What to know about shoulder labrum tear

Labrum is a soft cartilage which lines the shoulder ball and socket joints. The cartilage encircles the glenoid, a hollow inside the shoulder blade, which provides shoulder protection and support.

Wherever the labrum connects to the glenoid a tear can occur. Common causes for a torn shoulder labrum include shoulder overuse or trauma to this joint. A tear of the labrum can make a shoulder weaker and less stable, and cause pain.

Keep reading about the different types of torn shoulder labrum for more information including the symptoms they cause and how people can treat them.

Types

A person with a tear in the labrum can feel a grinding sensation when the shoulder moves.

There are various types of labrum tears in the shoulder including:

  • Bankart lesions or tears
  • superior labrum, anterior to posterior (SLAP) tears or lesions
  • posterior shoulder instability

Lesions or tears from bankart are common in younger people who dislocate their shoulder. The form of torn labrum takes place at the lower part of the glenoid socket.

A person who has suffered a tear in the Bankart can feel as if their shoulder will slip out of place if they move their arm in some way.

SLAP tears arise in the middle of the glenoid from the front to the back of the cartilage. This tear is more likely to occur in athletes in those who play tennis, baseball, or softball, as these sports require rapid snapping of arm movements over the top of the shoulder.

In the back of the glenoid socket, posterior shoulder instability tears occur, and are the least common type of labrum tears.

These tears account for around 5–10 percent of all injuries to shoulder instability. They can occur because of a severe injury, or when a shoulder dislocates later.

Alternatively, this form of tear may occur indirectly due to other injuries or symptoms, such as electrocution or seizures that cause sudden shoulder movements.

Reasons for tearing

The most likely causes of a torn shoulder labrum include overuse to the shoulder from repetitive motion or trauma.

Athletes who play tennis, softball, or other activities that require raising the arm above their heads to perform an action have an increased risk of repetitive motion injuries.

Anyone can injure their shoulder because of an accident, though. Some common causes of a labrum torn to the shoulder include:

  • a hard pull on the arm
  • falling onto an outstretched arm
  • a direct hit to the shoulder

A shoulder labrum tear may not always be preventable. A person may, for example, take steps to reduce the risk of being careful when climbing a ladder or walking up or down steep stairs.

Symptoms

Pain is a common symptom of a tear in a shoulder labrum. A person may have the following symptoms, too:

  • a popping sound or feeling when moving the shoulder
  • a grinding sensation when moving the shoulder
  • the sensation that the shoulder is catching
  • the shoulder locking
  • decreased range of motion
  • a feeling of instability in the shoulder
  • loss of strength in the shoulder

Torn lesions in the labrum often occur at the same time as other injuries in the shoulder. These may include torn tendons to the biceps, injuries to the rotator cuff, and dislocation.

A doctor will likely check for signs of other injuries in the shoulder and arms to help determine the best course of treatment.

Diagnosis

A person suffering a shoulder injury should see a physician for a physical exam. Anyone who plays a sport requiring them to frequently reach their arm over their head should see their doctor if they are having pain.

During the exam, the doctor will often begin by assessing the range of motion and pain level of the person, as well as the shoulder stability.

The doctor may order X-rays to check the shoulder and look for other bone injuries. Also, they could order an MRI scan to check for damage.

A doctor may do an arthroscopic examination if further examination is required. The doctor inserts a camera through a small cut inside the shoulder during this procedure. In doing so, they will view the inside of the joint on a TV screen.

Treatment

If anyone playing sports has a torn labrum, they will rest.

There are several possible approaches of recovery for a labrum tear, including both surgical and non-operative solutions. Doctors tend to prescribe surgery only if other treatment methods are not available, or if the shoulder is not fully healing.

Other non-circumcisive options include:

  • a doctor popping the shoulder back into place if it is dislocated
  • over-the-counter (OTC) pain relievers and anti-inflammatories
  • resting the shoulder
  • physical therapy
  • cortisone injections

Most people with torn labrum aren’t going to need surgery to repair the injury. When a tear requires surgery, a surgeon typically uses a procedure called arthroscopic surgery which is often referred to by people as keyhole surgery.

Arthroscopic surgery involves inserting, through a small cut near the shoulder joint, a long thin tube called an endoscope. The endoscope includes a camera, magnifier, and light and it is used by the surgeon to assess the labrum damage.

If necessary, the surgeon will create another incision by which additional instruments can be inserted to trim or remove the damaged part of the labrum, or reassemble it to the bone.

In severe cases, though this is rare, an operator may need to perform open surgery to repair the tear. This form of surgery requires that the surgeon make a larger cut in the skin to allow for greater access to the area that is damaged.

Recovery

Recovery from a torn shoulder labrum can vary depending on:

  • the location of the tear
  • the severity of the tear
  • whether surgery is necessary
  • whether surgery is keyhole or open

The American Academy of Orthopedic Surgeons states that recovery from the operation can take several weeks. The incisions can also take a few days to heal.

Following shoulder surgery to repair a torn labrum, a doctor will probably advise a person to wear a sling for a specified period after the surgery. Doctors may recommend wearing a sling for athletes the first 4 weeks after the procedure.

According to the Hospital for Special Surgery, an SLAP injury may take 6 weeks to 2 months to heal while a person is receiving treatments such as medication, physical therapy, or cortisone injections.

A person should avoid using the shoulder as much as possible during the recovery period, which may mean taking a break from playing any sport.

Individuals receiving arthroscopic surgery for a torn labrum will generally experience faster recovery and less pain than those requiring open intervention.

It can take 6 months to 1 year for athletes to fully recover from the injury. Although the injury can have a long-term effect on the ability of an athlete, with effective treatment, before the injury, the majority can return to at least 80 percent of their capacity.

Summary

A torn labrum of the shoulder also occurs due to overuse, or from a trauma of blunt force to the shoulder. A person may feel shoulder pain, decreased range of motion and restricted shoulder mobility when a labrum tear occurs.

OTC drugs, cortisone injections, and physical therapy are often used for care. Doctors will recommend nonchirurgical forms of treatment wherever possible. In more severe cases, surgery may be needed on a torn shoulder labrum.

Recovery times vary depending on the severity of the injury. Effective treatment in the most severe cases will ensure that patients recover the majority of their ability to compete before the injury.

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