What is a labral tear?
The labrum is a soft piece of connective tissue that helps to cushion and stabilize the three bones that make up the shoulder joint. If the labrum becomes damaged, the result is a labral tear. Labral tears are also known as glenoid labrum tears because they affect the tissue surrounding the shallow socket of the shoulder blade called the glenoid.
Two different types of labral tears exist: SLAP tears (Superior Labrum from Anterior to Posterior) and Bankart tears. SLAP tears occur near where the biceps tendon attaches to the shoulder and are most commonly seen in athletes, often baseball players. Bankart tears are seen when shoulder dislocation occurs. In the event that the humerus becomes shifted, it can cause the shoulder to become unstable and result in a tear to the ligament attached to the bone. This type of tear occurs most often in young children.
What are the causes of a labral tear?
The main causes of a labral tear include:
- Direct blow to the shoulder joint
- Traumatic fall on the shoulder
- An abrupt pull or overhead reach with the joint
- Repetitive shoulder motions that can cause wear and tear over time
Lifting a heavy object or trying to break a fall are examples of traumatic injuries to the shoulder than can cause the labrum to tear. Athletes and weightlifters are susceptible to labral tears due to the overuse of the shoulder joint.
What are the symptoms of a labral tear?
Symptoms of a labral tear include:
- Pain and discomfort in the joint
- Loss of strength or stability in the joint
- Reduced range of motion and flexibility
- Popping, grinding or locking of the joint
- Pain when lifting the arms over the head
Many of the symptoms experienced with a labral tear are similar to other conditions that affect the shoulder. If you have sustained an injury to your shoulder or suspect you may have a labral tear, it is crucial to have your condition diagnosed by a physician.
How is a labral tear diagnosed?
Labral tears cannot be diagnosed with one test alone. If you are experiencing symptoms and have recently suffered traumatic injury to your shoulder, you should make an appointment with your physician. Your physician will perform a physical examination of your shoulder and evaluate the strength, mobility and stability of your joint.
Specific tests such as X-rays, CT scans and a MRI may be ordered to get a detailed image of the damage. In many cases, X-rays alone do not have the ability to show certain labral tears; therefore other scans are needed to provide valuable evidence. Arthroscopy is a reliable method of confirming a labral tear diagnosis. From there, if a tear is detected, it can be corrected with the use of arthroscopic surgery.
How is a labral tear treated?
Most labral tears are treated with surgical measures. Some individuals choose to pursue nonsurgical methods first such as rest and rehabilitation exercises. Pain can be alleviated with anti-inflammatory medications. If conservative methods are not successful, surgery is typically recommended.
Labral tears are corrected with arthroscopic surgery. Regional nerve blocks are the most common form of anesthesia used for this procedure. A light general anesthetic may also be administered to make the patient more relaxed. An arthroscope is used to repair or removed the damaged tissue, as well as to restore stability and reattach the damaged connective tissues to the shoulder joint.
Many individuals may be referred to a physical therapy treatment plan after surgery to help restore strength and mobility to their shoulder.