Hip Labral Tears: Should You Try Conservative Treatment First?
Understanding Your Options with Neurohealth Wellness, Allambie Heights
Preserving Hip Health Matters
Your hip joint is one of the most important and complex joints in your body. It supports your weight, enables powerful movements, and absorbs impact with every step. At the heart of this joint lies the labrum, a ring of cartilage that seals and stabilises the joint while helping it move smoothly.
When this cartilage tears—a condition known as a hip labral tear—you may experience pain, clicking, instability, and stiffness. While surgery is often suggested, current research strongly supports conservative treatment as the first line of care, particularly in patients without severe structural damage.
At Neurohealth Wellness in Allambie Heights, our chiropractors understand the importance of addressing hip dysfunction early and holistically. We take a conservative-first approach, helping many patients avoid surgery through movement rehabilitation, joint support, and strengthening.
What Is a Hip Labral Tear?
The hip labrum is a fibrocartilaginous ring that cushions the acetabulum (hip socket) and suctions the femoral head in place. It helps circulate synovial fluid, prevents bone-on-bone contact, and maintains joint stability during movement.
Tears can occur from:
- Trauma (e.g., car accidents, falls, contact sports like rugby or ice hockey)
- Overuse (e.g., ballet, golf, netball, long-distance running)
- Structural abnormalities (e.g., hip dysplasia, hypermobility syndromes like Ehlers-Danlos Syndrome, femoroacetabular impingement)
You might feel:
- Pain in the groin, buttock, or side of the hip
- Clicking or catching in the hip
- Instability and reduced range of motion
- Stiffness or aching with prolonged sitting or standing
Interestingly, up to 70% of people with labral tears may not even feel symptoms [1].
The Labrum Doesn’t Heal Easily—So Now What?
Unlike muscles or skin, the labrum has very little blood supply, making it difficult to heal on its own. However, that doesn’t mean surgery is the automatic solution.
Studies show that with the right combination of exercise, lifestyle adjustments, and sometimes bracing, many people experience pain reduction, better function, and even improved outcomes if surgery is eventually needed [2].
Are Labral Tears Always a Problem?
Here’s something surprising: many people with labral tears have no symptoms at all.
One MRI study showed that up to 69% of asymptomatic adults had labral abnormalities (Register et al., 2012). That’s right—you can have a tear and not even know it. Pain often comes not from the tear itself, but from poor hip mechanics, muscle imbalances, and joint instability.
This reinforces a vital principle we share with our patients:
“The image tells you what’s there—not what hurts.”
Surgery: What It Involves (and Its Limitations)
Surgical options for labral tears include:
- Repair: Reattaching the torn labrum using anchors
- Debridement: Removing frayed or loose pieces of cartilage (common in older patients)
- Reconstruction or augmentation: Using tissue grafts when the labrum is too damaged to repair
Surgery can help in specific cases, especially when structural abnormalities are present. However, it does carry risks:
- Infection
- Nerve damage
- Complications from anaesthesia
- Poorer outcomes if performed by surgeons lacking specialised experience [3]
That’s why it’s worth exploring conservative options first, particularly if your symptoms are manageable.
Conservative Management: What It Looks Like at Neurohealth
At Neurohealth Wellness, we aim to restore joint control, reduce stress on the labrum, and improve movement patterns to prevent worsening.
Here’s what your plan might include:
1. Strengthening and Activation
We focus on improving strength in:
- Gluteus maximus and medius
- Hip lateral rotators
- Quadriceps and hamstrings
- Abdominals
This helps reduce abnormal hip movement that can place stress on the labrum.
✅ Research shows that patients with stronger and more flexible hips during squat tests had fewer symptoms despite having labral tears [4].
2. Mobility and Movement Re-education
Restoring normal hip range and eliminating compensations—like hamstring or quad dominance—is crucial. We teach patients how to avoid harmful movement patterns and engage the right muscles for efficient, low-impact movement.
3. Proprioception and Balance Work
Improved joint awareness helps protect the hip during daily activity. We may use BOSU balls, wobble boards, or single-leg stance drills to re-train your nervous system.
Home Exercises (Backed by Stanford Health)
Some exercises we may prescribe include:
- Standing hip abduction
- Side planks and bridges
- Step-ups
- Hamstring curls
- Prone isometric hip external rotations
- Wall squats with upright posture
- Lateral band walks
Always follow guidance from your practitioner to ensure you’re moving safely and correctly.
The Role of a Multidisciplinary Conservative Approach at Neurohealth Wellness
At Neurohealth Wellness, we believe conservative care isn’t just about avoiding surgery—it’s about restoring balance, mobility, and function.
Rather than focusing solely on the labrum, we look at the entire kinetic chain—spine, pelvis, core, knees, feet—and how movement patterns may be contributing to labral stress. This is where our multidisciplinary team shines.
