Expert: Dr. J. Shawn Leatherman - 11/6/2006

Question
I am having discomfort in my upper leg (hip Socket) I can be walking and have like a catch bad enough it will take my breath,but then it goes away but is beginning to happy more often .It is very painful when it happens but does not last long.I may limp 2-3 minutes after it happens.
                                    Thank you

Answer
Dear Becky,

If this is happening inside of the actual hip joint itself, it sounds like you may have what is called a labral tear.  If so, then this is not a chiropractic case, but rather an orthopedic case.  Let me explain.

The labrum is the cartilage that lines the hip socket (acetabulum) in which the ball of the hipbone (femur) sits. The labrum deepens the socket adding stability to the hip joint as well as cushioning the joint itself.

The cause of a tear in the labral cartilage may be degenerative or traumatic. Degenerative tears occur after years of repetitive minor injuries and are usually associated with arthritis of the hip. Traumatic injuries can occur with any sporting activity that causes rapid hip motion especially associated with sudden stops and turns on the field, mats, or court. Occasionally, a traumatic injury that causes a labral tear is somewhat trivial and is forgotten by the time of the diagnosis.

Many labral tears cause no signs or symptoms and don't need treatment. However, occasionally, they cause: A locking or catching sensation in the hip joint, or Pain, usually in the hip or groin.

Labral tears can be difficult to detect on physical examination, but Labral tears are increasingly being diagnosed. Physical exam techniques and the improvement in MRI techniques have helped to diagnose this problem. A doctor can confirm the diagnosis with contrast-enhanced magnetic resonance imaging (MRI). When needed, treatment for a labral tear may include:

-Physical therapy along with activity modification.
-Glucosamine and Hyaluronic Acid supplementation
-Corticosteroid injections
-Nonsteroidal anti inflammatory drugs (NSAIDs)
-Arthroscopic surgery: A surgical repair or excision through an arthroscopic procedure is the usual intervention for this orthopaedic injury when symptoms do not allow a continuation of desired athletic activities. The procedure is done on an out-patient basis and full recovery normally occurs by eight to 12 weeks.

I would recommend that you have this checked out by a medical orthopedist, or a chiropractic physician who has post-doctoral training in sports injury or orthopedics.  As mentioned above the MRI is the gold standard for diagnosis and will probably ordered to confirm any suspected internal derangement of the joint surfaces.

There are other causes of hip associated pain Becky, such as (illiotibial band)ITB syndrome, and muscular imbalances, but with the catch you mentioned a labral tear must be ruled out.

Respectfully.
Dr. J. Shawn Leatherman