Hip labral tears are a condition that can sometimes accompany sacroiliac joint dysfunction.
The labrum is a ring of cartilage found within the hip socket. Its main purpose is to absorb shock, as well as to help make sure your leg bone fits snugly inside the hip socket.
Cartilage is generally pretty tough, but sometimes it can become injured.
There are many different potential causes, according to the American Physical Therapy Association:
Labral injuries can be the result of trauma, such as a fall or a car accident, but are most commonly caused by repetitive trauma to the hip joint. Individuals who participate in sports that require extremes of motion, such as figure skating, repetitive twisting and ‘cutting,’ like hockey or soccer, or long-distance running are most often diagnosed with labral tears.
Basically, if you subject the labrum to forces it wasn’t intended to bear, for long enough, you can create a tear.
Sometimes, labral tears can be a result of SI joint dysfunction. When the ilium (hip bone) is rotated out of position, this means the hip socket is not where it is supposed to be. As a result, the thigh bone (femur) sits abnormally in the hip socket. Like anything in the body, when things are not lined up the way they are intended to be, this is when you run into problems. Having the femur in an abnormal position can put stress on the labrum in a way it was not intended to bear.
According to the Mayo Clinic, it is possible for labral tears not to cause any symptoms. However, possible symptoms include:
- A locking, clicking or catching sensation in your hip joint
- Pain in your hip or groin
- Stiffness or limited range of motion in your hip joint.
The difference for you to be aware of, as a patient, is that the SI joint and the hip socket are located in two very different places. It can definitely be confusing, since we often use the word “hip” to refer to the pelvis in general, or to the SI joints.
However, the actual hip socket is located in the front of your pelvis. It is where your legs attack to your body. (The official name for the hip socket is the acetabulum):
Meanwhile, the SI joint is towards the back. It is where the pelvis and spine connect.
Since some of the symptoms of a labral tear and SI joint dysfjunction can sound the same, it is very important for a physician or PT figure out where your pain is coming from.
***
In my personal experience, the question of a labral tear ended up taking up quite a lot of time while I was trying to find a physical therapist to help me with my SI joints. (Luckily I didn’t end up having one).
After the exercises my first PT gave me made me consistently worse, I went elsewhere for a second opinion. However, I was limping so much during my appointment, and found it too painful to stand on one leg at a time, that she ended up saying she wasn’t comfortable treating my SI joints until I saw a physician to rule out a labral tear.
I was really frustrated and annoyed by this at the time. I had to wait 3 weeks to get an appointment with a doctor, who ended up telling me I didn’t have one.
However, knowing what I know now, and after speaking with hundreds of coaching clients, I’ve actually come to believe this PT was completely right.
Sometimes, a labral tear really can cause identical symptoms to SI joint dysfunction, because of how it can refer pain — so it is absolutely something to get checked out!
**Hip socket and SI joint pictures both courtesy of BodyParts 3D, via Wikipedia.**
My Sacroiliac Joint Saga 
Thank you for your insight. I have been going to a chiropractor and doing yoga with no relief in sight. I have begun water exercise and still have pain. First, my pain seems to also stem from the crest of my hip bone. Second, who do I see as a doctor? Orthopedics just want to do surgery. I need to know what’s going on first! The initial scan indicates, arthritis, small labrum tear, slight bulging of L 4 and 5. I also have had terrible tailbone pain, which has finally subsided, after I stopped running. Please provide your thoughts and ideas of doctors to visit. This has been going on almost 2 years. Many thanks.
LikeLike
Hi Diana, I’m sorry to hear about what you’re doing through, and I’m so glad my blog has been helpful. As you know, I’m not a medical professional, but hopefully I can provide some useful feedback:
Pain at the crest of the hip bone– the most likely causes that come to mind are referred pain from the SI joint or the lumbar spine, or muscular pain. You have a major muscle there (the quadratus lumborum) which attaches to the crest of the hip bone, and it if tightens up, it can definitely create pain in that area.
Here’s a really informative video that provides an overview of the various causes of lower back pain– you might find it helpful: https://sijointsaga.com/2017/07/14/low-back-pain-part-1/
As for what type of doctor to see, the kind of specialist I most recommend is a physiatrist. The name is kind of odd-sounding– their specialty is Physical Medicine and Rehabilitation. Basically, they specialize in everything else you can do to improve a person’s pain other than surgery. Unfortunately not all physiatrists are familiar with the SI joint– the first one I saw was not. However, from there I went on to see two others who were much more familiar with it. You will probably have to do some research to find the right person, but it sounds like it’s worth getting another opinion before surgery.
Here’s a later video in that same series where a physiatrist talks in more detail about the SI joint. This should give you an idea of some of the non-surgical treatment options that are out there, and ideally the level of knowledge you’re looking for in a doctor. https://sijointsaga.com/2017/07/24/physiatrist-si-dysfunction/
And here are my posts about the second two physiatrists I saw:
https://sijointsaga.com/2017/06/13/what-i-learned-from-seeing-my-second-physiatrist/
https://sijointsaga.com/2017/03/11/prolotherapy/
As you probably know, I swear by aquatic physical therapy, if your doctor clears you to try that. I personally would recommend that over yoga– I think there is significant evidence to suggest that yoga can actually be hard on the SI joints. I know it has a great reputation, but I don’t think it’s always deserved:
https://www.yogajournal.com/teach/protect-the-sacroiliac-joints
Okay, that’s a lot of information so I think I better stop myself there. Hope this is helpful– let me know if you have any more questions!
