title: Myofascial treatment for patients with acetabular labral tears: a single-subject research design study.
abstract: METHODS
  Single-subject research design using 4 consecutive patients.
  
  
  OBJECTIVE
  To assess whether treatment using soft tissue therapy (ART or Active Release Technique), stretching, and strengthening of the hip abductors, hip external rotators, and tensor fascia latae muscles reduces pain and improves self-reported hip function in patients with acetabular labral tears who also have posterolateral hip pain of suspected myofascial origin.
  
  
  BACKGROUND
  Acetabular labral tears cause pain in some but not all patients. Pain commonly presents anteriorly but may also present posteriorly and laterally. The standard of care is arthroscopic repair, which helps many but not all patients. It is possible that these patients may present with extra-articular contributions to their pain, such as myofascial pain, making their clinical presentation more complex. No previous study has assessed soft tissue therapy as a treatment option for this subset of patients.
  
  
  METHODS
  This A-B-A design used repeated measures of the Hip Outcome Score and visual analog scale for pain. Four patients were treated for 6 to 8 weeks, using a combination of soft tissue therapy, stretching, and strengthening for the hip abductors, external rotators, and tensor fascia latae. Data were assessed visually, statistically, and by comparing mean differences before and after intervention.
  
  
  RESULTS
  All 4 patients experienced both statistically significant and clinically meaningful improvement in posterolateral hip pain and hip-related function. Three patients also experienced reduction in anteromedial hip pain.
  
  
  CONCLUSIONS
  Myofascial hip pain may contribute to hip-related symptoms and disability in patients with acetabular labral tears and posterolateral hip pain. These patients may benefit from soft tissue therapy combined with stretching and strengthening exercises targeting the hip abductors, tensor fascia latae, and hip external rotator muscles. Level of Evidence Therapy, level 4.
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Cashman
authors.forename: W Ben
authors.initials: WB
authors.lastname: Mortenson
authors.forename: Michael K
authors.initials: MK
authors.lastname: Gilbart
mesh_terms: D000077:Acetabulum / Q000293:injuries* / Q000503:physiopathology; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000209:etiology / Q000628:therapy*; D002358:Cartilage, Articular / Q000293:injuries*; D005260:Female; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D010147:Pain Measurement; D012107:Research Design; D064746:Therapy, Soft Tissue; D016896:Treatment Outcome; D055815:Young Adult
keywords: ART; Active Release Technique; connective/soft tissue techniques; hip; manual therapy