For a common hip condition, physical therapy and surgery lead to similar outcomes
All sports carry an inherent risk for injury based on the specific movements involved. Athletes that participate in sports with frequent leg extension and bending of the hips are at an increased risk for hip injuries, and issues like labral tears and hip impingement are becoming increasingly common in certain sporting populations.
The hip is a ball-and-socket joint in which the thighbone (femur) acts as the “ball” and a portion of the pelvis called the acetabulum is the “socket.” Both the femur and acetabulum are covered with smooth articular cartilage that protects bones and prevents them from rubbing against one another. Another specialized piece of cartilage called the labrum provides a suction seal and stabilizes the hip joint.
Hip impingement is a common condition in which excess bone that’s formed around the femur causes these two bones to rub against each other. Labral tears, which are also common, occur when the labrum is damaged from being pulled too far away from the acetabulum. These tears may result from a traumatic incident like a fall or an accident, but are most frequently overuse injuries caused by repetitive hip movement, particularly from sports like soccer, football, ice hockey, running, and golf.
Both conditions can lead to similar symptoms, which usually include pain in the hip or groin, stiffness, and a catching-like sensation in the hip. In many cases, labral tears don’t lead to signs or symptoms, but when they do, it can seriously interfere with your ability to function normally and participate in athletic activities.
Why we believe physical therapy is a better option than surgery
Injuries to the labrum can be treated conservatively (non-surgically), and we consider physical therapy to be the best solution available. A typical treatment program for one of these hip injuries will include the following:
- Recommendations for rest and limiting or temporarily stopping participation in sports
- A muscle-strengthening program that focuses on the muscles of the hip, core, and legs
- Manual (hands-on) therapy
- Movement re-education to help restore normal motion of the hip, back, and legs
The benefits of physical therapy for hip impingement have been highlighted in the medical literature, including one study published in 2018. In this trial, 80 patients with hip impingement were randomly assigned to undergo either surgery or three weeks of physical therapy, and were then followed up for two years. After this period, both groups experienced significant improvements, and “there was no significant difference between the groups at two years.”
These findings suggest that patients with hip impingement could expect to experience similar improvements, but it’s worth noting that surgery is associated with higher costs, a greater risk for complications, and often an extensive recovery period. Given these factors, we recommend that patients choose physical therapy because it’s a safer and less costly treatment option for their condition.