LikeLike
I can relate to everything you went through. Except mine has been going on for 13 years, most of which I was told my problem was si joint dysfunction.. After 6 surgeries to my si joint which included 2 failed si fusions and 7 years on crutches, I was just recently told the entire time my problem was never my si joint but a label tear in my hip. They said it’s so damaged now they can’t repair it so a hip replacement is my only option. To top it all, during the second fusion the surgeon hit my spinal cord with 2 x 3″ screws which left me with cauda equinea syndrome and 2 years in a wheelchair. I’ve had a positive attitude and worked hard with pt (but as you know that’s a difficult situation with a labral tear) and after 7 years I’m walking with no assistance. All l need now is the hip replacement but the nerve damage & pain in my legs is permanent caused by the damage to my spinal cord as is the lack of sensation in my bowel and bladder.
LikeLike
Hi Lorraine, thanks for stopping by my blog! I’m so sorry to hear about everything you’ve been through. But that’s awesome that you’re walking with no assistance! After everything you’ve been through, it’s pretty incredible.
I’m always a little skeptical about SI joint surgery. I’ve read stories of people who feel it changed their lives, but just as many stories of people who regret it. I think it’s pretty clear we need more research on the subject.
I really hope the hip replacement helps you turn a new page! Wishing you the absolute best of luck going forward!
LikeLike
Thank you for your kind thoughts.
LikeLike
I had SI joint surgery n Atlanta ,Ga about 16 ago. Bilateral fusion and screws n both sides of joints. I’ve done great over the years til a year ago I started with tailbone and groin pain and lower back. Was told it was bursitis some cartiLage wearing away. I was sent to PT and had injections n my lower back. I wanted a second opinion so I went to the spine institute in Charleston and they started doin some injections as well. . Then I had another MRI done and injections n my facet joints as well. Results were my SI joints and back seems to good and says he wanted to send me to a hip specialist that my back pain and groin pains is coming from my hip itself. Went there and he did a injection with the ultrasound to see. It helped alittle but not much. So he suspected a labral tear. And wanted me to stop PT for now and have an authrogram done. Later on confirmed I had a torn labral and tendonopathy. So I’m now suppose to have surgery n two weeks for a labral tear and my tendons repaired. I don’t know how I got this. I’m not an active person and don’t play sports either. I do have degenetive disease and I do have repepetion driving my SUV which aggravate s my hip a lot. Just worried could it b a labral tear really or b SI joint I’m n so much pain and I hope I’ll get better soon. I remember Vikki when I was n Atlanta.
LikeLike
Hi Tara, wow I’m so sorry to hear about all this! I’m curious– did you have the fusion done with the doctor who works with Vikki? I’ve heard mixed things about the results of SI fusion in general, so that’s really interesting you had relief for so long.
I hope your surgery goes well! Really hope everything gets sorted out! Thank you for stopping by my blog.
LikeLike
Thanks! It’s been a very long time since I had that surgery. My doctors at that time were Dr. Alan Lippitt and Dr Michael Amaral I only seen Vikki just that one time to determine that was what it was. I went thru a lot of tests and places n Atlanta. I was told I had Si dysfunction and needed surgery. It was from child birth that caused it and I was suppose to have only left side with screws but when I awaken I had both sides fused and 4 screws placed in and my piriformis muscle had to also b repaired. Of corse after having that type of surgery you are never the same as u were. But I’m a lot better that what I was. I have no pain and can walk without my pelvis catching and popping out. Just don’t understand with this labral tear that the doctor says. I hope this is a labral year because my Si joint seems to be ok. I know the symptoms are a lot the same. But my pain is all in my hip groin and thigh down to my knee. I also am so tender n those areas. Just hope this surgery works. And stops my pain. I’ll b having it one week from today. Both surgeries. Just hope it’s the right choice.
LikeLike
Thanks for providing such detailed info! That’s pretty shocking that you were only expecting to have one SI joint fused, but they did both. Did they ever explain why it happened? I would have been pretty upset, but at least it sounds as though things worked out okay, in the long run.
I also hope this surgery is the right choice for you as well! Wishing you the best of luck!!!
LikeLike
Hi Eileen, I’m not quite sure what you mean…?
LikeLike
I’m 3 years post-op on a L5-S1 laminectomy. Didn’t heal well and have lots of scar tissue in my QL. Lots of pain still radiating from iliac crest through butt and down sciatic nerve, low back pain, groin stiffness and when I squeeze my knees together there is a big pop in my groun area. Recently diagnosed with partial labral year with CAM. Had previously gotten SIJ injections to no avail. Does this sound like something you’d consider the arthroscopic surgery for to repair the rear and shave down the CAM?
LikeLike