A labrum tear is an injury to the firm ring of cartilage that surrounds and helps stabilize the socket of the hip or shoulder joint. In the hip, this structure is called the acetabular labrum, while in the shoulder it is called the glenoid labrum, and tears may include injuries such as SLAP or Bankart tears.

Symptoms vary depending on the joint affected and may include pain, clicking, catching, locking, reduced movement, or a feeling of instability. Hip labrum tears often cause groin pain, while shoulder labrum tears may cause deep shoulder pain, weakness, catching, or a feeling that the shoulder could give way.

Treatment depends on the symptoms, cause, severity of the injury, and the joint involved. Initial treatment commonly includes activity changes and physical therapy, while surgery may be considered when symptoms continue despite nonsurgical treatment or when the injury requires repair.

Main symptoms

The symptoms of a labrum tear can vary depending on whether the hip or shoulder is affected and the type of injury present.

Common symptoms may include:

Joint pain
Clicking or popping in the joint
Catching or locking sensations
Reduced range of motion
A feeling of joint instability or giving way
Pain with certain movements or activities

A hip labrum tear commonly causes pain in the groin or front of the hip. Pain may become more noticeable during deep or prolonged hip bending, twisting, or rotation, and some people experience a sharp catching sensation during these movements.

A shoulder labrum tear can cause deep shoulder pain, catching, weakness, or instability. Symptoms can be especially noticeable with overhead movements or after an injury such as a shoulder dislocation.

Symptoms alone cannot confirm a labrum tear because similar problems can occur with other joint conditions. Medical assessment is therefore important when pain, catching, locking, or instability persists.

Possible causes

A labrum tear can develop from several factors, including injury, repeated joint stress, differences in joint structure, and gradual wear of the tissue.

Trauma: A sudden injury, such as a sports injury, fall, forceful joint movement, or shoulder dislocation, can damage the hip or shoulder labrum.
Repetitive movements: Repeated twisting, pivoting, hip rotation, or overhead arm movements can place ongoing stress on the labrum and contribute to tearing.
Hip anatomy: Structural differences such as femoroacetabular impingement, hip dysplasia, or joint laxity can increase stress on the hip labrum and make injury more likely.
Wear and degeneration: Gradual changes in the labral tissue over time can weaken the cartilage and make it more vulnerable to tearing, even without a major injury.

More than one factor may contribute to a labrum tear, so identifying the underlying cause can help guide diagnosis and treatment.

Diagnosis

Diagnosis of a labrum tear is based on a combination of medical history, symptoms, physical examination, and imaging. For a suspected hip labrum tear, a doctor may ask about groin pain, catching, pain during prolonged or deep hip flexion, sports participation, and movements that trigger symptoms.

Physical examination may include hip movement tests such as the FADIR or FABER tests. Imaging often begins with X-rays to assess the bones and joint structure, while MRI or MR arthrography may be used to evaluate the labrum and other soft tissues. For shoulder labral injuries, MRI and MR arthrography may also help identify different types of tears.

Treatment options

Treatment for a labrum tear is individualized according to the joint affected, symptoms, underlying cause, activity level, and response to initial treatment.

1. Activity modification

Reducing or changing activities that repeatedly trigger pain may be part of initial treatment. This can help decrease stress on the injured joint while rehabilitation focuses on improving strength and movement.

Activity modification does not necessarily mean avoiding all physical activity. Instead, the goal is to reduce movements that repeatedly aggravate symptoms while maintaining appropriate activity whenever possible.

2. Physical therapy

Exercise-based physical therapy is commonly used as an initial treatment for nonarthritic hip pain and labral injuries. Rehabilitation may include hip and core strengthening, movement retraining, education, and exercises designed to improve joint function.

Evidence reviewed in the attached sources suggests that supervised, active rehabilitation programs emphasizing hip and core strength may produce better functional outcomes than passive or unsupervised approaches for femoroacetabular impingement-related symptoms. However, the response to nonsurgical treatment varies, and the ideal program and treatment duration are not the same for everyone.

3. Diagnostic injections

For some people with hip pain, an anesthetic injection into the joint may help determine whether symptoms are coming from inside the hip and provide additional information to guide treatment.

4. Hip surgery

Hip surgery may be considered when symptoms do not improve with nonsurgical treatment or when structural problems also need correction, with options including labral repair, reconstruction, or removal of damaged tissue depending on the condition of the labrum.

5. Shoulder surgery

Shoulder surgery may be considered when symptoms persist or significant instability is present, and options for Type II SLAP tears may include SLAP repair or biceps tenodesis depending on the injury and individual factors.