What Is a Torn Labrum?
A torn labrum is an injury to the ring of cartilage in a ball-and-socket joint, notably the shoulder but also the hip. The labrum (plural, labra) runs around the inside edge of the socket—the opening that receives the bone. In the shoulder, this opening is called the glenoid cavity or glenoid fossa.
The labrum acts as a cushion for the bone that sits in the socket (the femur in the hip or the humerus in the shoulder) and helps keep that bone secure in its socket. Additionally, the labrum is where a number of ligaments—connective tissues—anchor themselves.
The shoulder is a very mobile joint, but that mobility comes at the price of stability. Therefore the shoulder labrum has a greater risk of tearing than the hip labrum, since the hip is a more stable joint.
Two Types of Tears
The two most common types of labrum tears in the shoulder are the superior labrum from anterior to posterior (SLAP) tear and the Bankart tear. The SLAP tear occurs at the front of the shoulder where the biceps tendon connects to it. The Bankart tear is usually the result of a shoulder dislocation and can occur at either the front or the back of the shoulder, depending on which way the humerus moves during the dislocation.
Symptoms and complications of a shoulder labrum tear include:
- Catching, locking, popping or grinding of the shoulder joint
- Decreased range of motion
- Instability of the shoulder
- Loss of strength in the shoulder
- Pain, especially when raising the arm overhead
- Shoulder dislocations
A torn labrum may be the result of an acute injury or repetitive motion over time. Some possible causes include:
- Falling onto an outstretched arm
- Lifting a heavy object overhead
- Receiving a blow directly to the shoulder
Athletes who throw a ball often, such as pitchers in baseball or quarterbacks in football, are especially prone to torn labra, as are weightlifters.
Doctors will usually start with a medical history and physical exam to determine if any acute injury is causing the shoulder pain. Imaging studies that show soft tissue, such as computed tomography (CT) or magnetic resonance imaging (MRI), can reveal damage to the cartilage.
Treatment and Recovery
Conservative, nonsurgical treatments can often relieve symptoms and stabilize the shoulder. Rest, physical therapy and nonsteroidal anti-inflammatory drugs (NSAIDs) are the main conservative treatments for a torn labrum.
Surgery may be necessary if conservative treatments do not prove helpful. Surgery can be performed arthroscopically—with very small incisions, small tools and a flexible camera attached to a video monitor—or as an open surgery, with one larger incision.
The surgical procedure varies based on how much damage has been done to the labrum and the surrounding structures. If the damage is confined to the labrum, the surgeon removes the torn piece. If the biceps tendon has been damaged or detached, the surgeon repairs or reattaches it using screws or sutures.
After surgery, the shoulder needs to be kept immobilized in a sling for three to six weeks. Once the sling is removed, physical therapy designed to strengthen the shoulder and increase its range of motion can begin. Normal activity can be resumed after about 12 weeks, and the shoulder should be fully healed in four to six months.
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