Shoulder Labral Tear

The labrum is a cuff of fibrocartilage that surrounds the shoulder to help stabilize the ball of the joint. A shoulder labral tear refers to a tear of the labrum, which can result from an injury or wear and tear.

Symptoms

The symptoms of a torn shoulder labrum can range from mild to severe, depending on the size of the tear and the cause.
Shoulder labral tear symptoms may include:

  • Shoulder or arm pain when moving or at rest
  • A catching sensation in the shoulder
  • Arm or shoulder weakness
  • A popping sensation
  • Grinding sensation with movement
  • Loss of range of motion in the shoulder

Pain tends to be more severe when acute injury causes the labral tear. Shoulder pain tends to be mild and worsens gradually if the tear results from degenerative changes from everyday wear and tear.

Causes

A shoulder labral tear can occur suddenly as the result of trauma or gradually due to degenerative changes or everyday wear and tear.
Common causes of labral tear (shoulder) include:

  • Falling onto an outstretched arm
  • Accidents, such as motor vehicle or sports
  • Shoulder dislocation
  • Forceful movements that pull the arm, such as catching heavy objects
  • Repetitive shoulder motions
  • Degenerative changes due to aging

Risks

Anyone can suffer a torn shoulder labrum. Factors that can increase the risk of a labral tear include:

  • Participating in sports that require repetitive overhead motions
  • Having an occupation that involves repetitive shoulder motions or heavy lifting

Diagnosis

To diagnose a torn shoulder labrum, your doctor will first want to discuss details of your medical history. This may include:

  • A description of your symptoms
  • When your symptoms first started
  • Whether or not a specific activity or event caused your pain
  • What aggravates your symptoms

Your doctor will also perform a physical examination to check for any signs of trauma, such as bruising or inflammation, and to check your range of motion and shoulder strength by manipulating the shoulder into different positions. He or she will also check for weakness in the shoulder or arms.
Imaging tests are also used to diagnose shoulder labral tears. These include:

  • X-rays.
    These images are able to clearly show damage in the bones, including bone spurs, and narrowing of the joint space associated with osteoarthritis. Shoulder X-rays are often the first imaging test ordered to rule out other causes of your symptoms, such as fractures or arthritis. Labral tears will not show on an X-ray.
  • Magnetic resonance imaging (MRI).
    This procedure is the preferred imaging test for diagnosing shoulder injuries. MRI uses a powerful magnetic field and radio waves to create highly detailed images of soft tissues such as the labrum. A contrast material (dye) may be injected into the shoulder to highlight damaged tissue.

Options

There are several options for treating a shoulder labral tear. In most cases, the least invasive methods will be used first. These can include a combination of the following:

  • Rest.
    Limiting use of your shoulder and avoiding activities that aggravate the shoulder may help relieve your symptoms and prevent further injury.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs).
    These include over the counter and prescription medications, such as ibuprofen and naproxen, to relieve pain and reduce inflammation.
  • Physical therapy/exercise.
    Specific exercises can strengthen the shoulder and improve your flexibility and range of motion. Physical therapy can also relieve pain and other shoulder labral tear symptoms, such as stiffness.
  • Corticosteroid injections.
    A combination of cortisone and a numbing agent is injected directly into the shoulder for quick relief of pain and inflammation.
  • Surgery.
    Surgical labral tear repair can be performed using arthroscopy, which is minimally invasive. Shoulder arthroscopy is performed by inserting a thin tube with a fiber optic camera on the end into a tiny incision that allows the surgeon to view and repair your injury. We combine this procedure with regenerative medicine and denervation to help our patients get back to their active lives as quickly as possible.

Labrum tear recovery depends on factors such as the size of the tear, your anatomy, and also the treatment used.

Surgery is only recommended when the shoulder labrum tear is large or caused by acute injury, or when less invasive treatments have been tried for at least six months without an improvement in symptoms. Your doctor may also recommend surgery if your shoulder continues to dislocate or if the tear is preventing you from working or participating in your usual physical activities.