Anterior Hip Labral Tear

[cairn]

I was hoping someone on here has had experience with a similar injury to what I'm dealing with: an anterior hip labral tear with tearing of the cartilage on the femoral head.

If I use very very very light weight lifts, it is generally not a problem. But as soon as I hit even about 50% of 1RM on lower body lifts, I start having serious problems (my hip will start catching a lot more, I will start having very sharp pains randomly when walking as well as anytime I unweight my leg, and, eventually, my leg will be so fragile as to be almost unusable). I'm trying to find something I can do that won't make things worse. Wide stance movements with feet turned way out seem to be OK, at least for now. For a while I thought single leg movements might also be OK, but single leg DLs, even with less about 110lbs (I DL 500) are starting to cause noticeable problems. I am going to see a doctor (again), but I also wanted any opinions from people on here who have dealt with similar issues and might have suggestions about activity modification, lift variations, etc.

Thanks a lot.

[Derek Miles]

Hey Cairn,

There is a lot to this and it is likely better served with a consultation and possibly programming with us on the rehab team. First, there is a very high prevalence rate of anterior labral tears in the normal population so I don't know that I would recommend fixating on that as the root cause. From what you have said, I'm going to more broadly call it anterior hip pain with some symptoms of catching. Some of the reason this is difficult to really give recommendations for in the forum is as follows:

1) In order to make good recommendations we would need to know your training history. Often, strength athletes will get these symptoms more if they have had a higher specificity in training recently i.e. only S/B/D. Here, the recommendations are often to add some variety to the programming via different exercises, through different range of motion, through different positions. But it ultimately comes down to finding the proper starting point for each athlete. If you are experiencing symptoms at 50% 1RM there likely needs to be some modifications attempted on all fronts here.

2) Another contributor to this is often external stress. I think it is safe to say given the current constraints that many of us are experiencing that more people are stressed these days. This can also contribute to symptoms being present. Now, sometimes these can be managed by changing some behaviors like sleep, but sometimes this also falls in the "life" category and we need to find ways to train at an acceptable volume/intensity until things dial back.

3) When symptoms come on, there is also a factor of internal stress that could probably best be stated as "how worried am I about this." When I'm seeing words like "fragile" and "unstable" odds are things are a little dialed up. To this, I want to reiterate that there is a high rate of labral changes in the asymptomatic population so it is unlikely that any labral changes are the main driver of what you are experiencing. Plenty of people manage to come through anterior hip pain and build back up and beyond what they were doing prior to symptoms. There likely isn't a "quick fix" but seeing this more as a process that you can get through than an obstacle you are running up against is a big step.

4) How long this has been going on also factors in. If I were to guess from your writing, this isn't an acute injury. That can factor is as well as it can compound points 2&3. Sometimes the analogy for an injury that has been present for a while can go as follows. On a day to day basis, you do not feel your shirt on your back. Now that you are reading this sentence, it is literally impossible to not feel your shirt on your back (if you are wearing one and odds are even if you aren't I just made you itchy). The same thing can happen when an injury has been present for a while where, to the analogy, you just can't not pay attention to your shirt. This is when you need to work around the problem more than go directly at it. The good news is there are literal 1000's of exercises from which to choose and sometimes it comes down to finding the right combination with which to begin.

I realize this answer is somewhat vague, and while the exercise recommendations are often nearly the same for athletes, the subtle differences are really what are often the most high yield. While there are many athletes that experience symptoms very similar to your own, their journey back to full training is often different as they have various amounts of point 1-4 contributing.