Shoulder Labrum Tear

The shoulder joint is a ball and socket joint. The ball is the head of the upper arm bone (the humerus). It sits in a shallow socket on the shoulder blade (the scapula). The socket is rimmed by a piece of soft piece of cartilage called the labrum. The labrum deepens the socket to hold the ball in place and stabilize the joint. The labrum surrounds the socket. Different locations of the labrum have different functions. Some labral tears are more related to instability and others are more related to pain.

Labral tears typically result from a trauma such as a direct blow, an auto accident, a fracture, a dislocated shoulder, falling on an outstretched arm, repeated microtraumas from repetitive use and wear and tear, and quick forceful overhead motions like lifting a heavy object. Labral tears are common in overhead athletes who participate in overhead throwing activities like pitchers, quarterbacks, and swimmers. Weightlifters and golfers are also at risk of a repetitive use injury that causes a labral tear. Young and middle-aged laborers also often suffer with a labrum tears.

• Popping, clicking, or grinding sensations
• A deep ache and pain
• Pain with overhead motion
• Decreased range of motion
• Loss of strength
• Shoulder instability causing a feeling that the shoulder is loose and slips

The most common types are a SLAP tear and a Bankart (anterior) tear.

• A SLAP tear is a tear at the top of the socket where the biceps tendon attaches to the labrum. Symptoms include pain at the front of the shoulder and disability. SLAP tears are common in throwing athletes like baseball pitchers and patients who frequently perform overhead activities like volleyball players. SLAP tears commonly occur with concurrent shoulder injuries and can occur from traumatic impact to the shoulder.
• Bankart tears are the result of anterior shoulder dislocation. Bankart tears occur at the front of the socket. When the humeral head slips out of its socket it tears the labrum resulting in instability which predisposes to another dislocation. Symptoms include a sensation of the shoulder giving out, catching, and locking and an aching shoulder.

Our team at LALL Orthopedics ⁺ will take a history of your shoulder injuries related to sports and understand your occupation to determine how your symptoms interfere with your daily activities. They will perform a thorough orthopedic exam testing range of motion, shoulder stability, muscle strength and pain. They will order x-rays to evaluate the bones, and an MR Arthrogram (MRA) to detect tears and determine the severity of the tear. An MRA is an MRI with contrast injected into the glenohumeral (shoulder) joint; it is the preferred method of evaluating for labrum injuries.

Our team will then form an opinion about the cause of your pain and dysfunction and make recommendations about how to deal with your symptoms. This may include over the counter anti-inflammatory medications, injections of regenerative medicine such as Stem-Cell or Platelet-Rich Plasma (PRP), rest, activity modification and physical therapy. Many tears can be treated without surgery; however, if non-surgical management fails, our team will review minimally-invasive surgical options with you such as arthroscopic shoulder labral repair.