LABRUM TEAR

What is Labrum Tear (hip/shoulder)?

The labrum is made of fibrocartilage (a tough, very strong tissue) that lines the hip joint (acetabulum) and shoulder joint (glenoid fossa) to improve congruency within the joint. An analogy for the labrum is considering a golf ball sitting on a tee. The labrum is the tee and the golf ball is the humerus bone (shoulder) or femur bone (leg). The labrum functions to build a deeper socket for the arm or leg bone to sit in.

Labrum Tear (hip/shoulder) Symptoms

The labrum is critical for keeping the ball in the socket that is present in both the hip and shoulder joints. The function of the labrum is critical at end ranges of mobility. Therefore, symptoms of a labrum tear are:

Hip labrum: A sharp pain in the groin when you bring your knee to your chest (full hip flexion).

Shoulder labrum: This one is a bit more tricky because the motion that is painful will depend on where the tear is located. With that said, shoulder internal rotation and flexion (overhead mobility) are most likely to cause sharp pain.

Hip and shoulder labrum: The surest way to know if a labrum tear is in fact causing the pain is if you experience a painful clicking noise when moving your hip or shoulder. If there isn’t a painful click then the pain may not be due to a labrum tear. See further explanations below.

Does a Labrum Tear Always Cause Pain?

At our physical therapy in Durham, NC we regularly help clients overcome shoulder and hip pain. Most of them don’t have a diagnosed labrum tear. However, many people with hip or shoulder pain also present with similar symptoms as a labrum tearwould. Furthermore, the older you are the more likely there is to be a labrum tear.


Did you know: Research has shown 69% of people have a labrum tear in the hip, but most don’t experience any pain.


Did you know: Research has shown 55-72% of people have a labrum tear in the shoulder, but most don’t experience any pain.


This is why it’s so critical to not just assume the labrum tear is the cause of pain even when you find one. We have identified many clinical findings that can mimic symptoms similar to a labrum tear.

What Mimics Symptoms of a Labrum Tear?

Hip Labrum:

Referred pain from the lower spine: The nerves that function with the hip exit the lower spine. Typically if this is the problem there will be a limitation in spine extension (bending backward), and side bending towards the painful hip. Individualized exercise techniques can fix this problem.


Referred pain from the glutes (buttock muscles): We see this quite a bit for clients who have pain in the groin. We diagnose if this is the problem by gently pressing on the glute muscles. A positive test will cause the client to feel symptoms in the groin. Myofascial release and individualized exercises can fix this problem.


Hip impingement: This problem typically occurs with hip flexion and internal rotation. Essentially, the femur bone (leg) is hitting into the pelvis (socket within the hip joint). This occurs because of one of two problems:


1) Hip or core weakness

2) Hip or lumbar spine stiffness 


Stiff hip joint: The femur (leg bone) must move smoothly within the pelvis (hip socket). If they aren’t moving as a single unit it can cause pain. The hip moves in 6 different directions. A movement exam should be performed to test which movements are stiff and the problems should be addressed with exercises, typically strengthening.


Shoulder Labrum:

Referred pain from the cervical (neck) spine: The nerves that function with the shoulder exit the cervical spine. Typically if this is the root problem there will be a limitation in neck extension (looking up), neck retraction (pushing your head back to make a double chin), rotation to the same side as the painful shoulder, and side bending towards the painful shoulder. Individualized exercise techniques can fix this problem.


Referred pain from the rotator cuff muscles: We see this problem often at our PT clinic. This is diagnosed by gently pressing on the rotator cuff muscles individually (there are 4) and holding for 2-3 minutes. A positive test occurs when the client reports symptoms into the shoulder. Typically, the infraspinatus muscle is part of the root problem. Myofascial release and individualized exercises can fix this problem.


Shoulder impingement: This problem typically occurs with shoulder flexion and internal rotation. Essentially, the humerus bone (arm) is hitting into the glenoid fossa (socket within the shoulder joint). This occurs because of one of two problems:


1) Shoulder or core weakness

2) Shoulder or cervical spine stiffness 


Individualized exercises can fix this problem when diagnosed correctly.


Stiff mid-spine: The glenoid fossa which is the socket within the shoulder joint is part of the scapula (shoulder blade). The shoulder blade sits on the ribs located on your mid-back. These ribs attach to the mid-spine. When the mid spine is stiff it doesn’t allow the shoulder blade to move with the arm bone. A stiff mid-spine is typically part of what’s causing the shoulder pain.

