Some things to consider when dealing with a hip labral injury.

First off, I would not be one to jump into surgery or injections, as there are many options for targeted movement and manual therapy interventions that I have found to be helpful both personally (I have a hip labral tear and OA in the joint) and professional I have worked with many professional athletes who have had them diagnosed and both surgically repaired and done conservative treatment only.

Here are the top things to consider for an intervention:

• obturator nerve (ON)- the ON innervated the hip joint, and when entrapped can feel exactly like hip labrum pain. Also, because it innervates the joint, it can also be a great way to effective pain and movement as a treatment focus.

• pelvic floor mobility- the position of the pelvis has everything to do with the congruency of the hip joint and health of the labrum. When we excessively posterior pelvic tilt we tend to destabilize the hip joint, increasing mechanical friction and wear and tear on the joint structures.

• ankle mobility- when ankle dorsiflexion mobility is limited the postural control is lost at the foot, and weight shift towards the heel thus concurrently creating posterior pelvic tilt as a primary strategy for maintaining up right balance.

• hip cuff activation and strength- as with the shoulder joint the hip rotator cuff helps to center the joint, maintain dynamic stability and therefore decrease the abnormal forces that may lead to wear and tear on the labrum.

• movement pattern- cleaning up movements especially into hip loading and pushing it is key to learn to move with good joint congruency, stability and control. If you cheat your hip strength into hip extension with a posterior tilt and knee drive, you will set yourself up for an unhappy hip.

I’ve had an athlete scheduled for labrum and FAI surgery with only 55deg of hip flexion before pain follow this protocol and be able to train and play and cancel surgery. The key really being understanding how the pelvis moves and relates to the articulation and function of the hip during flexion and extension.