The tear is on the MRI. The pinch is in how the hip moves. Most labral tears settle without surgery when the strength and control around the joint change — and lifters keep lifting while they do. Dr. Cisneros does that work one-on-one, the full hour, every visit.
A labral tear is usually the result of a hip that pinches at the end of its range. The evaluation finds the position that pinches and the strength that is missing, because that is what the program changes.
A deep ache in the front of the hip after sitting, worse in low chairs and cars. Deep hip flexion pinching the labrum — the most common way an impinging hip announces itself.
A sharp catch in the groin at depth, or with a deep lunge or hip hinge. Lifters and CrossFit athletes: the depth and stance are adjusted and earned back, not abandoned.
A click or catch deep in the joint with rotation, sometimes a feeling of the hip giving way. Mechanical symptoms are assessed carefully; persistent locking changes the surgical conversation.
Front-of-hip pain that builds with mileage or hills and lingers after. Usually a hip that lacks the rotator and gluteal strength to keep the femur centred under repeated load.
Hip pain that flares after yoga, pigeon pose, or aggressive hip-flexor stretching. Stretching an impinging hip into the pinch is a common way the problem is made worse, not better.
Phase-based rehab after labral repair or debridement, following your surgeon’s protocol from crutches through return to running. See our post-surgical rehab page →
Each starts with a diagnosis of which position pinches and which muscles are not holding the femur centred, then a loading program built in the range the hip tolerates. Dry needling and manual therapy support that plan; they are not the plan.
The tear is on the MRI; the pinch is in how the hip moves. Dr. Cisneros changes the pinch — the strength, the control, and the way deep flexion is loaded — which is what lets most labral tears settle without surgery.
The exact angle of flexion and rotation where the hip catches, the strength of the deep rotators and glutes, how the pelvis moves into a squat, and whether the symptoms are mechanical or positional. The MRI is read alongside that exam, not instead of it — labral tears are common in pain-free hips.
Squats, hinges, and lunges kept just short of the pinch and progressed as control improves, rather than avoided. Lifters keep lifting with depth and stance adjusted; runners keep a dose the hip settles from within 24 hours. Depth is earned back, not assumed.
Deep hip rotator and gluteal strengthening — side-lying and standing rotation, bridges to single-leg, split squats, step-downs — and trunk control so the pelvis stops tipping into the pinch. This is the work that changes the impingement, and it is loaded progressively with real resistance.
Dry needling of the hip flexors, adductors, TFL, and deep gluteals that spasm around an irritated hip, including electrical dry needling for stubborn cases, plus joint mobilization for capsular stiffness. Aggressive stretching into the pinch is deliberately left out; it is one of the most common ways this problem is made worse.
Usually not first. Labral tears are common on the MRIs of people with no hip pain at all, and most painful tears improve with a 12-week program that addresses the movement and strength problems around the hip. Arthroscopic repair is a reasonable option when a genuine rehab course has failed, or when mechanical locking and catching persist, and Dr. Cisneros will say so plainly if that is where you are. The trial of rehab is what tells you.
They travel together. Femoroacetabular impingement (FAI) is a shape mismatch — extra bone on the femoral head (cam) or the socket rim (pincer) — that pinches the labrum at the end of hip flexion and rotation. Over time that pinching is what tears the labrum. Rehab for the tear is rehab for the impingement: reducing the pinch by improving hip control, strength, and the way you move into deep flexion.
Those positions put the hip into deep flexion and rotation, which is exactly where an impinging hip pinches its labrum. Groin pain with sitting, a pinch at the bottom of a squat, and pain swinging the leg out of a car are the classic pattern. It is a position problem more than a damage problem, which is why changing how you load those positions works.
Often, with the depth and stance adjusted. Squatting to the point of the pinch and no deeper, a slightly wider or toes-out stance that gives the femur room, and hip hinges that stay out of end-range flexion let most lifters keep training while the hip settles. Dr. Cisneros tests the exact angle the hip tolerates and builds the program around it, then earns the depth back as control improves.
Deep hip rotator and gluteal strengthening — side-lying and standing hip rotation, glute bridges progressed to single-leg, split squats and step-downs in a pain-free range — plus trunk control so the pelvis stops tipping into the pinch. Stretching the front of the hip aggressively usually makes it worse; loading the muscles that hold the femur centred in the socket makes it better.
Most people notice a real change in 4–6 weeks and reach a stable, trainable hip in 12 weeks or so. The labrum itself has a poor blood supply and does not heal in the way skin does; what changes is the pinch, the strength, and the way the joint is loaded, and that is enough for most people to return to sport and forget about it.
It helps the muscles that guard the joint. The hip flexors, adductors, TFL, and deep gluteals go into spasm around an irritated hip and add their own pain and stiffness; needling them, including with electrical stimulation, restores rotation and reduces pain so the strengthening can be done. It does not touch the labrum itself, and the loading program is where the recovery comes from.
Phase-based and slow at the start: crutches and protected weight-bearing for the first weeks per your surgeon's protocol, gentle range of motion within set limits, then progressive gluteal and rotator strengthening, and a return to running and sport somewhere around three to five months depending on what was done. Dr. Cisneros follows the surgeon's protocol exactly and one-on-one care matters most in the early weeks when every motion has a limit.
No. Texas is a direct access state — you can see a licensed physical therapist for a hip labral tear or impingement without a doctor's referral. At Solas PT in El Paso you can start without a referral or prior authorization; Texas direct access covers the first 30 consecutive calendar days, and a referral is needed to continue past that, which Dr. Cisneros plans with you early because labral rehab runs 12 weeks. After arthroscopy, the surgeon's post-operative order is the referral.
Solas Physical Therapy is a top-rated choice for hip labral tears and femoroacetabular impingement in El Paso, holding a 5.0-star rating across 36 Google reviews. Dr. Andrew Cisneros, PT, DPT, MS tests the exact range the hip tolerates, rebuilds the deep rotators and glutes that keep the femur centred, uses dry needling to release the guarding hip flexors and adductors, and keeps lifters lifting with the depth and stance adjusted. Every session is a full hour one-on-one. Solas PT is cash-based and direct-access at 300 N Resler Dr, Ste F in west El Paso.
Same-week appointments available. No referral needed. One-on-one with Dr. Cisneros every session.
Book Your Evaluation