Shoulder Labral Tears

Shoulder Labral Tears

What is the shoulder labrum and what does it do?

The shoulder joint is a ball and socket joint. The shoulder labrum is a ring of fibrocartilage that surrounds and supports the glenoid socket of the shoulder joint. It is an important structure for stabilizing and maintaining the integrity of the shoulder joint, as it secures and cushions the ball which is the head of the humerus (the upper arm bone).

The labrum also plays a role in providing extra bony surface area to the joint, which increases the range of motion in the shoulder. Several muscles of the shoulder attach to and extend over the labrum, providing additional stability and strength to the joint capsule.

By keeping the shoulder joint stable and increasing its range of motion, the shoulder labrum is an essential structure for allowing proper movement of the arm at the glenohumeral joint.  Without it, the shoulder joint would be much more unstable and less able to provide strong and reliable movement.

What is the shoulder labral tear?

A shoulder labral tear is a common injury that affects the shoulder joint. When the labrum suffers trauma or wear and tear, it can become partially or completely torn, creating instability in the joint. Labral tears can range in severity from minor to complete detachment.

What causes labral tears?

Labral tears are most commonly caused by overhead activities or sudden movements that exceed the labrum’s normal range of motion. Overuse injuries, such as repetitive throwing motions, can also lead to labral tears. Additionally, some degenerative conditions and prior trauma can increase the risk of a labral tear.

What are the symptoms of a labral tear?

Labral tears can cause a “catch” in the shoulder during movement, aching in the joint, and pain with certain activities, weakness, and a sense of instability or looseness within the joint.  A labral tear can also increase the risk of shoulder dislocation and instability.

How is a labral tear diagnosed?

Diagnosis is typically made through an MRI or CT scan, with confirmation through diagnostic arthroscopy. Treatment options vary depending on the severity of the tear and include immobilization, physical therapy, and in some cases surgery. Restoring the stability of the joint often aids in alleviating pain and returning to normal daily activities.

What are the types of labral tears?

The types of tears to the labrum generally fall into one of three patterns:

  • SLAP Tears appear at the top of the shoulder socket where the biceps tendon attaches to the shoulder.  This type of tear most commonly occurs in athletes utilizing an overhand throwing motion, such as tennis and baseball players. Symptoms include pain, weakness, and a feeling of instability in the shoulder.
  • Bankart Tears can occur during a shoulder dislocation as the ball of the joint pops out of the socket. It can also be caused by falling onto an outstretched hand. Symptoms may include pain while lifting the arm away from the body, weakness in the shoulder joint, or a feeling of instability when moving the arm.
  • Posterior Labral Tears occur less frequently and can be the result of either the rotator cuff and the labrum becoming pinched together at the back of the shoulder, or from traumatic injury that causes posterior instability. It can also result from overuse, or degenerative changes in the joint. Symptoms may include shoulder pain, catching or locking of the shoulder joint (sometimes referred to as a dead arm), and decreased range of motion.

How is a labral tear diagnosed?

A labral tear is usually diagnosed through imaging tests such as an X-ray, MRI, or CT scan. During these imaging tests, the doctor can identify any soft tissue damage and confirm a diagnosis of a labral tear. In some cases, arthroscopy may be required to fully evaluate the extent of the injury. This procedure is done under general anesthesia and involves a small camera being inserted into the joint to visualize the injury. Once a diagnosis is confirmed, treatment can begin.

What are the treatment options for a labral tear?

Treatment typically includes rest, physical therapy, and medications to manage pain, swelling, and inflammation. If symptoms persist following conservative treatment or the tear is severe, arthroscopic surgical intervention may be required.

Arthroscopic surgery may involve repairing or reconstructing the labrum, as well as removing any damaged tissue. After surgery, physical therapy is usually required to help restore strength and flexibility in the affected joint.

With prompt diagnosis and appropriate treatment, a labral tear can be resolved, and further complications avoided. It is important to work closely with an Ortho Illinois orthopedic surgeon and physical therapist to ensure the best outcome possible.

At Ortho Illinois, we provide an unsurpassed continuum of care from our team of board-certified orthopedic surgeons to physical medicine & rehabilitation physicians, and physical and occupational therapists – each focused on your successful recovery from shoulder pain and function.