Shoulder Labral Tear
Common in baseball players
What is the labrum?
The labrum is a cartilage encircling the shoulder socket (i.e. glenoid). This cartilage deepens the shoulder socket so that the ball of the shoulder joint securely fits within the socket, and also serves as an attachment point for ligaments that attach to the humerus. The glenoid labrum therefore plays an important role in shoulder stability.
What causes a shoulder glenoid labrum to tear?
Injuries to the glenoid labrum can occur from acute trauma or repetitive shoulder motion. Trauma commonly occurs from a fall, direct blow to the shoulder, or motor vehicle accident. Shoulder dislocations almost always cause glenoid labrum tears. Throwing athletes and weightlifters are two populations whose repetitive shoulder motions commonly result in glenoid labrum tears. Over time, with advanced age, almost all labrums eventually will have a degenerative tear.
What types of glenoid labrum tears are there?
Labral tears can occur in different areas: In the front of the shoulder it is called the anterior labrum (also known as a Bankart tear), most commonly torn in shoulder dislocations. In the back of the shoulder it is called the posterior labrum, which is commonly torn in football lineman or anyone directing a backwards force on the shoulder.
and at the top part of your shoulder, it’s called the superior labrum or SLAP tear. SLAP tears are covered in more detail in their own section on the website.
Symptoms:
Symptoms of glenoid labrum tears include pain (most commonly with overhead activities), weakness, catching, and locking. Patients with large glenoid labrum tears are also more prone to shoulder instability and even shoulder dislocation.
Diagnostic Imaging:
An x-ray is usually ordered to rule out other causes of pain such as arthritis and fracture. An MRI, which is the imaging test of choice when trying to visualize labral tears, may also be ordered.
Non-operative treatment:
The treatment of labral tears depends on the age of the patient, location of the tear, the type of injury, and the success or lack of success of previous treatment. Non-operative management is often the first line treatment and consists of physical therapy to strengthen the rotator cuff muscles and muscles surrounding the scapula, and possibly anti-inflammatory medications (so long as there are no contraindications).
Surgery:
Many patients whose tears have occurred as a result of shoulder dislocations will require surgery, however. The treatment of Shoulder dislocations are discussed elsewhere in this website.
Patients with large tears of the labrum that migrate into the joint and cause mechanical symptoms such as catching and locking are also good surgical candidates. In these patients, the torn portion of the labrum is either repaired or cut out so that the labrum once again resembles a smooth and stable rim that won’t migrate into the joint.
Dr. Steven Lee will perform shoulder arthroscopy when performing surgery on the labrum. Arthroscopy involves making very small one inch incisions over the shoulder and introducing a small video camera into the shoulder joint and other small arthroscopic instruments to remove the arthritic clavicle. Shoulder arthroscopy is minimally invasive and can result in less soft tissue disruption, less pain, and minimal scar formation.
Dr. Steven Lee is part of the teaching faculty for the Lenox Hill Sports Medicine Fellowship (which is the oldest sports medicine fellowship in the country), and is currently the Associate Director at NISMAT, which is the first institute in the country dedicated to sports medicine research. Dr. Lee has many years of experience successfully treating labral tears.
Learn more about scheduling surgery.
Recovery Expectations:
Patients are usually kept in a sling for 5-6 weeks following surgery. Physical therapy and weaning of the sling is usually started around 6 weeks post-op. Therapy helps restore range of motion and strength to the shoulder. Therapy lasts anywhere from 6-12 weeks. Return to normal activity/sports usually takes 4-6 months.
Immediate Post-Operative Instructions
Please refer to the following pages for more information:
*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.
*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.