Hip labral tears are a fairly common cause of hip pain during exercise. They can be caused by trauma, repetitive movements, or from changes in the bony anatomy in the hip.

Hip Labral Tear

We often see hip labral injuries in those who participate in sports and activities like hockey, football, dance, or martial arts. In dancers for example, many of the movements they are required to perform can place their joints in extreme range of movements and under load. This puts more pressure on the supporting structures of the hip joint. The resulting impact can cause damage to this structure suddenly, or over an extended period of time. A hip labral injury is specifically a tear in the cartilage that lines the rim of the hip joint (acetabulum).

Common Signs and Symptoms:

If a hip labral tear has occurred, then you might experience pain around the front of the hip or groin. The pain may occur on twisting, running, or hip flexion movements. There could also be clicking, catching, a locking sensation, and sometimes a sense of giving way.

Diagnosis and Treatment:

A physiotherapy assessment can help to diagnose labral injuries and the cause of hip pain. If physio conservative management fails to improve symptoms, an x-ray may be ordered to rule out other possible causes of hip pain including changes in the bony anatomy of the hip. An MRI may be ordered by a specialist to further evaluate the labrum and other bony and soft tissue structures.

Each person is different and based on your individual diagnosis your physio will create a unique treatment plan for you. This could begin with injury and activity modification (eg. avoiding deep squatting and twisting movements). Your physio can also help reduce pain through manual therapy techniques, and then progress to muscle strengthening to improve stability and control around the hip.

If symptoms do not improve as expected with conservative physio management, we provide an onward referral for further imaging, or referral to a hip specialist.

If you’re experiencing hip pain, book an appointment at Ponsonby Physiotherapy. We’re here to help.

Tai Chi is a low impact approach to exercise, originating from Chinese martial arts and characterised by slow, expansive movements. We now offer Tai Chi as part of our weekly class schedule at Ponsonby Physio, so you can try it for yourself.

The Benefits of Tai Chi

Tai Chi helps to relieve pain, decrease stress and blood pressure, improve muscle strength, flexibility, stability and balance. Tai Chi has also been found to be incredibly beneficial in improving ease with daily activities such as sit to stand, stairs, walking, speed, confidence and a reduction of falls and fear of falls, in older adults.

Poor strength and balance increases the risk of falls, which can have a dramatic impact on older adults and especially on their ease with daily activities and independence. The regular practice of Tai Chi can have real benefits here, which is so good because the current statistics on falls are disheartening. Unfortunately, at the moment some 30-40% of the population over the age of 65 fall every year. By the age of 80, this statistic reaches 50%, and continues to increase yearly. Adults aged over 65 also have an increased risk of hospitalisation following a fall compared to their younger counterparts.

Falls in older adults are highly associated with a dramatic reduction in independence, mobility, and function. The fear of falling is also a very real concern. It can ultimately increase the risk of falling as these individuals are less likely to maintain activity levels, will often experience a decrease in muscle strength and stability, and demonstrate a decreased level of overall independence.

Our lower limb strength is vital to our function, mobility, and stability. Research shows lower limb strength resistance training and balance enhancing exercise, reduces falls in individuals over 65 years and enhances confidence and quality of life.

Tai Chi is a low impact approach to exercise that research has consistently found to increase lower limb strength, improve balance, flexibility, postural control, proprioception (knowing where your body, ie your foot, is in space), and also to reduce the fear and risk of falls. It is a great option for anyone with reduced balance or stability, arthritis, stiffness, or those who just want to remain active and enjoy a calming and stress reducing activity.

Tai Chi Class

If you would like to try Tai Chi we invite you to get in contact and sign up for our new weekly class. You can view the full  Classes Schedule  here, or call us at the clinic to learn more.

Pelvic Health Physiotherapy can play a huge role in balancing a person’s physical, emotional, mental and social wellbeing.

If you’re experiencing pelvic pain, leakage or other issues, it really can have a disproportionate impact on your ability to enjoy the things you love and maintain an active lifestyle. This is why we’re passionate about being able to provide a Pelvic Health Physiotherapy service.

So let’s start by giving you some more information…

What is Pelvic Health Physiotherapy?

A Pelvic Health Physiotherapist treats pelvic pain and issues to help you regain the best possible functioning and management of your bladder, bowel and reproductive organs.

You would look to see a Pelvic Health physiotherapist if you have any problems with bladder or bowel incontinence, your hormonal health, post-surgery, pain around your pelvis or lower back during your normal every day activities, including intercourse or using tampons, work-related activities, or exercise. Remember that back pain, leakage and pelvic pain are all very common and treatable. It’s not something you just have to live with!

In addition to the above, seeing a Pelvic Health Physiotherapist during pregnancy, or after giving birth, can have enduring benefits. Your physiotherapist can assess your pelvic floor function during pregnancy and work with you to re-train your pelvic health and reduce risk of pelvic complications throughout pregnancy. Since October 2022, ACC cover a wide range of injuries women might receive after giving birth too.

