Labral Tear Shoulder Treatment
As recently as 20 years ago, it was difficult to diagnose and effectively provide labral tear shoulder treatment. But advancements in arthroscopy are now allowing doctors to use miniature cameras to see labral damage and repair it surgically.
Anatomy of a Labral Tear
The ball of the upper arm bone is usually much larger than the socket, and a soft fibrous tissue rim called the labrum surrounds the socket to help stabilize the joint. If the joint receives significant impact or repetitive stress, a labral tear can occur.
The kind of injuries that may cause a labral tear include:
- Falling on an outstretched arm (sliding into base)
- A direct blow to the shoulder (football)
- A sudden lift of too much weight (weighlifting)
- A violent overhead reach (basketball/baseball)
Any time a shoulder “dislocates” there’s nearly a 100 percent chance that a labral tear has occurred.
Labral Tear Symptoms
Symptoms of a labral tear can include:
- Pain, usually with overhead activities
- Catching, locking, popping or grinding
- Occasional night pain or pain with daily activities
- A sense of instability in the shoulder
- Decreased range of motion
- Loss of strength
Diagnosing a Labral Tear
You doctor will ask you if you remember a certain point at which the pain began. If clinical signs of a labral tear are present in your shoulder he or she will likely order an MRI arthrogram to detect a labral tear since X-rays cannot detect soft tissue injury.
Your doctor will perform physical examination that checks for range of motion, instability and pain. Ultimately, your doctor will rely on arthroscopy for final diagnosis and treatment.
Labral Tear Shoulder Treatment Options
Non-Surgical Treatment
Initially treatment for a torn labrum may consist of anti-inflammatory medication and rest. Rehabilitation exercises to strengthen the rotator cuff muscles, which helps stabilize the injured shoulder, may also be recommended.
If these conservative measures are insufficient, your physician may recommend arthroscopic surgery to repair the labral tear.
Surgery
During labral tear arthroscopy, the doctor will examine the entire labrum. If the labral tear appears to be unstable with detachment of the labrum from the socket of the shoulder, the surgeon will repair the labrum back to the socket of the shoulder.
If the tear involves only a flap of tissue torn from the labrum without detachment of the labrum from the underlying bony socket of the shoulder, the surgeon may just shave the flap of tissue away from the underlying intact labral tissue.
If the labral tear occurs at the site of the biceps tendon (SLAP lesion) or if the tear extends into the biceps tendon, the surgeon will sometimes need to repair the labral tear and reattach the tendon using absorbable tacks, wires, or sutures.
In cases where the labral tear is associated with shoulder instability or dislocations, the surgeon will not only repair the labrum but will also tighten up the stretched-out ligaments of the shoulder as well as tighten up the capsule to restore joint stability.
Recovery After Labral Tear Shoulder Surgery
After surgery, you will need to wear a sling for three to four weeks. Your doctor will also prescribe gentle, passive, pain-free range of motion exercises to keep the shoulder capsule from becoming stiff. When the sling is removed, you will need to do motion and flexibility exercises which gradually strengthen your biceps, rotator cuff muscles and other surrounding muscles.
Athletes can usually begin doing sport specific exercises eight to 12 weeks after repair, as it will be three to four months before the shoulder is fully healed.