Your doctor will conduct a complete medical history review and physical exam in order to diagnose a shoulder labrum tear, asking about when symptoms first began and which movements exacerbate them.
CUPERTINO, CALIFORNIA | NOW THEN DIGITAL — The shoulder labrum is a piece of soft tissue that connects the socket (called the glenoid) of your shoulder to the head of the humerus bone, acting like a cushion that keeps everything in its proper place.
Your doctor will ask about your symptoms and perform an exam of your shoulder. An MRI or CT-arthrogram with dye injection into the shoulder may detect tears in its labrum.
Shoulder Labrum Tear Symptoms
Pain
People living with shoulder labrum tears typically experience pain when placing pressure on their shoulder joint, or feeling loose and unstable in their shoulder joint. Sometimes there’s even an audible popping sound when moving it.
The shoulder labrum is a circular piece of cartilage found within the ball-and-socket joint in your shoulder that is supported by tendons and ligaments connecting shoulder blade, upper arm bone, and collarbone tendons and ligaments. Any damage to these structures leads to labrum tear.
Your physician will conduct a physical exam and discuss your symptoms, then move your arm and shoulder through different positions to assess range of motion, pain level and stability of the shoulder joint. They may take X-rays of the area in question to rule out other causes for symptoms like arthritis, pinched nerve or fractures.
Swelling
Labral tears cause inflammation and swelling in shoulder joints. A labrum is not technically considered bone but instead acts as a piece of cartilage connecting the glenoid (part of the shoulder socket) with the head of the humerus; when its protective cushion wears away due to tears in its structure, two bones become vulnerable against one another resulting in pain and inflammation.
Trauma or repetitive shoulder motions can lead to labral tears. Falling on outstretched arms, direct blows to the shoulder or aggressive overhead reaching activities can all cause labral injuries like SLAP tears or Bankart tears in labral tissues.
Your doctor will assess your pain levels and examine the injury area. They may place your shoulder and arm into different positions to test range of motion, stability and strength; manual assessments such as the Clunk and O’Brien tests could be used as well to help detect shoulder labrum tears.
Discomfort
Shoulder labrum tears can be very uncomfortable, especially for overhead athletes or throwers. But pain might not necessarily stem from your labrum itself – instead it might come from other structures in your shoulder joint, like tendonitis or compressed nerves.
Due to labrum tears’ similarity to other shoulder injuries, they’re difficult to diagnose without physical examination. Your doctor will ask about your symptoms and move your shoulder around before performing an arthroscopic exam by inserting a small camera through a tiny cut in the shoulder joint – giving them a clear view of any injured tissue that needs treating nonsurgically – typically using ice, rest and over-the-counter anti-inflammatory medication as remedies.
Loss of Range of Motion
An injury to your shoulder labrum can reduce its range of motion, restricting you from reaching items on shelves or raising your arm over your head easily. If this has happened to you, it’s important to notify your physician as it could be an early indicator of something more serious.
Your doctor will ask about your medical history and perform a physical exam to diagnose labral tears. They may conduct an inspection of the area of injury as well as have you hold different arm positions to test for pain, strength, and stability.
Since labral tears can be difficult to detect, imaging tests such as an X-ray or MRI may be used to view cartilage inside the shoulder joint and identify other issues which might cause symptoms; such as dislocated shoulder or rotator cuff injury.
Loss of Strength
An unstable shoulder labral tear may cause you to experience strength losses when engaging in overhead arm movements, such as throwing a ball or performing other sports that require quick overhead arm motions. This is often apparent when throwing or performing sports that involve quick arm motions like throwing.
Your doctor may perform both a physical examination and take X-rays of the shoulder joint to rule out potential causes for your symptoms. Although soft tissues such as labrum may not show up clearly on these images, X-rays provide valuable diagnostic insight that may identify other conditions which could be contributing.
An arthroscopic exam allows your doctor to conduct a more in-depth exam by inserting a camera into the shoulder joint through an arthroscopic procedure, enabling him or her to view any damage to your labrum and other parts of the joint.