Qualified Pelvic Health Physiotherapists

Pelvic Health Physiotherapists have undertaken dedicated post-graduate training in the assessment and treatment of pelvic issues and pain people may experience. Depending on your symptoms and concerns we review your medical history, assess full body function and can complete an internal examination if that’s needed. We then deliver individualised and accurate management strategies, as well as tailor a Pelvic Floor exercise program that is specific to you and your Pelvic Health.

We want you to receive the best support possible, regain confidence in your body, and get you back to doing the things you enjoy!

It’s time to give us a call

If you are experiencing pelvic health issues and would like to talk to us about treatment, please do get in contact. We’re here to help and we can discuss whether a pelvic health physiotherapy session would be beneficial to you.

You can also take a look at our website for some more info about pelvic health issues we treat and what is involved in a session. Click here to visit our Pelvic Health Physiotherapy page.

Physio turns Patient!  My Experience undergoing a Total Hip Replacement

Never did I imagine that I would be lining up to have a total hip replacement at my age. I am very aware that I am getting older but it still feels a bit out of place.

I thought it might be helpful to give my account of going through this procedure, what I found hard and what I also found useful in the hope that it may help others when faced with an impending joint replacement.

How did I develop Osteoarthritis in my hip?

There are several factors involved in this answer. I played a lot of hockey and sport when I was younger but had a change in sporting direction when I went to Dunedin for study. I got involved more in running, which then transitioned to triathlon and then eventually focused more on cycling. I was lucky enough to be able to take this a step further and race professionally overseas for a number of years. As tends to go with the territory, I had a few crashes during that time. No broken bones but I do remember always landing on my right side and one crash ended in my hip getting pulled out sideways. This resulted in a labral tear (protective lining for your hip that helps with joint stability). At this time, I also found out that I have particularly shallow hip joints (borderline Hip dysplasia).

The combination of all these factors results in decreasing the stability of the joint, the labral tear exposing the joint surfaces leading to cartilage damage and essentially the start of osteoarthritis.

At the time of the initial injury the hip was quite painful but eventually settled and I was able to run, cycle, tramp, play with the kids and swim. Only in the last couple of years has the above all caught up with me, where I developed pain and restriction of movement leading to limitation of activities and sport.

Deciding to go ahead with surgery

My choice to go ahead with the surgery was made around the thought that my hip was only going to be get worse, more dysfunctional and it was getting hard to keep the area strong. I did some research on the different procedures and opted to go with an Anterior approach (DAA) rather than the more traditional posterolateral approach. The Anterior approach has a faster recovery, less post-surgery restrictions and is more stable overall. It also doesn’t disrupt the gluteal muscles quite so much, which is a good thing.

I was anxious leading into the Surgery, not really knowing if I had made the right decision, not really knowing what it was going to feel like afterwards and as is always the case with surgery there can be complications. It also doesn’t pay to watch or think too hard about what the procedure involves and just leave that up to the surgeon!

As a Physiotherapist turned patient… here are some of the key things I learned from this experience:

1. Don’t delay too long in making a decision.  Don’t wait so long for the surgery that your world becomes narrower due to the limitations in function, pain and the dysfunction you start to develop such as moving differently. The more severe the osteoarthritis (OA) becomes the unhealthier your muscles and tendons become, making it harder to get a good post-surgical outcome. I have done a bit more reading around this area lately and it appears that we should be doing surgery at stage 3 rather than 4 OA because of the changes that start to take place in the muscles that can become irreversible.

2. Get into your ‘Pre-hab’.  Strengthening and conditioning the area as much as you can prior to the surgery will help with recovery for the affected and the unaffected leg.

3. Old sayings ring true: “Patience is a virtue.” “Time is a healer.”  Healing takes time and I think it is helpful to think about progression in terms of weeks rather than days.

This also applies to time with crutches. I was a little surprised at how long it took before I felt like I could lose the crutch for good – 4 ½ weeks. I did have a few thoughts about whether I would ever walk normally again!

4. It takes time for muscle function, proprioception (awareness of where your joint is in space) and confidence to come back.

5. If possible, hire a Game Ready machine for post-surgery. It is a machine that uses a wrap that then fills with cold and compression around the area and really helps with pain and swelling management – it really was a game changer for me.

6. Small regular bouts of movement are helpful even if it feels weird.

7. Use pain relief.  Surprisingly Panadol when taken regularly really helps. You’ll be prescribed different pain relief levels depending on pain. Pain impacts your sleep and sleep is important for recovery so if you are comfortable, you will sleep, and this obviously flows onto your recovery.

8. Do your exercises.  I found it so helpful (both physically and mentally) when I could start doing some cycling and swimming again and slowly adding some gym work in again (mostly upper body to begin but over time more for the lower body).

9. Follow up with your Physio post-surgery.  Even in the early days you have lots of questions, there will be bruising in other areas that is uncomfortable and your physio can help with this. They are also very good with advice around movement, reassurance and pain modulation.

I’m now 9 weeks in and it will probably take around 18months for the new hip to fully settle in, but I know I’m making good progress and feel hopeful of getting back into being able run around with the kids, to walk some of the Great walks, Cycle the epic trails around NZ and have fun!