The Neurohealth Wellness Method: A Closer Look
Here’s how our multidisciplinary team supports patients with labral injuries:
1. Chiropractic Adjustments and Joint Mobilisation
We use precise, gentle adjustments to improve joint biomechanics—especially the hip, pelvis, and lumbar spine. Improving alignment and joint mobility can reduce mechanical stress on the labrum and surrounding soft tissues.
2. Soft Tissue Therapy
Our team, including Ana (massage and myotherapy) and chiropractors trained in soft tissue techniques, address tension and compensation in muscles such as:
- Gluteus medius/minimus
- Piriformis
- Iliopsoas
- TFL
- Hamstrings and adductors
Techniques like myofascial release, cupping, and dry needling may be incorporated to reduce trigger points and restore muscle balance.
3. Rehabilitation and Exercise Prescription
We design personalised rehabilitation programs to address strength, flexibility, and motor control—progressing from isolated hip stability exercises to integrated functional movement.
Our programs typically include:
- Glute activation drills (e.g., clams, side bridges, monster walks)
- Pelvic stability work (e.g., dead bugs, single-leg balance drills)
- Core integration (e.g., planks, bird-dog)
- Functional re-education (e.g., step-downs, lunge patterns with focus on alignment)
We also assess and correct dysfunctional squat, lunge, and gait mechanics, particularly if there's excessive internal rotation or anterior pelvic tilt.
4. Education and Activity Modification
Education is a core pillar of our care. We help patients understand:
- Which movements to avoid (e.g., deep squats, pivoting on a planted foot, prolonged sitting)
- How to move safely during daily activities
- How to self-monitor for flare-ups
5. Acupuncture for Pain and Inflammation
Lucia, our skilled acupuncturist, provides targeted acupuncture to reduce pain and calm inflammation. This can be particularly effective for chronic labral-related pain or when patients are sensitive to manual therapies.
6. Neurosensory Repatterning & Nervous System Support
Chronic pain alters brain-body communication. Our practitioners may use neuro-informed techniques to reduce threat perception and promote better neuromuscular coordination. This helps restore confident movement and reduce compensatory bracing patterns.
When to Consider Surgery
While conservative care is our first recommendation, there are situations where surgical consultation becomes appropriate. This might include:
- Labral tears accompanied by mechanical symptoms (clicking, locking) not improving with care
- Significant femoroacetabular impingement (FAI) requiring structural correction
- Persistent pain despite 3–6 months of high-quality conservative rehab
- Advanced cases where labral integrity is entirely compromised
At Neurohealth, we support patients both before and after surgery, ensuring proper strength, stability, and movement precision to optimise recovery and outcomes.
Our Approach at Neurohealth Wellness
At Neurohealth Wellness on Sydney’s Northern Beaches, we believe in preserving the body’s natural structures wherever possible. Our chiropractors are trained in movement rehabilitation, joint mechanics, and nervous system regulation—all essential for effective hip care.
We work with patients experiencing:
- Labral tears
- Femoroacetabular impingement (FAI)
- Hip instability
- Early signs of osteoarthritis
If needed, we collaborate with local orthopaedic surgeons or imaging centres to ensure you receive the most appropriate care pathway for your situation.
Final Thoughts
Hip labral tears are not a one-size-fits-all diagnosis. While surgery has its place, a conservative-first approach that integrates strength, mobility, manual therapy, and nervous system support is increasingly proving effective—not just in delaying or avoiding surgery, but also in promoting long-term joint health.
If you’re dealing with hip pain, instability, or limited movement, reach out to our team at Neurohealth Wellness. We’ll help you understand what’s going on, create a tailored care plan, and guide you toward movement confidence—without jumping straight to the surgical table.
Book Your Appointment
📍 Visit us at Neurohealth Wellness, 33-35 Kentwell Rd, Allambie Heights
📞 Call (02) 9905 9099
💻 Book online
References
- Kivlan, B.R., et al. (2013). Hip Labral Tears: Diagnostic and Therapeutic Considerations. Sports Health.
- Bennell, K.L., et al. (2014). Physical Therapy for Hip Labral Tears. British Journal of Sports Medicine.
- Philippon, M.J., et al. (2007). Outcomes following hip arthroscopy for femoroacetabular impingement. JBJS.
- Nepple, J.J., et al. (2012). Clinical presentation and diagnosis of labral tears. Clinics in Sports Medicine.
- Clinical Journal of Sports Medicine (2020). Impact of Bracing on Hip Function in Conservative Labrum Care.
- Domb, B.G., et al. (2014). Rehabilitation Following Hip Arthroscopy. Journal of Hip Preservation Surgery.
