The labrum is a piece of fibrocartilage (rubbery tissue) attached to the rim of the shoulder socket that helps keep the ball of the joint in place. When this cartilage is torn, it is called a labral tear. Labral tears may result from injury, or sometimes as part of the aging process. Symptoms and treatment vary depending on the type and severity of the tear.
The two most common types of labrum tears are:
- Bankart Tear. The Bankart tear occurs near the front and bottom portion of your labrum, and frequently occurs when your shoulder dislocates.
- SLAP Tear. SLAP is an acronym for Superior Labrum, Anterior to Posterior. This is a tear in the upper portion of your labrum where your long biceps tendon attaches.
Your labrum in your shoulder can be injured in a number of different ways. Sometimes trauma causes a shoulder labrum tear. Other times, repetitive stress and strain cause your shoulder labrum to be torn. These include, but are not limited to sports injuries, weightlifting with suboptimal technique, repetitive throwing, falling onto an outstretched hand or onto the side of your shoulder, auto accidents, or a forceful blow to your shoulder.
A shoulder labral tear may cause you to feel pain over the top of your shoulder, “popping,” “clunking,” or “catching” with shoulder movement, shoulder weakness, often on one side, a sensation that your shoulder joint will pop out of place. Some movements that can be painful with labral tears include pain and instability in the front of your shoulder when you reach, lift, or press overhead. In our office we perform a series of special tests to determine if your shoulder labrum is torn. The apprehension test and relocation test are common tests to determine if your shoulder is unstable and a labrum tear may be present.
Once we diagnose a labral tear, our first recommendation is usually to take a short break from the aggravating activity. However, we caution against complete rest because this may lead to muscle atrophy and worsening of symptoms. On the other hand, relative rest allows for an environment for the inflammation to settle down and the labrum to heal. While taking a break usually helps with pain, we know for our patients to get back to the activities that they enjoy, we have to address the root of the issue.
In many cases, labral tears are coupled with poor mobility of the lats and the t-spine. This can be combined with weakness of the rotator cuff and the lat muscles. In addition, if there are imbalances at the core and hip muscles, the way an active person moves can be affected which may lead to faulty shoulder mechanics. However, the only way to know what is contributing to pain and injury is to perform a complete assessment.
When pain and stiffness is found via the assessment, our approach includes manual mobilization to alleviate pain and improve mobility. Improvements can be made very quickly if the right regions are targeted. If weakness is found, we teach activation exercises to help our clients better engage muscles that are not firing well. Once pain is controlled and muscles engage better, our next step is teaching our patients to develop stability of the shoulder girdle with resistance. We know for the labrum to become durable at less prone to future injury, proper movement must be taught and a well designed strength and conditioning program must be initiated.
When addressed with a through physical therapy assessment and plan of care, impingement syndrome is a condition that can resolve relatively quickly. However, any sort of repetitive activity with poor mechanics can develop into a severe tear that may require surgery. If you feel like you may have a labrum tear, the physical therapists at Movement Solutions would be glad to be a resource for you. We can begin the process with a free 15-minute phone consultation to talk about how your shoulder is affecting you. If your concerns warrant an in-person consultation, we offer a free Discovery Visit. This gives us the opportunity to examine your injury, provide you clarity about your condition, and instill confidence that we can help. Call us today at (864)-558-7346 and ask us how we can restore your active lifestyle.