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Labral tears: what are they and how can you prevent them?

With proper management, this common running injury doesn't have to sideline your running goals

Labral tears are a common injury among runners. For many people, a torn labrum causes little to no discomfort, and they are often completely unaware that they even have one. For others, a torn labrum can sideline them for weeks, months or even years. We spoke with Dr. Kris Sheppard, co-founder and clinical director of The Runner’s Academy in Toronto, who gave us the lowdown on why labral tears happen, why they affect some more than others and how to prevent them from becoming a problem.

Lanni Marchant marathon canadian record STWM
Elite marathon runner Lanni Marchant had surgery to repair her larbrum in 2019

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What is your labrum?

The labrum is a fibrocartilage ring that surrounds the hip socket (acetabulum). It functions to deepen the joint and provide it with a seal. It also helps with shock absorption around the head of the femur (thigh bone).

According to Sheppard, approximately 33 to 54 per cent of people have labral tears in their hips but don’t show any symptoms. Many of these runners can continue to train without causing any further damage to their hips or without experiencing any pain.

Why do labral tears cause pain for some people?

The difference between asymptomatic and symptomatic labral tears comes down to whether you have additional structural issues in your hips, degeneration in the joint or other injuries. Examples of these issues include hip dysplasia, joint or ligament laxity (looseness) or femoral acetabular impingement, which is a bony growth on your femur or the edge of your hip socket. Sheppard also explained that older age and general hip function are two of the biggest risk factors for developing a symptomatic labral tear.

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How do you know if you have a labral tear?

Of course, pain in your hip is the first sign that something might be wrong. You may expect that a tear would involve sharper, more acute pain, but most people who have had a symptomatic tear describe the feeling as more of a dull burning sensation. 

Simply having pain is not enough to accurately diagnose a labral tear, and Sheppard says diagnosis can take time because it requires excluding other possible injuries first. This usually involves a combination of clinical tests to assess pain and mobility through the hip joint, along with imaging. Still, Sheppard says this does not 100 per cent confirm a labral issue, and you must rule out other possible injuries first.

Alex Wilkie
Former Ontario university cross-country champion Alex Wilkie had surgery on his hip in 2016 Photo: OUA/Michael Hall.

So you have a labral tear what can you do about it?

For many of us, the first reaction to dealing with an injury is to stop running and wait until the pain goes away. Sheppard agrees that you should absolutely not run through hip pain, but rest alone will not solve the problem. As with most injuries, your treatment plan will depend on the severity of your issue. 

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Unfortunately, a labral tear will not heal without surgery. The good news is that most people can manage their labral tears for years, or even indefinitely, through nonsurgical treatment. Some clinicians might recommend a steroid injection into the joint, but according to Sheppard, the best way to effectively treat a tear is to improve function and mobility through your hip. A good sports doctor or chiropractor will be able to assess your mobility and give you exercises to improve the function of the joint.

Is running dangerous for your labrum?

In a word, no. Sheppard says even if you have an asymptomatic tear, it is not dangerous for your labrum, nor will it increase your risk for developing hip osteoarthritis. Because you likely won’t know you have a tear if you have no symptoms, it is important to take steps to keep your hips healthy to avoid problems later on

“For a runner, you need to have appropriate mobility, stability and power in the whole body, not just the hip,” Sheppard says.

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To help runners assess where their bodies are at, he has created a “Run Ready Checklist” that involves a series of movement tests to determine whether your body is ready to run, or if you might need some extra help with strength or mobility to avoid injury. You can take yourself through this checklist by clicking here.

Labral tears are a common injury among runners, but when left unchecked they can sideline you for a long time. For this reason, it is important to take care of your body and work on your areas of weakness. Not only will this help prevent injuries, but it can make you a stronger, faster runner, too.

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