(This blog was originally written by Dr. Tierney when she was a student on rotation at Sports PT in Rochester, NY in November 2014.  The Blog appears on their website at http://www.sptny.com/blog/?p=2202.)

Unless a traumatic injury occurs (like a dislocated hip and a concurrent tear after a car accident or a fall), hip acetabular labral tears often get misdiagnosed or go undetected. This is because non-diagnostic testing for labral tears coincides with more common problems like tendonitis.
 
The “hip labrum” is the cartilage that surrounds the socket of the ball and socket joint in the hip. It helps to provide greater stability by forming a ring around the edge of the socket. It is frequently torn, and here are some signs that you may have an acetabular labral tear:

1. Pain, locking, clicking, or catching sensation in the hip joint with a loss of motion or stiffness in the joint that has lasted more than 6 weeks and up to several years. In fact, people often go years without having their nagging hip pain checked out.
2. You have the symptoms listed above, and you also participate in a repetitive motion sport such as hockey, soccer, or football requiring sideways movement, cutting, sidestepping, and other actions that cause stress on the hip joint.
3. You had a fall or were tackled and landed on your hip and have had unresolved pain, clicking, or catching in the joint. Many labral tears are the result of a fall directly onto the femoral head, pushing the head of the femur (your thigh bone) tightly into the acetabulum (the socket of your hip bone) with force greater than normal and thus tearing the labrum.
4. You have a known hip abnormality such as dysplasia, or retroversion, or you’ve had prior surgical intervention for another problem that resulted in complications. Some cases of acetabular labral tears occur after a hip surgery that left bony fragments behind, leaving them to consistently graze against the labrum and cause a tear.
5. Conservative treatment has not worked. Physical therapy does not always resolve symptoms of a labral tear. If your hip pain is not resolved after a typical physical therapy treatment routine, it may be time to seek another opinion. It will be important to weigh risks vs. benefits to determine if the pain is tolerable to live with or if more serious intervention, such as surgery, is necessary.

For more information on hip labral tears, please contact us at info@sptny.com.
 
Sources:

• Groh MM., Herrera J.  A comprehensive review of hip labral tears.  Curr Rev. Musculoskeletal Med. 2009; 2: 105-117.
• Lewis CL., Sahrmann SA.  Acetabular labral tears.  Phys Ther. 2006;86:110-121.
• Mayo Clinic Staff. Hip labral tear.http://www.mayoclinic.org/diseases-conditions/hip-labral-tear/basics/causes/con-20031062.  Accessed September 30, 2014. Updated April 23, 2014.

​Knee injuries are very common in athletes due to high impact collisions and cutting or direction changes. 
 
 A very common injury in sports with high impact and/or sudden cutting and direction changes is a tear to the ACL (Anterior Cruciate Ligament) in the knee.  This ligament runs from the femur (thigh bone) to the tibia (shin bone) and prevents the femur from moving too far forward or slipping off the tibia.  There are 3 other ligaments in the knee that prevent excessive movement in all directions, the PCL (Posterior Cruciate Ligament), MCL (Medial Collateral Ligament) and LCL (Lateral Collateral Ligament).  These ligaments, along with the medial and lateral menisci that act as a cushion on top of the tibia, provide all around stability in the knee and maintain the bending motion required for ideal knee function. 
 
In some occasions, ACL tears are accompanied by tears to the MCL and medial meniscus, thus resulting in the “unhealthy triad” injury of the knee.  This injury is characterized by extreme pain, swelling, a popping or tearing sound at the time of impact, a feeling of instability and difficulty moving or standing on the knee.  An x-ray or MRI will confirm the diagnosis and depending on the severity of the ACL, MCL and meniscus tears, surgical repair is recommended, followed by physiotherapy for a safe recovery.