Shoulder

Shoulder Labral Tears

The labrum is a ring of cartilage that attaches to and effectively increases the surface of the shoulder joint. It help stabilize your shoulder and serves as point of attachment for your shoulder ligaments and the biceps tendon.

The labrum can be injured by overuse or a single traumatic event. Overuse injuries occur to the superior labrum where the biceps tendon attaches and are known as SLAP tears. Traumatic injuries occur to the anterior labrum.

Symptoms

  • Clicking or popping
  • Sharp pain when you move your arm as the torn labrum is pinched or displaced
  • Sense of instability or apprehension with activity
  • Aching pain

Diagnosis

Labral injuries can be diagnosed by physical examination, but often require further testing, such as an MRI with contrast, so your doctor can collect enough information about the tear.

Treatment

Conservative care to eliminate pain and restore motion is the first step in labral tear treatment. Anti-inflammatory medications and rest are usually recommended. Depending on the size and location of the tear, strengthening is often successful. The focus is typically on exercises to strengthening the periscapular and rotator cuff muscles. Alternative treatments including glucosamine, hyaluronic acid, and non-steroidal anti-inflammatory medications (NSAIDs) are also considered.

When conservative treatment fails, surgical repair can be performed. Large tears usually require surgery to enable a return of shoulder function. This is particularly the case for patients with anterior labral tears that occur along with shoulder dislocations. Anterior labral tears can be fixed arthroscopically or through open surgery. Superior labral tears (SLAP tears) can cause persistent problems for athletes who compete in overhead sports such as baseball, basketball, and volleyball, so surgery may be necessary. These tears can only be treated arthroscopically.