Labral Tears in the Shoulder by Lindsay Young
About the Shoulder
The shoulder is a joint that has an incredible amount of mobility, however this does not come without its own set of problems. The bony stability of the shoulder is similar to that of a golf ball sitting on a golf tee…very little. Overlying the bone in the shoulder is a layer or cartilage and then on top of this something called a labrum. The labrum acts to increase the surface area of the joint as well as suction the joint together and provide a point of attachment for surrounding ligaments and muscles.
Injury
The labrum can be injured during trauma (such as a fall onto an outstretched hand or shoulder dislocation) or from overuse such as an overhead athlete who repeatedly throws. People suffering a labral tear with often report symptoms of pain, lack of shoulder mobility and or instability of the shoulder as well as clicking, clunking and catching. Orthopaedic testing can be carried out by your surgeon or physiotherapist to help diagnose a labral tear but the most reliable diagnostic tool is an MRI arthrogram.
The most common type of labral tear is a SLAP lesion (Superior Labrum Anterior to Posterior) which is typically when the arm is overhead the long head of the biceps tendon rips the superior portion of the labrum from the front to the back.
Recovery
The labrum has no blood supply so once it is torn it cannot repair itself and the stability of the shoulder is then compromised. Small labral tears can be managed conservatively by restoring poor muscle control around the shoulder and modifying load. Depending on the future function required from the shoulder, most large labral tears go on to be surgically managed via arthroscopic surgery which requires a period of rehab afterwards lasting between 6-12 months.
Lindsay Young
Master Physiotherapist
