What is the labrum?
The shoulder joint is a ball and socket joint and is composed of three bones: the shoulder blade (scapula), the collarbone (clavicle) and the upper arm bone (humerus). The head of the humerus rests in a shallow socket in the shoulder blade called the glenoid. The labrum is a cuff of cartilage that circles the shallow socket or glenoid, to make the socket deeper, so that the head of the humerus fits better.
The function of the labrum is to:
- Create a deeper socket for the humerus
- Allow for a wide variety of shoulder movements
- Serve as an attachment site for several ligaments
What causes the labrum to tear?
The labrum can tear as a result of a direct injury to the shoulder or repetitive shoulder motion that can occur through activity or sports. Examples include:
- Falling on an outstretched hand
- Weightlifting
- Baseball pitchers or any throwing athletes
- Golfers
- Direct blow to the shoulder
- Lifting a very heavy object
Symptoms:
- Catching or “pop” sensation in the shoulder during certain movements
- Aching sensation in the shoulder joint
- Pain with overhead activities
Diagnosis: Your physician will take a detailed history and do a thorough examination of your shoulder. You may or may not associate your pain with a specific injury. Labral tears are difficult to see, even with imaging studies. In general, your physician will obtain baseline x-rays to look at the structure of your shoulder and rule out other reasons for your pain. Because x-rays only show bone and the labrum is soft tissue, x-rays will not determine if the labrum is torn. He/she may order a CT or an MRI at the Imaging Center, but often a labral tear can only be detected by inserting a small camera into your shoulder through a small incision, called an arthroscope.
Common types of labral tears:
- SLAP tears. The tear occurs at the top of the shoulder socket where the biceps tendon attaches to the shoulder. Common in overhead throwing athletes such as baseball and tennis players.
- Bankart lesion. When the shoulder comes out of its joint, or dislocates, the labrum tears or detaches from the rim of the glenoid socket and also involves injury to the inferior glenohumeral ligament. A Bankart lesion makes the shoulder more susceptible to future dislocations.
Treatment options:
Non-surgical treatment: Initial treatment may include rest and anti-inflammatory medications to control pain and relieve symptoms. Your physician may instruct you in strengthening exercises or refer you for formal Physical Therapy. If these measures fail to relieve your symptoms, then your physician may recommend arthroscopic surgery to further evaluate the labrum and treat any tear that may be present.
Surgical treatment:
Your physician will make a small incision and use an arthroscope to visualize the shoulder. The surgical procedure that your physician performs will be determined by your specific injury. The procedure that is performed can vary from a debridement (cleaning out) of the tear to more extensive surgery, which may include reattachment of the torn labrum and ligaments.
Rehab following surgery:
In general, your shoulder will be in a sling for 3-4 weeks following labral surgery. During this time, you will be instructed in gentle, range of motion exercises. When the sling is discontinued, your physician will instruct you in strengthening exercises and if indicated, refer you to formal Physical Therapy.
