Shoulder Labral Tear

A shoulder labral tear refers to a condition in which the ring of fibrocartilage surrounding the glenoid (shoulder socket) in the scapula (shoulder blade) has been torn.

The shoulder joint is a large ball and socket joint in which the rounded head of humerus fits into the glenoid, a shallow socket in the shoulder blade. A thick band of cartilage, known as the labrum, surrounds the glenoid and deepens it to accommodate the larger head of the humerus. Firmly attached to the socket as well as several shoulder tendons and ligaments, the labrum aids in maintaining the stability of the shoulder.

Labral tears may be caused by a direct trauma, or develop as a result of the chronic stress of certain repetitive shoulder movements. A labral tear can occur in the following situations:

• A Fall on an outstretched arm
• A Fall on the shoulder
• Lifting a heavy object
• Violently bracing the arm in an outstretched or overhead position
• Repetitive overhead shoulder activities like throwing a baseball or lifting weights

Symptoms of a labral tear may range from mild to severe. A labral tear can produce feelings a sharp pop or catching sensation in the shoulder during specific movements. It may also cause acute pain with overhead arm activities, as well as a vague aching shoulder pain that is difficult to describe or pinpoint.

Many individuals with labral tears have other shoulder injuries. Furthermore, an injured labrum can compromise joint stability and lead to additional shoulder damage.

As there are many causes for shoulder pain, a labral tear can be very difficult to identify. The doctor will begin evaluating the shoulder by taking a thorough history of the injury and performing a physical exam. The doctor will check which shoulder movements are causing pain while assessing range of motion, and any muscle weakness. Imaging tests, including ones using a contrast medium, are often ordered to check for tears and to rule out other shoulder disorders. An arthroscopic procedure on the shoulder joint might be necessary to confirm the presence of a labral tear.

Treatment depends on the needs of the individual and the severity of the injury. Often the initial approach is to see if conservative therapy can address the pain and the inflammation, as well as restore function. When symptoms persist or worsen, the doctor may recommend arthroscopic surgery.

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