We have no research that states that once a labrum tears, it can heal. I’m stating this right off the bat because I’ve heard some different ideas from other clinicians and online. But do not despair! What we do have is plenty of research showing that many people—and many athletes– have labral tears, and only a small segment of them have pain. We have research showing similar statistics with FAI (hip impingement—or femoral acetabular impingement).
I recently tore my acetabular labrum. I wanted to see if I could move myself from the smaller bucket of people with pain, to the much larger bucket of people who do not have pain, regardless of what my MRI showed. Initially, it felt like rehab would go on forever! I was in a lot of pain. No joke, labral tears hurt so much! However, 3 months later, I am mostly pain free and almost fully back to all activity, no surgery required.
What did I do?
I decreased activities that caused the most pain. For me, this meant that I stopped sitting on hard surfaces and tried to sit on surfaces with a backrest as much as possible, since sitting was the most painful activity. I used a pad in my car for sitting in order to make the seat softer and reclined back a little bit more than usual. I cut out exercises like “leg circles” and anything similar where I would get painful clunking.
I began strengthening the deep external rotators in my hip because the side that tore has always been internally rotated and weaker than the other side. I strengthened first with boring exercises on the floor, but then soon moved to fun and dynamic exercises on the Pilates Reformer as I became stronger and more pain free.
Most importantly, I found physical activities that I could still do and enjoy and look forward to each week because my mental health depends greatly on getting in fun physical activity!
In no way am I discounting surgery. I left the door open for surgery if I truly needed it. I am also not discounting regenerative medicine and injections. I’m actually a huge fan of regenerative medicine and injections and I love how well these things work with therapy in order to help people (and myself) get back to activity. I am planning on trying a regenerative injection in my hip to see if it speeds up the process in getting me that last little bit of relief. All I am saying is that if you can spare a little time, Physical Therapy and Pilates can often give you the results you want. And if they don’t… well… then you know for sure that surgery is the right option, don’t you?
If you’re struggling with pain, decreased activity, and wondering if you should have surgery, reach out and see what Pilates and PT can do for you.