Does a labral tear on my MRI mean I need surgery?

Not necessarily. Asymptomatic labral tears are common. Register et al. (AJSM 2012) found labral tears on MRI in around 69 percent of pain-free adults across a broad age range. Imaging findings need to line up with a matching clinical picture. Many patients with both imaging findings and symptoms do well with loading-based physiotherapy. Surgery becomes a more reasonable conversation when progressive strength work has genuinely been tried and the hip still cannot meet life or sport demands.

Can a torn labrum actually heal?

The labrum has limited blood supply, so structural healing of a true tear is not typical. That is not the same as pain continuing. What usually changes with rehabilitation is the irritability of the tear and the way the surrounding capsule and muscles control the joint. Many patients become functional and largely pain-free without the tear itself changing shape on imaging.

What does the C-sign mean?

The C-sign is when a patient cups their hand around the side of the hip from the front of the groin to the greater trochanter to describe where the pain sits. It is a pattern I see frequently with intra-articular hip pain, including labral tears, but it is not exclusive to labral pathology. It is a useful starting point, not a diagnosis.

Should I avoid squats and deadlifts?

Usually no, but the range matters. Deep squatting with rotation is often provocative early on. I typically keep patients squatting to a comfortable box depth and lifting through hip hinge patterns such as Romanian deadlifts, which respect the labrum while still building the hip. Rebuilding strength is part of the treatment, not the enemy.

Does clicking mean my labrum is tearing further?

Clicking by itself, without pain, does not usually indicate ongoing damage. Symptomatic clicking that comes with sharp groin pain, giving way, or true mechanical locking is a different story and warrants reassessment. I pay more attention to whether the hip feels trustworthy under load than to the noise it makes.

How long should I try physiotherapy before considering surgery?

A genuine trial of 3 to 4 months of progressive strengthening, mobility work, and load management is fair for most patients. Hip-related pain research, including Kemp et al.'s BJSM 2020 systematic review and meta-analysis of physiotherapist-led interventions, supports physiotherapy as a reasonable first-line approach for hip-related pain that includes labral involvement. If symptoms are still significantly limiting life after that, a surgical consult is reasonable, and I am happy to coordinate.

Why does sitting on a low couch hurt my hip so much?

Low seats drop the hip below 90 degrees of flexion, which increases compressive load on the anterior labrum, particularly if there is any underlying cam morphology. A firmer, higher seat, or a small wedge cushion, often makes a large difference while you rebuild tolerance.

Hip Labral Tears Treatment in Burlington | Kareem Hassanein Physiotherapy

Hip Labral Tears

Cartilage ring tears causing clicking, catching, groin pain

Treating hip labral tears at my Burlington clinic. Convenient for Waterdown and Flamborough residents.

Important: When to seek immediate medical attention

Significant mechanical locking preventing movement

Urgent orthopedic assessment for displaced tear or loose body

Severe, constant pain not responsive to position changes

Assessment for other pathology or complications

Pathophysiology and contributing factors.

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The Science of Hip Labral Tears

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Hip labral tears involve damage to the acetabular labrum - a ring of fibrocartilage that runs along the rim of the hip socket (acetabulum), acting like a suction cup to enhance stability. The labrum provides a suction seal that maintains negative pressure within the joint, contributing significantly to hip stability. When torn, this can result in mechanical symptoms and altered joint biomechanics. Critically, labral tears very often occur in conjunction with femoroacetabular impingement (FAI). An X-ray or MRI can identify the specific bony morphology and assess the health of the acetabular labrum, but understanding the relationship between these conditions is crucial. A cam-type FAI morphology can make contact with the socket and labrum during deep hip flexion, leading to a pinching sensation and potential stress on the labrum over time. However, not all labral tears are symptomatic - many people have labral tears without pain. The development of symptoms depends on the tear's location, size, the individual's activity demands, and importantly, the presence of underlying bony abnormalities like FAI. Treating an isolated labral tear without addressing underlying FAI morphology may lead to poor outcomes, as the mechanical cause of the tear remains unaddressed.

Hip Labral Tears

The Science of Hip Labral Tears

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