Some of my favorite professional and semi-professional hockey players have been benched because of a hip problem with labral tears. I thought this was just something young athletes got, but guess what? That's what the doc says is causing my hip pain, too. I don't play hockey (never have), so how could I get this kind of hip problem?
The labrum is a dense fibrocartilage ring around the hip socket. It is firmly attached to the bone and serves to deepen the socket, giving depth and stability to the hip joint. Everyone with normal anatomy has this feature. Labral tears can occur as a result of femoroacetabular impingement (FAI). That's a description of what happens if the head of the femur (thigh bone) butts up against the hip joint cartilage and pinches the labrum. Impingement means pinching.
Normally, the femoral head moves smoothly inside the hip socket. The socket is just the right size to hold the head in place. If the acetabulum is too shallow or too small, the hip can dislocate. In the case of femoroacetabular impingement, the socket may be too deep. The rim of the cartilage hangs too far over the head. When the femur flexes and rotates, the cartilage gets pinched. This causes deep groin pain with activities that stress hip motion. Prolonged walking is especially difficult.
Hockey players (especially goalies) stay in a flexed position for much of the game. This repetitive hip flexion can set up a situation where impingement and then labral tearing can occur over time. But impingement can also occur in the aging hip. Small structural changes (probably present at birth) in the hip progress over time, creating impingement that leads to joint arthritis.
And some more recent research has shown that the labrum is key in keeping a tight seal on the joint so the synovial (lubricating) fluid doesn't leak out. Any damage to the labrum can disrupt this seal, adding to the risk of joint wear and tear.
The surgeon who is evaluating you may be able to give you an idea why you developed this problem. X-rays of the bones and MRIs of the joint and surrounding soft tissues may help identify which structures have been altered and why.
FAI: An Emerging Problem in Orthopedics That Can Have a Major Clinical Impact. In Orthopedics Today. June 2009. Vol. 29. No. 6. Pp. 12, 24, 18.
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