Hip Labral Tear vs. Hip Bursitis - Key Differences Explained

Chronic hip pain is debilitating and can make walking, sitting, or lying down difficult. For those who experience frequent hip pain, identifying the cause of the discomfort is the hardest part of the process in seeking the right treatment.

Hip labral tears and hip bursitis are two common causes of hip pain that often overlap in their presentation of symptoms. The pain caused by these two conditions present in a similar region on the hip, and a physiotherapist can help to accurately differentiate between them.

If you are experiencing pain around the groin or outside of the hip, this guide can help you to determine the differences, and how you can manage the injury until you seek further guidance from your physio or doctor.

What is A Hip Labral Tear?

A hip labral tear can occur when the surrounding cartilage of the hip joint socket (acetabulum) becomes damaged.

The fibrocartilage surrounding the rim of the acetabulum is known as the labrum and is responsible for cushioning the ball and socket joint at the hip. The labrum also helps deepen the ball and socket connection between the pelvis and the femur (thigh bone), for increased stability.

When a tear appears in the labrum, it may cause instability of the hip joint, with sensations such as grinding and/or locking causing significant pain through the groin and hip regions. A hip labral tear can occur due to a sports injury, repetitive motion, and normal degrading over time with age. 

What is Hip Bursitis?

Hip bursitis is caused by the inflammation of the bursae around the femoral joint; bursae are fluid-filled sacs that counteract friction between soft tissue structures around a joint. Thereby, a hip bursitis is often a result of repetitive movement over prolonged periods.

There are two types of hip bursitis: trochanteric bursitis, which affects the outer side of the upper thigh bone, and iliopsoas bursitis, which affects the inner part of the femur closer to the groin. Trochanteric bursitis is more common than iliopsoas bursitis.

Both types of hip bursitis cause pain that is localised to either the inner or outer regions of the hip and can be triggered by prolonged walking, climbing stairs, or when standing up from a sitting position. 

Difference in Hip Labral Tear and Hip Bursitis Pain

A hip labral tear will result in sharp pain during specific movements and an aching feeling in the hip region at night. It can result in reduced hip joint movement, often on rotation, and can sometimes cause clicking or locking of the hip. Some with a hip labral tear can also feel weakness in the joint, like it’s ‘giving way’or fragile.

Hip bursitis will feel sore, stiff, and result in increased pain when loading the area. Bursitis will result in the area being both swollen and tender to touch, which can radiate down the thigh, hamstrings, or buttocks. 

Pain is your biggest indicator:

• If the pain is on the outer side of the hip (away from the groin), it is likely to be a case of hip (trochanteric) bursitis.
• If the pain gets worse when pressure is applied, it may be a sign of hip bursitis.
• If the pain is triggered when moving the hip joint, it may be a hip labral tear. 

How Does Treatment for Hip Labral Tear and Hip Bursitis Differ?

A qualified physiotherapist can accurately differentiate a hip labral tear or hip bursitis. After a physical examination, a physiotherapist may recommend an MRI or X-ray imaging to narrow down the cause of the hip pain and confirm the diagnosis.

Physiotherapy is the first line of treatment for both a hip labral tear and hip bursitis.

Minor hip labral tears can be treated through regular physical therapy sessions that help to improve the range of motion around the hip and strengthen the stability of the joint. Physio treatment for hip labral tears is also effective at reducing pain and inflammation around the groin.

Treatment for hip bursitis will involve both activity modification and physiotherapy. Your physiotherapist will recommend avoiding certain activities that worsen symptoms while applying graded loading program to increase hip strength and flexibility. Over time, the pain and swelling in the affected bursae will subside. 

NQ Physio Solutions is Townsville’s trusted physiotherapy clinic - we regularly treat individuals with hip pain and can help provide a diagnosis for hip labral tear and hip bursitis. Our team of physiotherapists specialise in sports injury treatment in Townsville, as well as in wear-and-tear conditions with general physiotherapy. Book an appointment with us today to start your journey toward freedom from hip pain.