Labral Tear or Hip Impingement?

Why So Many Active Adults Are Misdiagnosed

If you live an active mountain lifestyle and develop deep hip pain, you are often told it is a strain. A tight hip flexor. Maybe overtraining.

But for many patients in Eagle and Summit Counties, the real issue is structural.

Two conditions frequently overlap and are commonly missed: hip labral tears and hip impingement. And when they are not recognized early, the hip joint can continue to deteriorate.

At Vail-Summit Orthopaedics & Neurosurgery, Dr. Max Seiter routinely evaluates patients whose hip pain has lingered for months before they receive the correct diagnosis.

Quick Overview

• Hip impingement is often the underlying structural problem

• Labral tears frequently develop as a result of impingement

• Symptoms can mimic groin strains or overuse injuries

• Many active adults are treated conservatively for too long

• Early diagnosis can prevent long term joint damage

The Structural Problem Most People Do Not Know They Have

Hip impingement, medically called femoroacetabular impingement, is a shape mismatch between the ball and socket of the hip joint.

In a perfectly shaped hip, the femoral head rotates smoothly inside the socket. In impingement, extra bone or abnormal shape creates contact where there should not be contact.

Over time, that repeated contact can damage the cartilage rim that stabilizes the joint.

That rim is called the labrum.

Dr. Seiter explains it this way, “The labrum is not meant to absorb repetitive pinching. When the bone shape is slightly off, every deep squat, ski turn, or pedal stroke can stress that cartilage.”

What a Labral Tear Actually Feels Like

A labral tear does not always present dramatically. Many patients describe:

• A deep ache in the groin

• Clicking during certain movements

• Pain after sitting for long periods

• Loss of flexibility compared to the other side

• A vague feeling that something is not right

Because the pain is deep and not superficial, it is often mistaken for muscle tightness.

In Colorado’s high activity population, patients frequently push through symptoms during ski season or summer biking. Months later, they finally seek evaluation.

Why These Two Conditions Almost Always Travel Together

Here is where confusion happens: hip impingement often causes labral tears.

The abnormal bone contact repeatedly compresses the labrum until it frays or tears. Treating only the tear without addressing the bone shape can lead to recurrence of symptoms.

According to Dr. Seiter, “If we only treat inflammation but ignore the structural impingement, the underlying mechanics remain unchanged. That is why a precise diagnosis matters.”

Patients may have:

• Isolated impingement

• A labral tear caused by impingement

• Combined cartilage and labral damage

Each scenario requires a different approach.

Why So Many Cases Are Missed

There are several reasons hip labral tears and hip impingement are frequently overlooked:

1. X rays may appear subtle

Small structural differences require careful evaluation by a hip specialist.

2. MRI findings can be confusing

Labral abnormalities can exist in asymptomatic patients, so imaging must match the exam.

3. Symptoms mimic muscle injury

Groin pain is commonly labeled as a strain without deeper evaluation.

4. Highly active patients compensate well

Strong athletes can mask instability longer than sedentary individuals.

Dr. Seiter often sees patients who have completed months of physical therapy before advanced imaging is ordered.

How Diagnosis Is Different at Vail-Summit Orthopaedics & Neurosurgery

A proper hip evaluation includes:

• A movement based physical exam

• Impingement specific testing maneuvers

• Careful analysis of hip morphology on X ray

• MRI or MR arthrogram when indicated

The key is correlating imaging with symptoms, not relying on one test alone.

Because Dr. Seiter specializes in hip preservation procedures, his focus is on identifying problems before they progress to arthritis.

Treatment Is About Preserving the Native Hip

For some patients, targeted physical therapy can improve mechanics and reduce irritation.

For others, particularly those with mechanical catching or persistent pain, minimally invasive hip arthroscopy may be recommended.

This procedure can:

• Repair or reconstruct the labrum

• Reshape bone causing impingement

• Remove damaged tissue

• Improve joint mechanics

“Our goal is always to preserve the natural hip joint whenever possible,” says Dr. Seiter. “Especially in active patients in their 20s, 30s, and 40s.”

The Bottom Line

Hip labral tears and hip impingement frequently overlap and are commonly mistaken for simple strains. Because symptoms can be subtle and gradual, many patients are misdiagnosed or treated conservatively for too long.

Dr. Max Seiter at Vail-Summit Orthopaedics & Neurosurgery specializes in evaluating complex hip pain and helping active adults throughout Eagle and Summit Counties return to high level activity.

If hip pain persists, especially with clicking or deep groin discomfort, a specialist evaluation can clarify whether hip impingement, a labral tear, or both are contributing to your symptoms. Contact us today!