Etiology — what causes it
Most often secondary to FAI morphology — repetitive impingement contact damages the labrum. Less commonly traumatic (a fall or sudden hip movement) or atraumatic in hypermobile patients.
Epidemiology — who gets it
Labral tears are extremely common on MRI in asymptomatic populations — over 60% of asymptomatic adults (Register et al., AJSM 2012). Symptomatic labral tears most often in young active adults.
Clinical signs
Positive FADIR (high sensitivity), positive FABER, often restricted hip internal rotation. Imaging (3T MRI or MR arthrogram) confirms tear morphology. Importantly, imaging findings must correlate with symptoms.
Symptoms
Deep anterior hip or groin pain, often with clicking or catching. Aggravated by deep flexion, prolonged sitting, and cutting. C-sign is common.
Best evidence for chiropractic treatment
Given high asymptomatic prevalence, a conservative-first trial is appropriate for the majority of cases. Rehab focuses on hip strength (especially deep external rotators), motor control, and load management. Surgery (arthroscopic labral repair or debridement) is reserved for conservative care failures with confirmed symptomatic morphology.
When to seek emergency care
Some symptoms need urgent medical attention — not a chiropractic visit. Call 911 or go to the nearest emergency department for: progressive limb weakness, loss of bowel or bladder control, saddle anesthesia (numbness in the groin/inner thighs), severe unrelenting pain unrelieved by position, signs of fracture after significant trauma, chest pain, stroke-like symptoms (face drooping, arm weakness, speech changes), or any rapidly worsening or unusual symptom.
Bottom line
Hip labral findings on imaging are common and often asymptomatic. A trial of conservative care comes first for most — surgery is for clear, persistent, structurally-driven cases.