damage. As a result, patients experience improved joint function, increased mobility, and enhanced quality of life,” said John Yu, MD, an orthopedic specialist at Orlin & Cohen in Port Jefferson, NY.