Sports Medicine · Hip
Hip Labral Tears and Getting Back to Sport
By Dr. Shayne Kelly, DO — Fellowship-Trained Sports Medicine Surgeon · Tri-City Orthopedics, Kennewick, WA
Hip pain that stops you from running, cutting, sitting for long periods, or even putting on your shoes is frustrating at any age. For active patients across Eastern Washington — from soccer players in Richland and cyclists in Yakima to ranch workers in Walla Walla and high school athletes in Pasco — a hip labral tear is one of the most frequently missed diagnoses in sports medicine. Here is what you need to know about labral tears, why they often go undiagnosed for years, and how to get back to what you love.
What Is the Hip Labrum and Why Does It Tear?
The labrum is a ring of fibrocartilage that lines the rim of the hip socket (acetabulum). It deepens the socket, helps create suction to hold the femoral head in place, and acts as a shock absorber and seal for joint fluid. When it tears, the hip loses that suction seal — resulting in pain, clicking, catching, and a deep ache that patients often describe as “inside the joint.”
Most labral tears do not happen from a single traumatic event. They develop over time as a result of repetitive hip loading combined with underlying bony abnormalities — most commonly femoroacetabular impingement (FAI). Without addressing the underlying cause of impingement, even a repaired labrum can re-tear.
The FAI Connection
FAI is a condition where abnormal bone growth on the femoral head (cam impingement), the acetabular rim (pincer impingement), or both causes the hip bones to pinch the labrum during normal motion. It is extremely common in young athletes who play sports involving repetitive hip flexion — soccer, hockey, cycling, gymnastics, martial arts. Over time, the repeated pinching damages the labrum and the cartilage underneath it.
The critical point: if you have FAI causing a labral tear, surgery must address both the bony impingement and the labral tear. Repairing the labrum without reshaping the impingement will almost always lead to re-tear.
Diagnosis: More Than Just an MRI
A standard MRI misses a significant percentage of labral tears. An MRI arthrogram — where contrast dye is injected into the hip joint before the scan — is the gold standard for diagnosis and is far more sensitive. I also carefully evaluate hip X-rays for the bony abnormalities that cause FAI, because understanding the shape of your hip is as important as finding the tear itself.
Many patients I see from Walla Walla, Yakima, Hermiston, and the Columbia Basin have been told their hip X-rays are “normal” and sent home without further workup. A normal plain X-ray does not rule out FAI or a labral tear.
Treatment: Repair vs. Conservative Care
Not every labral tear requires surgery. For smaller tears in low-demand patients, physical therapy focused on hip stabilization and movement pattern correction can manage symptoms effectively. Cortisone or platelet-rich plasma injections can reduce inflammation and provide diagnostic confirmation.
However, for athletes who want to return to sport or active adults with mechanical symptoms — clicking, locking, giving way — arthroscopic hip labral repair combined with FAI correction gives the best long-term outcome. Through two or three small incisions, I reattach the torn labrum to the acetabular rim with suture anchors and reshape the impinging bone with a burr. Most patients go home the same day.
Return to Sport After Hip Arthroscopy
Recovery follows a structured progression: crutches for 2–6 weeks to protect the labral repair, progressive weight-bearing, physical therapy to restore strength and motion, then sport-specific training starting around month 3–4. Most athletes return to full competitive sport at 5–6 months. Compliance with physical therapy is the biggest determinant of outcome.
Hip Arthroscopy in Eastern Washington & Eastern Oregon
Dr. Kelly is one of the only fellowship-trained hip arthroscopy surgeons in Eastern Washington. He sees patients from Kennewick, Richland, Pasco, Walla Walla, Yakima, Moses Lake, Sunnyside, Hermiston OR, Pendleton OR, and Umatilla OR at Tri-City Orthopedics in Kennewick. Call 509-460-5588 or request an appointment online.
Frequently Asked Questions
Hip Labral Tear Questions Answered
What does a hip labral tear feel like?
The most common symptoms are a deep groin ache, pain with prolonged sitting, clicking or catching in the hip, and pain with hip flexion activities like running, biking, or climbing stairs. Many patients describe feeling like something is “off” inside the joint rather than a sharp localized pain. Symptoms are often worst at end ranges of motion and can mimic low back or groin pain.
Can a hip labral tear heal without surgery?
The labrum has poor blood supply and does not heal on its own once torn. Conservative treatment — physical therapy, activity modification, injections — can manage symptoms in some patients, particularly those with smaller tears or lower activity demands. However, in active patients and athletes with mechanical symptoms, arthroscopic repair typically provides the best long-term outcome, especially when combined with treatment of any underlying FAI.
Does Dr. Kelly perform hip arthroscopy in Eastern Washington?
Yes. Dr. Kelly is one of the only fellowship-trained hip arthroscopy surgeons in Eastern Washington, performing hip arthroscopy for labral tears and FAI at Tri-City Orthopedics in Kennewick, WA. He regularly sees patients traveling from Richland, Pasco, Walla Walla, Yakima, Moses Lake, Hermiston OR, and Pendleton OR.
How long does recovery take after hip labral repair?
Most patients use crutches for 2–6 weeks after hip arthroscopy, with weight-bearing gradually increasing as the repair heals. Physical therapy runs for 3–5 months. Most athletes return to full sport at 5–6 months. Compliance with the rehabilitation protocol is the single biggest factor in achieving a successful outcome.
Does fixing a labral tear prevent hip arthritis later?
Addressing FAI and labral tears early reduces the progressive cartilage damage that leads to hip arthritis over time. Untreated FAI acts like a grinding mechanism inside the hip joint, continuously damaging cartilage with every step. Early arthroscopic treatment — before significant cartilage loss occurs — gives the best chance of preserving the natural hip joint long-term.