Labrum Tear Treatment

As you can see there are a lot of factors that play into hip and shoulder pain. I hope we did a good job of showing you that just because someone has a torn labrum does not always mean it’s the cause of pain. An assessment should be done to rule out any problems that can mimic a labrum tear. Many times people can avoid surgery and pain meds when diagnosed correctly and given the proper treatment that is individualized to their specific problem(s).


If you have a labrum tear and want to find out if our physical therapy clinic can help get you out of pain then we invite you to schedule a free phone consultation with us today!

  • Do labrum tears always cause pain?
  • How can I tell if the torn labrum is the cause of my pain?
  • Can labrum tears heal without surgery?
  • What happens if a labral tear goes untreated?
  • Will a cortisone (steroid) shot help a torn labrum?
  • Can you exercise with a torn labrum?
  • What should I avoid if I have a torn labrum?
  • Will physical therapy help a torn labrum?
Do labrum tears always cause pain?

No, they don't. In fact, research here and here has shown that anywhere between 55-72% of people with a labrum tear experience no symptoms. 


There are many other problems that can mimic symptoms similar to a labrum tear. Therfore, even if you do have a torn labrum, and pain, it doesn't always mean the pain is due to the torn labrum. 


Hip pain can be coming from the spine, referred pain from the glute muscles or TFL muscles, osteoarthritis, or due to movement dysfunctions. 


Shoulder pain can be coming from the neck, referred pain from the rotator cuff, osteoarthritis, or due to movement dysfunctions. 


Our advice is to find a great physical therapist who assesses the entire body before assuming the pain is due to a labrum tear. 


Our physical therapy clinic helps a lot of people who are told their pain is caused by a 'scary' diagnosis when in fact it's something else that is much easier to fix.

How can I tell if the torn labrum is the cause of my pain?

An MRI will be able to diagnose a labrum tear. However, you should always rule out other causes of pain prior to assuming the labrum tear is causing the pain. 


Typically hip flexion and internal rotation are going to be limited and painful with a torn labrum. However, these two movements can be fixed by using repeated motions at the spine and many people without a labrum tear also have hip pain with flexion and internal rotation. 


Typically shoulder flexion and internal rotation are going to be limited and pain with a torn labrum. However, similar to the hip, we can generally fix this problem with repeated motions at the neck. And many people without a torn labrum in the shoulder also have pain with these two movements. 


Find a physical therapist who doesn't just treat the diagnosis and rules out other possible causes for the pain.

Can labrum tears heal without surgery?

Generally, no they won't. But that doesn't mean a torn labrum is always going to cause pain. If there's a painful 'click' with deep flexion (i.e. squat) or internal rotation then surgery may be necessary as this is a sign of a severe tear.


However, most labrum tears don't require surgery for long-term pain relief. A program that addresses any movement dysfunctions at the spine, hip, knee, and ankle (hip labral tear), or the spine, shoulder, elbow, and wrist (shoulder labral tear) will be adequate for most people suffering from a labrum tear.

What happens if a labral tear goes untreated?

If there's a painful 'clicking' or 'popping' noise then surgical intervention may be necessary as this is a sign of a more severe labrum tear. However, surgical intervention is not necessary for the majority of labral tears.


Treatment should include addressing any movement dysfunctions found in the arm and neck (shoulder labrum tear), or leg and lower spine (hip labrum tear).

Will a cortisone (steroid) shot help a torn labrum?

A cortisone shot can help with the pain, but it won't assist in healing. In fact, cortisone shots have been shown to decrease muscle and bone mass as well as cause cartilage damage. Therefore, they should be used sparingly.

Can you exercise with a torn labrum?

Yes. However, let pain guide you. Do not push through pain as it can lead to further damage. Exercises that focus on returning joints back to their full mobility and improving overall strength are extremely important for labral tears. Movements that are slow and controlled will improve motor control and stability.

What should I avoid if I have a torn labrum?

Avoid movements that cause pain. Sounds simple yet it's important. Many labrum tears can be treated conservatively. But if continue to move through pain then you risk further damage that may require surgery. 


You will also want to initially avoid any ballistic movements such as sprinting. That doesn't mean you can't return to all activities once the pain has diminished and any movement dysfunctions found are addressed.


Will physical therapy help a torn labrum?

Physical therapy won't heal a torn labrum but it will likely take away the pain. A torn labrum doesn't have to cause pain. Physical therapy should address any movement dysfunctions found at the arm, leg, and spine where the tear is seen. 


Most times the pain is caused by compensation which is why we need to work on movement problems seen outside of where the pain is felt.

Wondering if our physical therapy clinic is the right approach for your problem?

Medical Disclaimer:

All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.