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 labral 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.
The labrum can be injured in a number of different ways. Sometimes trauma or an accident can cause a labral tear. Other times, repetitive stress and strain can result in a torn labrum. These include, but are not limited to sports injuries, weightlifting with poor technique, repetitive throwing, falling, auto accidents, or a forceful blow to your shoulder.
A labral tear may cause you to feel pain over the top of your shoulder, "popping," "clunking," or "catching" with shoulder movement, shoulder weakness, or a sensation that your shoulder joint will pop out of place. Some movements that can be painful with labral tears include reaching, lifting, or pressing overhead. There are a series of clinical tests that a physical therapist can perform to determine if the labrum is torn. these include the apprehension test and relocation test.
If you have a painful labral tear, the first common-sense recommendation is to take a short break from aggravating activity. This creates an environment for irritation to settle down and the labrum to heal. If pain is persistent, hands-on therapy to mobilize the shoulder and soft tissue can be effective for pain relief. Once pain is under control, you can get to work on rehabilitation.
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, faulty movement mechanics can lead to shoulder pain. The best way to know what is contributing to shoulder pain is to have an assessment performed.
If you have weakness, learning how to activate muscles that are not firing well is key. Exercises like a pullover and side-lying shoulder rotation can be effective for developing lat and rotator cuff control. Once muscles engage better, the next step is developing strength with compound movements. When performed with good technique and proper tension rows, push-ups, pulldowns/pull-ups, and presses can create a good base of shoulder strength. Exercises like the kettlebell armbar and Turkish Get-up will develop more dynamic control of the shoulder. Most of these movements can be found in our video library.
When addressed with a specialized physical therapy program, overcoming a torn labrum is possible. However, ignoring pain and engaging in repetitive activity can create a more serious shoulder condition. If you have concerns about a torn labrum the physical therapists at Movement Solutions would be glad to be a resource for you.
We offer a free guide on relieving shoulder pain that can give you further insight into shoulder problems and help kickstart your recovery.
If you want help, you can request a shoulder consultation with one of our specialists. This is an opportunity to ask questions, obtain clarity about your shoulder pain, and foster confidence that we can help you. If you’re certain that we’re a good fit to work together, you can decide on the next step.
If you’re in pain but unsure about what you should do, call us at (864) 558-7346 and ask how we can help.