Labrum is soft cartilage that lines the ball-and-socket joints of the shoulders. This cartilage encircles the glenoid, a cavity in the shoulder blade, providing protection and stability to the shoulder.
A tear can occur anywhere that the labrum connects to the glenoid. Common causes of a torn shoulder labrum include overuse of the shoulder or trauma to this joint. A labrum tear can make a shoulder weaker and less stable, as well as causing pain.
Keep reading for more information about the different types of torn shoulder labrum, including the symptoms that they cause and how people can treat them.
There are several types of shoulder labrum tear, including:
- Bankart lesions or tears
- superior labrum, anterior to posterior (SLAP) tears or lesions
- posterior shoulder instability
Bankart lesions or tears are common in younger people who dislocate their shoulder. This type of torn labrum occurs in the lower portion of the glenoid socket.
A person who has sustained a Bankart tear may feel as though their shoulder could fall out of place if they move their arm in a certain way.
SLAP tears go from the front to the back of the cartilage in the middle of the glenoid. Among athletes, this tear is more likely to occur in those who play tennis, baseball, or softball, as these sports involve quick snapping arm movements over the top of the shoulder.
Posterior shoulder instability tears occur in the back of the glenoid socket and are the least common type of labrum tear.
These tears account for approximately 5–10% of all shoulder instability injuries. They can occur due to a severe injury or if a shoulder dislocates posteriorly.
Alternatively, this form of tear can indirectly occur as a result of other injuries or symptoms, such as electrocution or seizures, which cause sudden shoulder movements.
The most likely causes of a torn shoulder labrum include overuse from a repetitive motion or trauma to the shoulder.
Athletes who play tennis, softball, or other sports that involve lifting the arm over the head to perform an action have a higher risk of repetitive motion injuries.
However, anyone can injure their shoulder due to an accident. Some common causes of a torn shoulder labrum include:
- a hard pull on the arm
- falling onto an outstretched arm
- a direct hit to the shoulder
It may not always be possible to prevent a shoulder labrum tear. However, a person can take steps to reduce the risk, for example, being careful when climbing a ladder or walking up or down steep stairs.
A common symptom of a shoulder labrum tear is pain. A person may also experience the following symptoms:
- a popping sound or feeling when moving the shoulder
- a grinding sensation when moving the shoulder
- the sensation that the shoulder is catching
- the shoulder locking
- decreased range of motion
- a feeling of instability in the shoulder
- loss of strength in the shoulder
Torn labrum injuries often occur at the same time as other shoulder injuries. These can include torn biceps tendons, rotator cuff injuries, and dislocation.
A doctor will likely check the shoulder and arms for signs of other injuries to help determine the best course of treatment.
A person who has a shoulder injury should see a doctor for a physical examination. Anyone who plays a sport that requires them to reach their arm over their head frequently should see their doctor if they experience pain.
During the examination, the doctor will often start by assessing the person’s range of motion and pain level, as well as the stability of the shoulder.
The doctor may order X-rays to examine the shoulder and look for other injuries to the bones. They might also order an MRI scan to check for damage.
If further examination is necessary, a doctor may perform an arthroscopic examination. During this procedure, the doctor inserts a camera through a small cut in the shoulder. Doing this allows them to examine the inside of the joint on a television screen.
Anyone who plays sports should rest if they have a torn labrum.
There are several possible treatment methods for a labrum tear, including both surgical and nonsurgical options. Doctors only tend to recommend surgery if other methods of treatment are not working or if the shoulder is not healing properly.
Some nonsurgical options include:
- a doctor popping the shoulder back into place if it is dislocated
- over-the-counter (OTC) pain relievers and anti-inflammatories
- resting the shoulder
- physical therapy
- cortisone injections
Most people with a torn labrum will not require surgery to repair the injury. When a tear does require surgery, a surgeon will typically use a procedure called arthroscopic surgery, which people often refer to as keyhole surgery.
Arthroscopic surgery involves inserting a long thin tube called an endoscope through a small cut near the shoulder joint. The endoscope contains a camera, magnifier, and light, and the surgeon will use it to examine the damage to the labrum.
If necessary, the surgeon will create another incision through which they can insert additional instruments to trim or remove the damaged part of the labrum or reattach it to the bone.
In severe cases, a surgeon may need to perform open surgery to repair the tear, though this is rare. This form of surgery requires the surgeon to make a larger cut in the skin to allow greater access to the damaged area.
Recovery from a torn shoulder labrum can vary depending on:
- the location of the tear
- the severity of the tear
- whether surgery is necessary
- whether surgery is keyhole or open
The American Academy of Orthopaedic Surgeons note that it can take several weeks to recover from the surgery. It can also take a few days for the incisions to heal.
Following shoulder surgery to repair a torn labrum, a doctor will likely advise a person to wear a sling for a set period following the surgery. Doctors may recommend that athletes wear a sling for the first 4 weeks after the procedure.
According to the Hospital for Special Surgery, a SLAP injury can take between 6 weeks and 2 months to heal while a person receives treatments, such as medications, physical therapy, or cortisone injections.
During the recovery period, a person should avoid using the shoulder as much as possible, which can involve taking a break from playing any sports.
People who receive arthroscopic surgery for a torn labrum will generally experience a quicker recovery and less pain than those who require open surgery.
Athletes may take 6 months to 1 year to recover fully from the injury. Although the injury can have a long-term effect on an athlete’s ability, with effective treatment, the majority can return to at least 80% of their capability before the injury.
A torn shoulder labrum often occurs as a result of overuse or from a blunt force trauma to the shoulder. When a labrum tear occurs, a person will experience shoulder pain, a reduced range of motion, and limited shoulder stability.
Treatment often involves OTC medications, cortisone injections, and physical therapy. Where possible, doctors will recommend nonsurgical forms of treatment. In more severe cases, a torn shoulder labrum may require surgery.
Recovery times vary according to the severity of the injury. In the most severe cases, effective treatment can ensure that most people regain the majority of their ability to compete before the injury.