You’d think a labral tear would be obvious—a pain, a rip, that stops you in your tracks—but it’s not.
Ricardo Rose, a 31-year-old trainer based in New York City, describes the labral tear in his hip as a “dull, burning sensation that wouldn’t go away.” So even though overuse (running, basketball, HIIT classes, lifting) was the problem, his hip pain wasn’t enough to make him lay off. “I pushed it too much, and it got so bad, I couldn’t run for a year.”
How’s that for some words of warning? But the good news is, Rose eventually rehabbed his labrum, switched up his fitness routine, and started running again.
“This injury really made me slow down and focus on things I normally wouldn’t, like the smaller muscle groups around my hip joints, along with my lower back, glutes, hamstrings, and core,” he says. “Once I switched my focus, I started to feel less discomfort over time.”
Here’s how you can do the same—and ideally, avoid a hip problem in the first place.
Symptoms of an Inflamed Hip Labrum or Hip Labral Tear
First off, the labrum is a ring of cartilage that stabilizes the hip joint. “It also helps distribute pressure, allows for more shock absorption, and improves joint articulation,” says Cameron Yuen, D.P.T., C.S.C.S., a senior physical therapist at BESPOKE Treatments in New York City.
And like Rose mentioned, a labral tear isn’t as obvious as you’d think. “You could have a labral tear and not even know it,” Yuen says. But pain in the front of your hip, or deep in your groin, should clue you in. “It’s a fairly constant ache with clicking or clunking as you move your hip.”
The sensation and of course, the location, is similar if you’re dealing with inflammation, not a full-fledged tear. “Both create similar signs and symptoms, but labral tears don’t heal on their own and often have mechanical symptoms—such as that clicking or clunking,” Yuen says. So, if the pain subsides and you don’t notice any strange sounds, it’s probably not a tear. If you want to be sure, you’ll need an MRA, a magnetic resonance arthrogram, which is a type of MRI that can show blood vessels and blood.
What Causes Labrum Problems?
The same stuff that causes most running injuries, really: overdoing the running and underdoing the strength training. “You want the muscles surrounding your hip to absorb the forces of running,” Yuen says. That means your glutes, quads, abs, and hamstrings need to be strong. “If you don’t have the strength, endurance, or motor control at your legs, hips, and core, you’ll shift additional ground reaction forces to the labrum and the rest of the joint.” This is where the risk of injury increases.
How to Prevent Labrum Problems
“Running itself isn’t dangerous or unhealthy for the labrum, but if you’re subjecting your hips to repetitive high forces, you need to make sure the muscles and tendons are absorbing the majority of the impact, not the joint,” Yuen says.
[The best runners don’t just run, they hit the gym. The Women’s Health Guide to Strength Training is a 12-week plan that will teach you all the fundamentals to get the most out of your weight session.]
Again, that means you need to strength train, with a specific focus on your glutes, hip rotators, quads, and hamstrings. “Control of the pelvis and core is also extremely important, because pelvic positioning can shift stresses to different parts of the hip joint and place additional stress on the labrum.” (Exercises below.)
How to Treat a Torn or Inflamed Labrum
First, take a few weeks off of running to give the joint a break. Sadly, your loyal cross-training friend, cycling, is off-limits, too. “The most aggravating position for the hip labrum is hip flexion combined with other movements,” Yuen says. This is basically cycling, so the elliptical or pool are safer cardio options while you’re recovering.
Surprisingly, stretching your hips isn’t so great, either. “If you don’t have adequate hip range of motion, you’ll want to work on your hip mobility, but otherwise, stretching has little benefit for a labral tear,” Yuen says. In fact, stretching too hard and too far can make the pain worse, he says, noting that dynamic stretches are generally better than static stretches in this case. “Oftentimes, people will static stretch into positions that worsen their pain.”
So, what should you do? “Perform low-intensity exercises that activate muscles of the hip and core, foam roll, and try to stay active with workouts that don’t cause pain,” Yuen says. (Rose relied on lateral steps with a mini-band, monster walks with a mini-band, and tons of core work.)
“As the pain decreases, increase the intensity of exercises for the hips and core and work on improving your hip range of motion.” Then, you can slowly (and carefully), start running again, taking note of any pain.
Monster Walk (Forward and Lateral)
Benefit: Opens up your hips and builds endurance
Place a resistance band just above your ankles and send hips back to come into a mini squat position. Staying low in squat position, walk forward for 15 to 20 reps. Rest for 30 seconds, then walk laterally for 15 to 20 reps. Rest for 30 seconds, then repeat on the other side.
Benefit: Strengthens your hips and improves coordination
Standing with feet hip-width apart, grab a kettlebell with one hand and lift the same-side leg slightly behind you. Hinge from the hips so your chest approaches the floor and your leg lifts higher behind you until it’s parallel to the floor. Pause, then return to start. Do 10 reps on each side. You can master this move without a weight first (as shown above), then add the kettlebell. (More: 6 Deadlifts That Will Make You a Better Athlete)
Benefit: Strengthens your core without tilting your pelvis
Lie faceup with knees bent at a 90-degree angle, feet in air, and arms extended straight up so wrists are over shoulders. Engage core, then slowly straighten and lower right leg to the ground as you reach left arm back overhead. Return to starting position, switch legs and repeat.