Hip Labral Tear

About a week ago, I started to feel a general soreness in my left hip. There wasn’t a specific event where it started, no rip, tear, click or pop. I pushed through some body weight workouts (air squats, push-ups etc.) over the weekend but it eventually became painful to walk or stand. By Tuesday, I could not walk 100 yards without a lot of pain. My doctor examined my range of motion and pain response and suspected a labral tear in my hip. A 5mm labral tear was confirmed by MRA. I have been referred to a hip specialist and will see him on Monday.

  1. I am not freaking out but think it is prudent to suspend training until this is resolved. Your thoughts doc?
  2. There are multiple COA’s to treat this ranging from a shot in my hip to surgery. Is there anything I should know going into my initial consult?
  3. Is this a common lifting injury?
  4. I imagine there is a best practice to resuming training. SSLP? I would love to hear your thoughts.

My plan is to blog my journey as I resolve this injury for anyone else who may find themselves here. I hope the doctors will weigh in as appropriate.

45yo male
non-novice
350/255/405 squat/bench/deadlift PR’s at time of injury

I hope I’m not over stepping my bounds my responding, but I’d just like to throw out general comments that may hopefully be helpful.

First, I’m sorry you got the injury man. That sucks. It’s good to hear you’re not freaking out about it though. You’ve done your homework on the pain science stuff! :slight_smile:

Second, I think one statement you made is interesting: “I think it’s prudent to suspend training until the problem resolves.” You’re not freaking out, but you may still be overgaurding the injury—which is understandable. But does training make the injury worse? Is there any ROM or intensity you can train? If all of the “main” exercises cannot be done at any intensity or ROM, I’m sure there are creative ways in which you can still train, whether than involves isolation exercises, machine exercises, or whatever. It’s just doubtful that doing nothing at all is the best option, ya know?

Thirdly, as far as the “best” way to resume ordinary training once the problem is resolved, if you take a more long term approach to training, there’s no really convincing reason to try to rush your way, 5-10 pounds a training session, back to your pre-injury numbers. That said, if you can do that without issues, go right ahead. The point is to find a way to train that sets you up for long term success and that allows for variability session-to-session. If you’ve already made it to post-novice, there’s no convincing return to LP to try and “milk out” any “novice gains.” Just to re-emphasize: long term.

Many of these are managed non-operatively, so I wouldn’t automatically stop all forms of training in this situation. I would not aggressively load movements that exacerbate pain, of course, so it may require some experimentation to find things you can do a bit more comfortably.

You are correct that there are multiple ways to manage this, ranging from “conservative” (e.g., physical therapy) to “aggressive” (arthroscopic surgery). I don’t have much to add before going to your appointment with the specialist here.

While it certainly does happen, I don’t think it’s particularly common among lifters – though I don’t have data on that.

This will depend entirely upon how you ultimately choose to manage this. If you can get the symptoms improved without surgery, then sure, doing a gradual LP would be a fine approach.

Good luck! Don’t know how helpful this will be but 6 years ago I was diagnosed with a labral tear and cam-type femoroacetabular impingement in my right hip. At the time wasn’t really strength training in earnest but doing a lot of running and playing recreational soccer. Currently I’m 46 y/o. I didn’t have to do anything more invasive than some PT to manage the injury. I was able to resume running – have trained and run a bunch of races since then, including a marathon, but haven’t gone back to playing soccer.

When it comes to strength training, I started to develop some progressive soreness in my right hip on the low bar squat running the SSLP. Prior to starting the SSLP, I knew I could high bar squat pain-free so that’s what I train now.

I’d say ideally your “hip specialist” is an orthopedist who treats a fair number of patients with sports injuries and not someone who does mostly hip replacements on an older population.

Thanks everyone for the replies and encouragement. The NSAID regimen has been helping. I can walk longer distances and stand longer without pain. I have been doing some unloaded ROM work to keep everything moving and forcing myself not to limp. The limping part became a psychological reflex and I found myself doing it sometimes when the pain was not present. It is very important to nip this in the bud! I am going to get under a bar tomorrow and feel it out.

The official diagnosis is “left hip Labral tear, femoral acetabular impingment.” The corrective COA is a fluroscopic guided cortisone shot and PT. It is good to have a plan forward but the “impingement” part has opened up some new questions.

  1. The doctor does not want me to squat past 90deg to prevent “impingement.” Is there validity to this?
  2. Is there a squat variation that would reduce hip angle and still allow a below parallel squat?
  3. Can anyone recommend a good PT on the west side of Houston?

Thanks again for the replies.

1/2. Lots of people have been diagnosed with FAI and can find a way to squat below parallel without exacerbating their symptoms. It may take some experimentation, of course.

  1. Look up a guy named Roderick Henderson and tell him I sent you.
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Austin,

Thank you, doctor. I appreciate all the great work you guys are doing. I will look up Mr. Henderson and get this underway. Hope to see you at a BBM seminar in Houston soon!!