Similar to the hip, the shoulder joint is a ball-and-socket joint. The ball of the upper arm bone is held in place within the socket of the shoulder blade. However, the shoulder socket, called the Glenoid, itself is extremely shallow and unstable. The bones of the shoulder are not held in place adequately, thereby requiring extra support. To help compensate for this instability, the shoulder joint has a cuff of cartilage (labrum) that forms a cup for the end of the arm bone to move within. The labrum wraps around the shallow shoulder socket, thus making the socket deeper. In addition, the biceps muscle tendons of the upper arm attaches to the shoulder just above the labrum. This arrangement makes the shoulder much more stable and allows for a very wide range of movements.
Injuries to the labrum can cause discomfort and inability to perform certain activities of daily living. There are many different types of injuries that can occur to the labrum. Each type of tear has its own characteristics and treatment plans.
| Glenoid Labrum Tear | SLAP Tear | Bankart Lesion | |
| Symptoms | -Feeling of instability-Shoulder dislocations-Pain-Catching, locking, popping, or grinding feeling-Night pain-Decrease in range of motion-Loss of strength | -LockingPoppingCatchingGrinding-Pain with movement-Pain when lifting heavy objects-Decrease in shoulder range of motion and strength-Feeling shoulder is going to “pop out of joint” | -Pain-Repetitive shoulder dislocations-“Shoulder giving out” -Feeling of hanging loose |
| Causes | -Falling on an outstretched arm.-Direct blow to the shoulder-Sudden pull to the shoulder such as when lifting a heavy object.-Violent overhead reach, can occur when trying to stop a fall or slide. -Shoulder Dislocation | Acute Trauma Repetitive Shoulder Motion | Severe Injury Trauma Shoulder Dislocation |
| Diagnosis | Physician Exam;X-ray;CT Scan;MRI (with or without contrast) | Physician ExamX-RayMRI | Physical Exam; X-ray; MRI |
| Risk Factors | Throwing Athletes or Weightlifters | Throwing Athletes, weightlifters, over 40 years old | High Impact Activities; Shoulder Dislocations; Shoulder Instability |
Treatment Options
Once a Labrum tear is suspected your physician will go over the possible treatment options to determine which route best suites you. To determine which type of labrum tear you have your physician will order imaging, if the imaging is inconclusive the physician will not know which repair they will be making until they perform arthroscopy.
Your physician may prescribe anti-inflammatory medication and rest until a final decision on treatment is made. Physical therapy may be prescribed to help strengthen the rotator cuff muscles and improve any loss of range of motion.
Treatment options include both nonsurgical and surgical options. Nonsurgical method may be prescribed to help relieve symptoms and heal the injured structures through physical therapy. If this method is unsuccessful in relieving symptoms surgery may be recommended.
Surgical Options
- Open Incision
- Arthroscopic procedure
What do I expect after surgery?
After surgery you can expect to be in a sling for 3-6 weeks. Physical therapy will be prescribed to begin gentle, passive range of motion exercises. When sling is removed physical therapy will be progressed.
Those trying to return to sport-specific exercises will gradually begin at 12 weeks. It will not be until 4-6 months that the shoulder will be fully healed.
