Everything you need to know about a torn shoulder Labrum

The Labrum are sections of soft cartilage that line the ball-and-socket joints of the shoulders and hips. The labrum helps guide movement of the joint and provides stability. When the shoulder labrum becomes torn, it can cause pain or a sensation of popping or clicking.

There are several types of torn shoulder labrum, including:
– Bankart lesions or tears
– Superior labrum, anterior to posterior (SLAP) tears or lesions
– Posterior shoulder instability

Bankart lesions or tears are common in younger people who dislocate their shoulder. This type of torn labrum occurs in the lower portion of the glenoid socket. A person who has sustained a Bankart tear may feel as though their shoulder could fall out of place if they move their arm in a certain way.

SLAP tears go from the front to the back of the cartilage in the middle of the glenoid. Among athletes, this tear is more likely to occur in those who play tennis, baseball, or softball, as these sports involve quick snapping arm movements over the top of the shoulder.

Posterior shoulder instability tears occur in the back of the glenoid socket. They can occur due to a severe injury or if a shoulder dislocates posteriorly.

A common symptom of a torn shoulder labrum is pain. A person may also experience the following symptoms:
a popping sound or feeling when moving the shoulder
a grinding sensation when moving the shoulder
the sensation that the shoulder is catching
the shoulder locking
decreased range of motion
a feeling of instability in the shoulder
loss of strength in the shoulder

Nonsurgical treatment

a doctor popping the shoulder back into place if it is dislocated
over-the-counter (OTC) pain relievers and anti-inflammatories
resting the shoulder
physical therapy
cortisone injections

Surgical treatment

Surgery for a torn shoulder labrum can often be performed arthroscopically, using minimally invasive techniques. Depending on the type of tear and the severity, the labrum and ligaments may need to be reattached to the bone using sutures and anchors. In severe cases, a surgeon may need to perform open surgery to repair the tear, though this is rare. This form of surgery requires the surgeon to make a larger cut in the skin to allow greater access to the damaged area.

If your symptoms are not properly managed by a nonsurgical treatment, shoulder labrum tear surgery may be required to correct the injury. There are 3 main forms of shoulder labrum surgery that can help alleviate symptoms. Some of the most common surgeries include arthroscopic labrum surgery, shoulder labral repair surgery, and open shoulder labrum surgery.

Arthroscopic Labrum Surgery

Arthroscopic labrum surgery is used to treat the symptoms from a shoulder labrum tear. In cases of a small shoulder labrum tear, removal of the damaged edges of the labrum and any loose parts within the shoulder can adequately treat a torn labrum. Arthroscopic labrum surgery is also known as labral debridement surgery.

Shoulder Labral Repair Surgery

In a more severe case of a torn shoulder labrum, the labrum itself may need to be fully repaired rather than having the ends removed. Staples may be applied to the torn labrum to help promote healing. These staples are designed to secure the labral tissues to the glenoid. Shoulder labral repair surgery is often performed through an arthroscope for a less invasive surgery.

Open Shoulder Labrum Surgery

Some patients may require open shoulder labrum surgery, which is performed through a large incision without the use of an arthroscope. While a larger incision makes for a more invasive shoulder labrum surgery, many patients experience a dramatic improvement of their symptoms and regain proper functionality of their arm. Patients undergoing open shoulder labrum surgery may require additional time to fully heal after surgery.

Physical therapy is suggested even after undergoing a nonsurgical treatment for a torn shoulder labrum. Physical therapy for a labrum tear is designed to help increase the strength and control of the shoulder muscles and tendons. By strengthening the rotator cuff, physical therapy can help the shoulder to become more stable. After your physical therapy sessions end, your physical therapist will create an at-home exercise plan that you can continue to help promote a healthy shoulder.

If you have undergone shoulder labrum tear surgery, recovery time may be longer. Physical therapy can help to protect the labrum during this time of healing. The initial exercises and physical therapy sessions will be designed to reduce pain and inflammation. In cases of arthroscopic shoulder surgery, physical therapy may progress more quickly, as patients generally heal at a faster rate due to the less invasive surgery. Immediately following shoulder labral tear surgery, your physical therapist will start by introducing passive exercises. Passive exercises are where your physical therapist or a machine will move your arm and shoulder gently so that the joint is exercised while the muscles stay relaxed.

Strength training and active exercises are introduced approximately 6 weeks following the day of your glenoid labrum tear surgery. These exercises are designed to help you move your arm and shoulder independently and rebuild strength. 2-3 months after your shoulder surgery, your strength exercises will slowly become more complicated and difficult. This helps to rebuild strong, healthy muscles of the arm and shoulder. Strength exercises also can help treat shoulder instability. As your physical therapy sessions end, your physical therapist will provide you with a list of at-home exercises that you can continue to reduce any future shoulder pain or discomfort.