The hip joint is a ball and socket joint. The head of the femur is the ball and the acetabulum of the pelvis is the socket. The labrum is a cartilaginous ring that lines the outer rim of the acetabulum. The labrum not only creates a seal around the joint but provides stability and shock absorption and assists in creating smooth movement between the head of the femur and the acetabulum. In some instances, the labrum can tear away from the bony structure underneath. These tears are often considered repetitive stress injuries. This means stress applied repeatedly, over time, has weakened the structure of the labrum which leads to the tear. Some examples of repetitive movements that may lead to a labral tear are:

• Running
• Cutting
• Twisting
• Deep squatting

• Bony abnormalities on either side of the joint (hip impingement)
• Hip muscle weakness
• Decreased coordination and motor control around the hip joint
• Improper biomechanics with repetitive movements

• A deep ache in the front of the groin, often worse upon standing and initiating walking
• Painful pinching or ache with deep squatting
• Pain with end range flexion and internal rotation of the hip
• Painful clicking or catching in the hip
• Stiffness
• Weakness or instability around the hip

WHY CHOOSE PREHABILITATION BEFORE LABRAL REPAIR SURGERY?

Most people who undergo labral repair surgery are experiencing significant pain and have likely decreased their exercise and activity in response to this pain. While the decision to decrease movement and exercise to avoid provoking uncomfortable or painful symptoms is logical, it doesn’t necessarily put you in the best position for an easy recovery from surgery. These changes in activity combined with the tear, typically results in a presentation of joint stiffness and loss of hip range of motion, muscle weakness, decreases in neuromuscular control and impairments in overall endurance and aerobic fitness.

If the surgery isn’t an emergency, there are many ways that a physical therapist can help prepare you and your body for the upcoming procedure. The better condition your hip, your leg and let's face it, your entire body is prior to surgery, the easier it is to return to your normal activities.

If you decide to work with a physical therapist to help with prehab labral repair issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

WHAT CAN YOU EXPECT FROM LABRAL REPAIR SURGERY PREHABILITATION?

My team of therapists will individualize a prehabilitation program just for you, however, there are many elements that are common across different prehabilitation programs. To help you gain a better understanding of what to expect, here is a list of some common goals of labral repair prehab:

Set expectations: The idea of surgery can be daunting. Having an idea of what to expect after the procedure can ease some of your anxiety and help ensure you have what you need to support your recovery. Getting to know your physical therapist before surgery will help build trust with them when it comes time for post-operative care. They can advise you on movement precautions or weight bearing restrictions you may have after surgery and on any equipment or modifications to your home that might be necessary. They can also help you understand what kind of help or support you will need from others and prepare you for how your body may feel after surgery.

Manage pain and inflammation: Pain and inflammation are not uncommon with a symptomatic labral tear and can benefit from physical therapy to help reduce the pain response prior to surgery, especially if surgery is delayed for any reason. Learning strategies to manage pain and inflammation will help you stay comfortable and as active as possible in preparation for surgery.

Learn how to use assistive devices: Immediately post-surgery, when you are still feeling the effects of anesthesia, and pain and stiffness are setting in, is not the best time to learn how to use an unfamiliar device like a walker or crutches that is meant to protect your recently operated-on hip.

Build or maintain strength and flexibility: While the brain knows that surgery is intended to “heal” the injury, the body views the surgical procedure as another injury to the tissues. Though the surgeon has repaired the labrum, which will ultimately improve your symptoms and help get you moving again, the body will need to heal from the effects of the surgery before that can happen. Maximizing strength, soft tissue mobility and flexibility prior to the surgery can help decrease muscle atrophy and stiffness following the procedure which can ultimately quicken your recovery.

Prehabilitation for hip labral repair surgeries is an excellent choice for those wanting to get a head start on their recovery and to help improve their chances of a good surgical outcome. My team of therapists and I would love to help you prepare for your upcoming hip surgery. Call the office at Evolve today to get started.