Shoulder Labral Tear Infographic
The shoulder labrum is a ring of cartilage that surrounds the rim of the shoulder socket, providing stability to the shoulder joint and a cushion to the shoulder during activity. The labrum also serves as an attachment point for other structures in the shoulder, such as the biceps tendon and some ligaments.
A shoulder labral tear occurs when the labrum is disrupted, frayed, or torn, leading to shoulder pain and shoulder joint instability. Labral tears can result from a fall, heavy lifting, or overuse from repetitive work activities or sports that require overhead activity like baseball, softball, and volleyball players and swimmers.
There are three types of labral tears:
The most common labral tear is the SLAP tear or superior labral anterior-posterior lesion. With a SLAP tear, the tear extends from the front to the back of the cartilage in the middle of the glenoid and near where the long biceps tendon attaches to the labrum. This is more likely to occur in tennis, baseball, or softball players as these sports involve quick snapping arm movements over the top of the shoulder.
Bankert tear: this type of tear is more common in younger people who dislocate their shoulder. It occurs in the lower portion of the glenoid socket. During this type of tear, the shoulder moves forward forcefully in the socket and pushes against the front, lower portion of the labrum.
Posterior labrum tear: a rare tear that occurs at the back of the shoulder labrum and may cause the shoulder to dislocate toward the back of the body.
Symptoms of a shoulder labral tear can include pain over the top of the shoulder, a deep ache in the affected shoulder, shoulder weakness and stiffness in the affected shoulder, sensation that the shoulder will pop out of place, and popping, catching, or “clunking” with shoulder movement due to the torn labrum having loose ends that are flipped or rolled within the shoulder joint during arm movement. Symptoms can also decrease the internal rotation of the shoulder, increase pain with overhead activities, and decrease and loss of strength and endurance in muscles that stabilize the scapula.
Physical therapy can help those with shoulder labral tears regain strength, stability, and range of motion in the shoulder joint. Patients are recommended to start with conservative physical therapy treatment, particularly for partial tears, to regain function in the shoulder. Surgery is recommended if conservative treatment fails, the tear is severe, or if athletes plan to return to high-level athletic activity.
If surgery is performed, you will be placed in a sling initially to protect the tissue, especially the healing tissues and fibrocartilage of the labrum. The first month or two post-surgery focuses on regaining range of motion with shoulder movement on your own by weeks 6-8. After 2-3 months, you can progress to strengthening and shoulder stabilization exercises and return to sport and functional training.
Physical therapy treatment for a shoulder labral tear can include:
Manual therapy: hands-on soft tissue and joint mobilizations to decrease pain and restore movement and range of motion in the shoulder joint.
Shoulder stretching exercises: stretching of the shoulder joint, chest, and back muscles to help improve the function of the muscles around the shoulder and avoid muscle tightness. Greater flexibility in these muscle groups allows the body to rotate and twist more easily without forcing the shoulder to overstretch.
Targeted strengthening exercises: strengthening of the shoulder joint and scapular muscles, especially the rotator cuff, to decrease the stress placed on the torn labrum and improve shoulder joint stability.
Core stabilization: strengthening of core and trunk muscles provides a strong base from which the arm and shoulder can function.
Postural training: posture correction and modifications for proper positioning of the shoulder during daily activities to minimize strain on the shoulder.
Dry needling: targeted dry needling of trigger points in muscles around the shoulder, scapula, and back to improve the patient’s ability to move and increase the range of motion that is limited due to muscle tightness.
Patient education: instruction on proper technique during work and sports-related activities to minimize injury risk.
Home exercise program: stretching and strengthening exercises to maintain shoulder joint function.
Post-surgical rehabilitation: control pain and swelling during the acute phase of post-surgical recovery and help patients regain function through a progressive stretching and strengthening program.
Are you experiencing shoulder joint instability and pain after a shoulder labral tear? Work with a physical therapist to address pain and restore strength and mobility in the shoulder safely!
