The acetabular labrum glenoidal labrum of the hip joint or cotyloid ligament in the older text) is a cartilage ring that surrounds the hip acetabulum. The anterior part is most vulnerable when the labrum is torn.
It provides an articulation surface for acetabulum, allowing the femoral head to articulate with the pelvis.
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It is estimated that 75% of acetabular labrum tears have an unknown cause. Tears of labrum have been credited to various causes such as excessive strength, hip dislocation, hip hipobobilitas hip, hip dysplasia, and hip degeneration. The tight iliopsoas tendon has also been associated with tear labrum by causing compression or traction injury that eventually causes a tear of the labrum. Most torn labrums are thought to originate from tear stages due to repeated microtrauma. Incidence of springs increases with age, indicating that they may also be caused by damage through the aging process. Labrum tearing on athletes can occur from one recurring event or trauma. Running can cause the labrum rips because the labrum is used more to hold the load and take excessive force while at the end of leg motion: hyperabssi, hyperextension, hyperflection, excessive external rotation. Sports activities may be the cause, especially those requiring lateral rotation or spinning on the femur loaded as in hockey or ballet. A constant place of hip rotation increases the pressure on the capsular tissue and damages the iliofemoral ligament. This in turn causes rotational instability of the hip puts an increase in pressure on the labrum.
Traumatic injuries are most often seen in athletes who participate in high-impact contacts or sports such as soccer, soccer, or golf. The prevalence rate for traumatic hip injuries that cause very low labrum tears. Less than 25% of all patients can connect certain incidents with their torn labrum, but they are often the result of dislocations or fractures. Falling into one's side causes a blunt trauma to the major trochanter of the femur. Because there is very little soft tissue to reduce the strength between impact and the greater trochanter, all the blows are transferred to the surface of the hip joint. And since bone density does not peak until age 30, hip trauma can cause fractures. Tears from the hip labrum can be classified in various ways, including morphology, etiology, location, or severity.
Anatomic modification of the femur and/or pelvic socket causes slow buildup of cartilage damage. Femur or acetabular dysplasia may cause an acetabular femoral impulse (FAI). Impingement occurs when the femoral head rubs abnormally or does not have full motion in the acetabular socket. There are three different forms of FAI. The first form is caused by a bone deformity in which the extra bone is present on the femoral head, causing the head to become non-spherical. The second deformity is referred to as the pinning deformity and it is due to the excessive growth of the acetabular socket. The third type of FAI is a combination of the first two deformities. When one of the abnormalities is present, it changes the position that the femoral head occupies in the hip socket. Increased pressure that the experience of femur and or acetabulum can cause acetabular rim fractures or release of distressed labrum.
Epidemiology
In the United States, labular acetabular labrum usually occurs in the anterior or anterior superior region, probably due to sudden changes from the labrum to acetabular cartilage. The most common teardrop labrum in Japan is in the posterior region, probably due to the habit of sitting on the floor. Posterior labrum tears in the Western world usually occur when the force pushes the posterior femoral head that transfers the shear and compressive force to the posterior labrum.
Rehabilitation
With physical therapy, there is little evidence of acetabular labrum rehabilitation techniques. Even considered that physical therapy can be controversial because there is no evidence of effective specific therapy. But there are some studies that report physical therapy can benefit patients by bringing them back to "ready-to-exercise" skills. It is recommended that physical therapists follow new findings and stay in close contact with orthopedic surgeons so they have the best idea of ​​how to approach them. Patient case After surgery, crutches will be used up to six weeks and there should be no hope of returning to activity such as running for at least six months
Some things to keep in mind when rehabilitation happens is it is important to know the size and placement of tears. Usually there are four phases in the rehabilitation process recorded as: "Phase I - initial exercise (weeks 1-4), Phase II - intermediate exercise (weeks 5-7), Phase III - follow-up exercises (weeks 8-12), and Phase IV - return to exercise (week 12) "All physical therapy regimens should be individualized from person to person based on all adequate criteria
In phase I of the rehabilitation process the first goal is to minimize pain and inflammation. It is important to start doing small motion exercises that have a bearing capacity of up to 50% by weight of the patient. A symmetrical gait pattern is a necessity because it does not create an imbalance in the hip muscles. Aquatic therapy is highly recommended and viewed for its ability to help patients move more freely without gravitational pressure. To advance to the "II" phase of the patient the rehabilitation process should be able to finish lifting the legs straight while lying on their sides to strengthen the sartorius and tensor fasciate latae muscles to build support in the legs.
In phase "II" the physical therapist should try to promote more flexibility in the soft tissues. There should be more emphasis on the initial aspects of strength training while adding some resistance over time. To advance to the "III" phase, the patient should be able to demonstrate a normal walking pattern and minimal pain with exercises such as single foot bridging to help strengthen hamstring muscles to help with leg equality.
In phase "III" the focus is to start building functional strength. The movement should include a one-leg training to build muscle and challenge the strength of the hip.
To advance to phase "IV" patient's flexibility should be adequate. Phase IV is the final stage in which the physical therapist will assess and prescribe the exercise further until the patient is ready to return to the sport. Usually the therapist will start using complex movements such as squatting, kicking, and running. The therapist will look for symmetrical movements on both sides of the body without pain. If the patient shows symmetrical movements without pain, the physical therapist will use their discretion to permit the patient. Some things to avoid from rehab is to sit with "knees lower than hips, legs crossed where the hips are rotated, and sit on the edge of the chair and contract the hip flexor muscles
Prevention
Tears of hip robrum can occur in various ways such as frequent twisting, direct trauma, or degeneration. Despite many different possibilities, most of the labral lobe tears are not directly related to specific actions. Thus, making it difficult to prevent such injuries. But it is possible to lower the risk by strengthening the gluteus, stretching before exercise, and stopping the use of repeated play activity.
One way to prevent a tear of the hip labrum is to lower the pressure on the anterior region. Labrum has a thickness of about 2 to 3 mm but is wider and thinner in the anterior part. Research has found that in the United States and European countries, the labal robral of the hip is usually found in the anterior region. Pelvic muscle imbalance may develop a lower crossed syndrome. This is due to a rigid flexor of the hip and a weak gluteal and abdominal spina erector. Muscle imbalance may cause pelvic anterior pelvis, increased pelvic flexion, and lumbar spinal lumbar hyperlordosis. This increases the pressure in the weak anterior Gluteal labrum during pelvic extension also shows increased joint pressure in the anterior labrum. To prevent tearing of the hip tear, you must strengthen the muscles or stretch tight muscles that may cause muscle imbalance. A good exercise to strengthen the gluteus is pelvic kidnapping on the side. You will lie on your side with your feet on top of each other. You will raise your upper legs upward while keeping your knees and hips straight. This exercise targets gluteus medius and is particularly effective in those who have pelvic anterior pelvis. To stretch a tight hip flexor, you can stretch a knee flexor flexor that targets iliopsoas. These exercises are a great way to strengthen and stabilize hip and hip joints to prevent a tear of the hip labrum.
Stretching before exercise will affect cartilage through "creep". This will place a constant load on the labrum, allowing the liquid to leak out and damage the applied load. This is significant for labrum viscoelasticity. The hip labrum acts as a shock absorber, joint lubricant, stabilizer and pressure distributor. With this essential warming, it is possible to be better prepared to prevent a tear of the hip labrum. Weight squats are a great example for stretching and warming the body to trigger creep before exercise.
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See also
- Glenoid labrum
References
Source of the article : Wikipedia
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