What the Hell is a Shoulder Labral Tear?

Understanding A Shoulder Labral Tear

Shoulder glenoid labrum injuries are common in sports that require repetitive overhead movements and physical contact. The shoulder enjoys more range of motion than any other joint in the human body. Unfortunately, it also consists of a very shallow ball socket joint that makes it vulnerable to injury.

The clavicle, humerus, and scapula are the three bones that comprise the shoulder joint. A combination of connective tissues, joint capsule and ligaments hold the proximal head of the humerus (upper arm bone) in place. The labrum’s fibrous tissue “cups” the head of the humerus, holding it within the glenoid cavity. The labrum helps ensure stability within the mobile joint, but may tear due to a shoulder joint injury or repeated strain.

Shoulder labral tears may also occur when the biceps muscle contracts against the labrum, such as when throwing a baseball. SLAP is an easy acronym that stands for “superior labral from anterior to posterior,” which is used to describe a superior labrum tear commonly seen in pitchers. Conversely, an anterior labrum tear is referred to as a Bankhart tear, which is often associated with shoulder subluxations and dislocations. Less common posterior labrum tears involve pinching of the rotator cuff and labrum.

It was markedly difficult to identify the cause of shoulder pain prior to the dawn of arthroscopic surgery and subsequent ability to see the inner workings of a joint. This, in turn, limited labrum tear treatment within the sports medicine community. Thankfully, this is no longer the case.

Signs and Symptoms of Shoulder Glenoid Labrum Injury

A ‘catching’ feeling with overhead movement
Pain on the anterior or posterior side of the shoulder
A sense of hesitancy and insecurity during exercise that requires shoulder strength and range of motion
Deep aching and/or grinding within the shoulder joint
Unexplained weakness of the shoulder and surrounding muscles
Decreased shoulder range of motion

Physical examination may not always immediately link shoulder joint labral tear symptoms with the precise injury. Consequently, correct diagnosis may require an MRI-arthrogram to properly assess the presence and location of the tear.

Professional Treatment for a Torn Labrum

Discontinue overhead shoulder activities.
Utilize the latest physical therapy modalities and rehab devices available to reduce swelling and pain.
Massage the chest muscles, upper traps and posterior shoulder rotator cuff muscles to help reduce pain and foster pain-free range of motion.
Work with a physical therapist to properly strengthen the rotator cuff and surrounding musculature while improving biomechanics of the shoulder girdle during activities of daily living (ADLs).
Seek out arthroscopic surgery options, but only after an aggressive non-invasive rehab plan is given sufficient time to reduce symptoms.

Ask the Right Questions Like a Pro

Here’s what smart pro athletes would ask their sports medicine specialist to ensure a fast and safe return to the game they love:

1. Is an MRI or MRI-arthrogram required to confirm the diagnosis of a torn shoulder labrum?

2. Which specific physical therapy activities should I focus on to speed up recovery?

3. What is the likelihood that surgery will be required?

4. How much healing time is required before I can return to my sport? Moreover, can you provide me with a general plan to follow as I anticipate my return to athletics?

5. What else can I do on my own to avoid a re-injury?

Elite Sports Medicine Tips from Mike Ryan

Ice, Ice, Baby – Icing immediately after a workout or rehab is the simplest way to control swelling and reduce pain.
Pay Attention – Do not disregard recurring shoulder pain. A failure to diagnose a shoulder labrum tear early on can increase the need for surgery later.
Listen Up – If you experience shoulder pain following any activity, listen to your shoulder to help pinpoint the specific movement or activity that aggravated the injury.
Stretch and Stretch Some More – Stretching/warming up the shoulder joint and its associated muscles, tendons, ligaments and fascia prior to any physical activity will help keep you in the game.
Remember It’s a Marathon, Not a Sprint – Take your rehabilitation program seriously to help keep you in the game and hopefully avoid further downtime and surgery down the road.