The hip is a ball and socket joint. A very big ball and quite a deep socket.
But to help deepen the socket, and increase the joint stability, there is a fibrocartilaginous ring around the outside of the socket. (coloured blue below)
If the ball is not centred in the socket optimally, abnormal wear patterns set up and, like any fibrocartilage in the body, degenerative wear patterns can appear. These can progress into tears of the labral tissue which may cause significant catching type deep hip pain.
It was once thought that if a labrum is torn that surgical intervention (arthroscope and debridement (clear out) and/or repair) was the only solution. However with rest and anti-inflammatory medication we can settle the acute inflammatory response and then try to evaluate whether there is a biomechanical causation.
Tight adductors (groin muscles), weak gluteals, overactive hip flexors can all have a significant effect in altering where the head of the femur (ball) sits in the acetabulum (socket). Careful analysis of the deepest layer of muscles (the deep hip stabilisers – kind of like the rotator cuff of the hip!) using real time ultrasound may reveal timing deficits or poor control which can also have an effect on increasing labral stress.
Once the specific causation is worked out a plan of rehabilitation can be started and surgery may be able to be averted. However if the labrum is being pinched by bony outgrowths (a condition called FemeroAcetabular Impingement – FAI )- it can be much harder to completely alter the biomechanical components.
One thing is for certain…a deep pinching pain in your hip or groin region needs investigating…so don’t put it off…get it checked out.
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