GUSTAVEL ORTHOPEDICS BLOG

09Jul

How Do I Treat a Labral Tear?

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The shoulder joint is made up of 3 bones: the shoulder blade (Scapula), the upper arm bone (Humerus), the collarbone (Clavicle).

The head of the humerus rests in the socket of the shoulder blade called the Glenoid. The head of the humerus is usually much larger than the socket and is supported by a rim of soft fibrous tissue called the Labrum which surrounds the socket to help stabilize the joint. The labrum is also the attachment place for the ligaments and supports the joint along with the rotator cuff tendons and muscles.

Labrum tears are of 3 main types:

SLAP tear: If the tear is above the middle of the glenoid it is called a SLAP tear or lesion. SLAP means “Superior Labrum, Anterior to Posterior,” which indicates front to back. This kind of injury is common among players who play baseball, tennis, basketball or anyone who uses a lot of overhead arm movements. It may also occur with damage to the biceps tendon.

Posterior labrum tear: It is usually caused due injury to the back of the shoulder joint. Posterior labrum tear is a rare condition and contributes only 5 to 10 % of all shoulder injuries.

Bankart tear: If the tear is on the lower half of the glenoid socket it is called a Bankart tear or lesion. This injury is more commonly seen in younger people with a dislocated shoulder.

What are the causes for Labral tear?

Injuries to the Labrum may occur due to an acute injury or repetitive shoulder movement, like:

  • Direct hit to the shoulder
  • Falling with an outstretched arm
  • A sudden pull while trying to lift a heavy object
  • A sudden and forceful overhead reach

Athletes involved in throwing motions or weightlifting can experience labrum tears as a result of repetitive shoulder motion.

What are the symptoms of Labral tear?

The symptoms of Labral tear are very similar to those of other shoulder injuries. Symptoms may include:

  • Instability in the shoulder
  • Locking, catching, popping or grinding sensation
  • Pain, usually during overhead activities
  • Pain at night or during daily activities
  • Reduced range of motion
  • Loss of strength
  • Shoulder dislocation

What is the treatment for shoulder labral tear?

Nonsurgical method: They are effective in relieving symptoms in patients who are not involved in high impact physical activities. It includes medications, rest and physical therapy. The doctor may also give an intraarticular injection to relieve pain and swelling.

Surgical treatment: If the patient does not get relief from conservative methods or if the patient uses his shoulder a lot, then the doctor may recommend arthroscopic surgery. During the procedure, the doctor examines the Labrum and the biceps tendon. If the injury is confined only to the rim and the shoulder is still stable, the torn flap is removed, and other associated problems are corrected.

If the tear involves the biceps tendon, the shoulder joint is considered unstable. A capsular shift or tightening is performed to stabilize the joint and prevent dislocation.

After surgery, the shoulder has to be supported with a sling for 3 to 6 weeks. You may start physical therapy 2-3 weeks after the surgery. Athletes can usually start sport-specific exercises 12 weeks after surgery, although it may take 4 to 6 months for full recovery.

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