Labrum Tear Overview
The main symptom of a torn labrum is pain.
Your shoulder is a ball-and-socket joint. The rounded top of your arm bone sits in the hollowed-out socket of your shoulder blade like a golf ball on top of a tee. This position makes your shoulder easy to move but also very unstable. The ball can easily slip out of its socket.
A rim of rubbery cartilage called the labrum surrounds the socket and holds your shoulder in place. The labrum is pretty thick, but a hard-enough hit or fall can tear it. That makes your shoulder more unstable than it already is. The ball can more easily pop out of its socket — or dislocate. Dislocations themselves often cause labrum tears.
Here’s information you can use to understand what may have happened to cause the tear and what you can expect in terms of treatment and recovery.
Types of Shoulder Labrum Tear Injuries
There are a few types of labrum tears. The two most common are SLAP and Bankart tears.
- SLAP tears affect both the front and back parts of the labrum. That’s what the name means: superior labral tear from anterior (front) to posterior (back). In this type of injury, the tendon that attaches the biceps muscle to the shoulder may also tear. People who hit or throw balls really hard, like baseball pitchers and volleyball players, can get SLAP tears.
- Bankart tears, named for English orthopedist Arthur Bankart, happen when the top of the arm bone moves forward or backward in its socket and the lower part of the labrum tears. Often young people who've dislocated their shoulder get Bankart tears. This type of labrum tear leaves the shoulder very unstable and likely to dislocate.
- A superior tear refers to a rip in the top of the labrum. Posterior tears are in the back of the labrum. These are less common.
Symptoms of a Labrum Tear
The main symptom of a torn labrum is pain. With a SLAP tear, the pain is in the front of your shoulder. Your shoulder joint may feel unstable, as if the ball could slip out of its socket.
These are a few other symptoms of a labrum tear:
- A popping, catching, locking, or grinding sound when you move your shoulder
- Reduced range of motion in the shoulder
- Stiffness
- Weakness
Causes of a Labrum Tear
Labrum tears are common in athletes who throw a ball or perform other shoulder motions repeatedly. You can also tear your labrum if you fall or hit your shoulder really hard.
Other possible causes of labrum tears include:
- A fall onto an outstretched arm
- A car accident
- A hard pull on your arm when it is above your shoulders
- The gradual wearing down of your labrum as you get older
- Shoulder dislocation
Shoulder Labrum Tear Test and Diagnosis
Your doctor will ask about your symptoms and what you were doing before the injury happened. The doctor may move your shoulder in different directions to check your range of motion and find the source of your pain.
Imaging tests, like an X-ray, MRI, or CT scan, can show the tear and how big it is.
The doctor or nurse may inject dye into your shoulder before certain imaging tests. The dye helps your doctor see the damage to your labrum more clearly.
Arthroscopy offers the clearest view of your shoulder. During this minimally invasive procedure, your doctor inserts a camera into your shoulder. A monitor displays video from the inside of your shoulder for your doctor to view.
Shoulder Labrum Tear Treatment, Exercises, and Home Remedies
Home remedies may be all the treatment you need for a labrum tear. Anti-inflammatory pain relievers, like ibuprofen or naproxen, can help ease pain and bring down swelling. Your arm and shoulder will also need rest so the tear has time to heal.
A physical therapist (PT) can teach you exercises to slowly stretch and re-strengthen your shoulder. You may need to see a PT for up to 2 months.
Labrum Tear Surgery and Recovery
If the tear doesn't improve with home treatment, your doctor may recommend surgery. Doctors perform labrum repair surgery in one of two ways:
- Through an open surgical cut in your skin
- With arthroscopy, through several smaller openings
Which procedure your surgeon chooses depends on the location of your tears. SLAP tears, for example, are hard to fix through a large incision, so arthroscopy may be the best choice.
During a Bankart repair procedure, the surgeon fixes the torn labrum and attaches it to the socket. If the tear affects your biceps tendon, your doctor will trim away the torn part of the labrum and secure the biceps tendon to the bone with stitches or tacks. This will help stabilize your shoulder.
Recovery From Surgery
After surgery, you'll need to wear a sling for 3 to 6 weeks. Your doctor or PT will prescribe gentle exercises to restore range of motion in your shoulder.
Athletes may not be able to fully return to their sport for 6 months or more. Most people do, though, get back their ability to play.