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Football season is underway and everyone loves cheering for their favorite team.  One thing that fans never want to see, however, is one of the star athletes getting injured.  There are many different types of injuries that occur during football, but one in particular that can cause a prolonged loss of playing time is a hip labral tear.

The hip is a ball and socket joint made up of the head of the femur as the ball and the acetabulum of the pelvis as the socket. The labrum is a fibrocartilaginous structure that outlines the socket in order to provide stability and create a deeper socket for the ball of the femur.  The labrum of the hip serves as shock absorption, joint lubrication, pressure distribution, and aids in stabilization.  Damage to the labrum often occurs due to trauma, femoroacetabular impingement (FAI), capsular laxity or hip hypermobility, dysplasia, or degeneration.  FAI is a disorder where bone spurs grow around either the socket or the head of the femur causing damage to the labrum.  Dysplasia refers to a disorder where the socket is abnormally shallow thus increasing the likelihood of a tear along the labrum.  No matter the cause, a labral tear can be a very painful injury.

Common symptoms associated with a labral tear include hip pain (typically along the front or groin region but less commonly in the buttock region), clicking, locking or catching, “giving way”, and slight hip range of motion limitations (primarily in rotation).  Due to common misdiagnosis, symptoms can last years prior to being recognized as a labral tear.  Common imaging techniques do not detect hip labral tears well which is why arthroscopy (commonly known as a “scope”) is the gold standard for diagnosing a tear.  This procedure is ever more frequently being used for treating a tear of the labrum as well.

Hip arthroscopy or a hip scope can be used for several different conditions including FAI, dysplasia, cartilage injuries, loose bodies in/around the joint, tendonitis or tendon tears, synovitis, hip joint infection, and of course labral tears.  An arthroscopy is minimally invasive which allows surgery to be performed by making only small incisions in the body.  Through these incisions a miniature camera and specialized instruments are utilized to perform the surgery.  Depending on the nature of the labral tear, a surgeon may opt to either remove damaged tissue or actually repair the labrum.  Hip arthroscopies are different from those of the shoulder and knee due to the fact that the hip joint sits deeper beneath muscle and has a tight vacuum seal to hold the joint in place.  This is why traction (pulling along the leg) is utilized for the hip joint during surgery  to create enough room for the surgical instruments to move within the tight joint space.  An athlete typically can return to play 4-6 months after surgery with the help of physical therapy.  Physical therapy can be utilized prior to surgery as a non-invasive form of treatment, as well, in order to address deficits and correct mechanics that may be increasing stress along the labrum.  However, if pain persists for greater than 12 weeks despite therapy or the hip is locking, a hip scope may likely be recommended.

Sports injuries can be devastating for both players and fans, but recovery is possible with the right tools.  I hope this information helped shed some light on one particular area of sport injury.  If you have any questions on this topic or any others in which you are interested, feel free to leave any questions, comments, or suggestions. Thank you for reading and stay active.

Resources:

http://orthoinfo.aaos.org/topic.cfm?topic=A00572

http://sportsmedicine.ucsd.edu/conditions/hip-arthroscopy/Pages/default.aspx

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697339/

http://www.mayoclinic.com/health/hip-labral-tear/DS00920

http://ajs.sagepub.com/content/36/11/2187.abstract

http://ptjournal.apta.org/content/86/1/110.full

 

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