Shoulder Pain: Labrum Tears - Midwest Orthopedic Specialty Hospital

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Published on April 10, 2017

Shoulder Pain: Labrum Tears

By: Joshua Neubauer, MD

If you're suffering from shoulder pain, learn more about treatments on The Edge Blog.Labrum tears can occur from many causes, the most common being an acute traumatic injury or repetitive overhead activity, including sports like volleyball, tennis, or baseball. Falling on an outstretched arm or forcefully pulling the arm away from the body such as lifting a heavy object or catching oneself while falling can also injure the labrum.

Anatomy of a Shoulder

The shoulder is essentially a ball and socket joint. The official term for the socket is the glenoid, which is an extension of the scapula (shoulder blade). The upper part of the humerus, or the bone which goes from the shoulder to the elbow, makes the ball portion of the joint. Structures including the labrum help keep the ball in the socket while also allowing for the wide range of motion of the shoulder. If the socket was completely bone, we would have much less shoulder range of motion. The combination of bone with a fibrous peripheral rim of labrum allows tremendous range of motion while also keeping the humerus in place. A shoulder injury can cause the labrum to pull away from the bone resulting in pain with activity or the feeling that the shoulder may come out of place. In more extreme cases, the shoulder can fully dislocate, which means the rounded "ball" of the humerus no longer sits in the "socket" of the glenoid.

Symptoms of a Labrum Tear

If you have a labrum tear you may experience pain, catching, popping, or a clunk feeling with shoulder range of motion. One may also feel night pain, pain with reaching, loss of range of motion or strength.

A feeling of instability or pain that continues after a period of rest should prompt a visit to an orthopedic physician. The next step will be a thorough history of your symptoms, any specific injury or painful activities you may have, and an exam including tests to evaluate range of motion, stability and strength.

Diagnosing a Labrum Tear

In addition to a physical exam, you can expect your doctor to take X-rays of your shoulder. And, although the soft tissue of the labrum will not show up on the X-ray, the image will show other problems that might be causing your symptoms. If the labrum is suspected to be the problem, more advanced imaging like a CT scan or MRI may be ordered. In some cases, contrast fluid may be injected into the shoulder prior to the test. This fluid then fills in the areas of tearing, making them more apparent on the MRI images.

Treatment Options

In the event you have a labrum injury, treatment options vary from conservative treatment including anti-inflammatory medications and physical therapy to surgical repair. Surgery is usually done via arthroscopy, with a few small incisions made at different points around the shoulder. In surgery, we bring the torn labrum back to where it belongs and reattach it to the bone, recreating the stable shoulder joint. Successful surgery also involves a several week period of rest in a sling to allow the reattached labrum the time needed to fully heal in place. Physical therapy for helping regain range of motion and strength usually begins one to two weeks after surgery. Depending on your level of activity and what your sport or activity demands of your shoulder, you may need three months of healing time with expected return to full activity at six months. The expectation and goal, however, is your return to all activities including sports.

More Information

If you’re suffering from shoulder pain, turn to the experts at Midwest Orthopedic Specialty Hospital.