After surgery to repair your labral tear you will usually require rest, pain medication and physical therapy for recovery; including hands on manual physical therapy sessions designed to decrease pain while increasing movement as well as strengthening exercises designed to regain strength.
“If physical therapy fails and the athlete still can’t complete overhead motions, or the shoulder continues to dislocate, surgical treatment might be required to reattach the torn ligaments and labrum to the bone,” says Dr. Fealy, a surgeon at HSS.
Weakness
Labral tears may leave your shoulders feeling weak, with loose or unstable feeling in certain activities such as throwing.
Your doctor will perform a physical exam and order imaging tests to detect labral tears. While x-rays don’t show cartilage directly, they can rule out fractures. Magnetic resonance imaging (MRI) scans or computed tomography arthrograms provide your physician with a more in-depth view of your shoulder joint; you may require receiving an injection of dye during these procedures.
If the labrum tear is only mildly torn, at-home treatment may suffice to alleviate pain and swelling. Anti-inflammatory pain relievers, ice packs and rest can all be effective ways of decreasing swelling and discomfort; your doctor may suggest physical therapy sessions for gradually strengthening and stretching out your shoulder muscles.
Frustration
Your shoulder labrum helps deepen and secure the socket for the ball of your upper arm bone (called the humerus) as well as connecting to various other parts of the joint like the biceps tendon.
Over time, your labrum may become frayed at its edges – this is especially common among older adults – but these tears may not cause symptoms.
When experiencing a superior labral anterior to posterior (SLAP) tear, the front of your shoulder may hurt and feel unstable as you lift your arm overhead. This type of injury often affects baseball pitchers and other athletes who use quick movements that put their shoulders at risk of dislocation; your physical therapist can teach you ways to reduce this risk.
Frequently Asked Questions
Q: What is the shoulder labrum?
- A: The shoulder labrum is a type of rubbery cartilage that lines the shoulder socket (glenoid) of the shoulder joint.
Q: What functions does the labrum serve?
- A: The labrum helps keep the shoulder joint in place and prevents shoulder instability.
Q: What are the different types of labral tears that can occur in the shoulder?
- A: The different types of labral tears include Bankart tear, posterior labrum tear, and SLAP tear.
Q: What symptoms may indicate a torn shoulder labrum?
- A: Symptoms of a torn shoulder labrum can include loss of range of motion, loss of strength, popping, catching, locking or grinding sensation in the shoulder joint, shoulder instability, and shoulder pain.
Q: How are labral tears diagnosed?
- A: Diagnosis of labral tears involves a physical examination by an orthopedic specialist, including tests to check range of motion and a discussion of the patient’s health history and past injuries. Further imaging tests such as X-ray, MRI, CT scan, or musculoskeletal ultrasound may also be required.
Q: What are the treatment options for shoulder labral tears?
- A: Treatment for shoulder labral tears depends on the type and severity of the tear. Conservative methods may include activity modification, anti-inflammatory medication, corticosteroid injections, icing or applying heat, and range-of-motion exercises/physical therapy. Severe tears may require surgery.
Q: How is surgery performed to repair a torn shoulder labrum?
- A: Shoulder arthroscopy, a minimally invasive technique, is commonly used for labral tear repair. A small incision is made, and an arthroscope is inserted to visualize the damage. The surgeon can then trim frayed areas of the labrum or reattach it to the rim of the joint socket.
Q: What is the recovery process after shoulder labrum tear surgery?
- A: After surgery, the arm and shoulder are typically immobilized with a sling for four to six weeks. Physical therapy is initiated once healing begins to help regain mobility. Rehabilitation programs are personalized and can last several months, aiming to restore maximum function and reduce shoulder pain.
Q: How can patients work with their orthopedic team for a successful recovery?
- A: Patients collaborate with pain management specialists, physical therapists, and orthopedic specialists to create a tailored recovery plan based on their condition, surgery type, and individual needs and goals. Long-term rehabilitation is essential for optimal arm and shoulder function and pain reduction.
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