Shoulder Labral Tear

The shoulder labrum is a rim of thickened tissue that surrounds the rim of the shoulder socket. The labrum is important because it deepens the shoulder socket and functions as an anchoring point for the supportive ligaments surrounding the shoulder joint. Labral tears are common sports injuries where the labrum is partially or completely detached from the underlying bone. Symptoms of labral tears include clicking, pain and a feeling of instability in the shoulder joint with certain movements. An MRI arthrogram in which a small amount of contrast in injected into the shoulder joint prior to the MRI scan is the confirmatory test. The contrast is important because it allows clear delineation between the labrum and the underlying bone. Treatment of labral tears focuses on surgical reattachment of the torn labral fragment back to the bone using bone anchors and stitches. This outpatient procedure is done using minimally invasive arthroscopic techniques. Rehabilitation takes roughly 3-9 months depending on the tear and expected post-surgical activity level. A progressive therapy program is critical in achieving a good outcome and most patients have excellent return of function after repair.

Anterior labral tears are common after partial or complete shoulder dislocations. The supportive ligaments are avulsed (torn away) from the bone along with a sleeve of labral tissue. Patients with this type of tear usually complain of a feeling of laxity or instability in their shoulder when their arm is in a throwing position.

Superior labral tears are also referred to as SLAP tears. They occur when the anchor of the biceps tendon is avulsed from the upper portion of the glenoid. Patients with this type of tear complain of clicking in their shoulder and pain with arm rotation.