A labrum tear is also known as a labral or glenoid labrum tear. The humeral head or upper arm bone rests in the glenoid, a shallow socket in the shoulder blade. The humeral head is usually much larger than the glenoid; the labrum, a soft fibrous tissue rim, surrounds the socket to help stabilize the joint and allow it to fit better. It is also an attachment site for several ligaments.
Labrum tears can occur for a variety of reasons including traumatic injury, degeneration due to normal wear and tear, and repetitive shoulder motion. Symptoms of a tear in the shoulder socket rim are similar to those of other shoulder injuries such as:
- Shoulder dislocation
- Shoulder instability
- Overhead activity prompts pain in the shoulder
- Catching, locking, popping, or grinding
- Occasional pain with daily activities and during the night
- Decreased range of motion
- Loss of strength
Several types of labral tears exist including:
- SLAP lesion – SLAP stands for Superior Labrum Anterior to Posterior and is a tear of the labrum that is usually seen on the upper part of the socket.
- Bankart lesion – Usually caused by an anterior shoulder dislocation, this tear is usually of the front part of the labrum at the bottom of the socket.
- Posterior labral tear – A labrum tear that is usually in the back part of the socket.
The labrum deepens the socket of the shoulder joint, making it a stronger fit for the head of the humerus.
Dr. Stowell will ask you about the history of your injury. He will perform several tests to assess your range of motion, stability, and pain. Labrum tears deal with the soft tissue and X-rays will often not show damage to it. Dr. Stowell, may request an X-ray, however, to see if there are any other reasons for your problem. He may also order a CT scan or MRI where a contrast medium may be injected to help detect your tear. Your diagnosis may ultimately be confirmed with arthroscopic surgery.
Until final diagnosis, Dr. Stowell may prescribe anti-inflammatory medication and advise rest to relieve your symptoms. He may also recommend rehabilitation exercises to strengthen your rotator cuff muscles. In many cases, nonsurgical methods can be effective in pain relief and healing. If they prove insufficient, Dr. Stowell may recommend surgery.
During arthroscopic surgery, Dr. Stowell will examine your labrum and biceps tendon. Small unstable flaps may often be simply removed arthroscopically. If your tear extends into the biceps tendon or if the tendon is detached, the biceps tendon may be unstable. Dr. Stowell may need to repair or even transfer the tendon to a safer location using absorbable tacks, screws, or sutures. Tears of the labrum at the bottom half of the socket may result in your shoulder becoming unstable. Dr. Stowell may reattach the labrum and ligaments and tighten the shoulder socket tissue by using small anchors.
After surgery, your shoulder will be kept in sling for 2 to 6 weeks. Dr. Stowell may prescribe gentle range-of-motion exercises. When your sling is removed, you will be advised to do motion and flexibility exercises to gradually strengthen your shoulder. Athletes can usually begin sport-specific exercises 16 weeks after surgery; however, expect about 4 to 6 months before your shoulder is fully healed with return of function occurring completely over the ensuring months.