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30 SECONDS OF THERAPY: Hip Labral Tear Recovery

Apr 23

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  1. Specific Orthopedic Tests

    1. Incorporate tests like FADIR, log roll, and FABER into your initial assessment. These tests help identify intra-articular pathology. Combine them with history-taking that focuses on groin pain, mechanical symptoms (Clicking / Sticking), and activity-related discomfort.

  2.  Early MRI Arthrography 

  1. When your clinical suspicion is high, push for an MRI arthrogram. Unlike plain radiographs or standard MRIs, it has >90% sensitivity in identifying labral tears. Educating referring physicians on this can be critical for faster diagnosis.

 3. Implement Phase-Based Rehab Exercises

  1. Structure your rehab using the HIPARTI protocol and progressive loading. Key exercises by phase include:

i. Early Phase (Weeks 0–4):

  1. Prone hip extension

  2. Glute bridges with band abduction

  3. Seated piriformis stretch + PROM series (FABER, circumduction)

ii.  Mid Phase (Weeks 4–8):

  1. Side-lying hip abduction

  2. Double-leg Romanian deadlifts

  3. Wall slides with resistance band around thighs

iii.  Advanced Phase (Weeks 12+):

  1. Single-leg deadlifts

  2. Agility ladder drills

  3. Assisted step-ups and BOSU squats

  4. Sport-specific cutting and plyometrics (as tolerated)


STOP


  1. Treating All Hip Pain as Soft-Tissue Dysfunction

    1. In labral tear cases, pain may be deep, non-palpable, and activity-specific. Avoid treating with generic soft-tissue release or lateral hip strengthening only. Instead, target intra-articular mobility, capsular tension, and neuromuscular control.

   2.  Relying Solely on Plain X-Rays

  1. Don’t get falsely reassured by normal radiographs. Many patients with labral tears have negative X-rays but clear findings on arthrogram or arthroscopy. Stay vigilant and push for better imaging when symptoms persist.

3. Delaying Specialist Referral for Active Patients

  1. Patients with persistent groin pain, especially athletes, benefit from early orthopedic evaluation. One study showed 84% return to sport after arthroscopy and rehab. Delayed diagnosis risks chondral damage and poor surgical outcomes.


WHY


  1. Labral Tears Disrupt Hip Joint Stability

    1. The labrum plays a crucial role in hip stability and joint pressurization. Tears compromise the joint seal, leading to increased shear forces, cartilage degeneration, and progressive mechanical symptoms if untreated.

2.  Physical Therapists Influence Recovery Trajectory

  1. Post-op rehab success heavily depends on PT guidance. Therapists help:

  2. Restore ROM with passive and active mobility.

  3. Rebuild strength in glutes, abductors, and deep rotators.

  4. Correct gait patterns and prevent Trendelenburg Gait.

  5. Educate patients on load management and return-to-sport timing.



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https://doi.org/10.1016/j.arthro.2011.12.004


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