The labrum is a piece of cartilage that lines and reinforces a ball-and-socket joint, like the shoulder joint. The diagram to the right illustrates two possible locations labral tears can occur in the shoulder joint.
The shoulder is a ball-and-socket joint: the top of the humerus (upper arm bone) forms the ball and the edge of the scapula (shoulder blade), called the glenoid cavity, creates the socket. The glenoid cavity is extremely shallow and capped by a layer of cartilage called the labrum. The labrum molds the glenoid cavity to the head of the humerus to stabilize the joint. The labrum also attaches to several ligaments and tendons, such as the biceps tendon.
A torn labrum, also known as “thrower’s arm” in young athletes, occurs when the soft tissue of the labrum gets caught between the glenoid cavity and the head of the humerus. Labral tears can result from either acute injury or degeneration over time. Both types of tears are associated with overhead, lifting, pulling, and jerking motions. In individuals under the age of 40, symptomatic shoulder pain is generally the result of a labral tear.
- Acute Injury: acute tears account for the largest percent of labral tears. Common injuries include falling on an outstretched arm, a blow to the shoulder, or a shoulder dislocation.
- Degeneration: degeneration tears are the result of repetitive stress, pulling the labrum farther between the glenoid cavity and the humerus.
Labral tears are commonly seen in athletes who play baseball, golf, football, tennis, or lifting weights.
Symptoms:
- Popping/catching/locking sensation with specific movements
- Loose/unstable feeling in the shoulder
- Deep shoulder pain
- Loss of throwing velocity (in young athletes)
- Loss of or limited range of motion
- Loss of strength
- Pain with:
- Turning a steering wheel
- Lifting objects
- Sleeping on affected side
- Daily activity
If your symptoms last longer than 2 weeks and interfere with daily activity you should consult your primary care physician for a referral.
What To Expect During Your Appointment:
During your appointment, Dr. Betz will perform a physical exam to test range of motion in the shoulder and the arm strength. In-office imaging may be done or an MRI may be set up to diagnose the cause of your pain. Once the results of your imaging come back, Dr. Betz will provide treatment options and help you decide the course of action that is best for you.
Treatment
Dr. Betz performs an in-office exam on the patient to check for range of motion and arm strength.
Non-Surgical Options:
- Rest
- Medication: non-steroidal anti-inflammatories are often prescribed to minimize swelling and pain.
- Physical Therapy: strengthening the shoulder muscles will help relieve pain and prevent further injury. Stretching is also performed to help regain mobility.
- Injections: If the other non-surgical treatments fail, Dr. Betz can use injections to help reduce pain.
- Steroid Injection (Cortisone): steroids are proven to be very effective at reducing inflammation and pain when injected directly into the joint space.
- Platelet Rich Plasma (PRP): your own blood is used to extract platelet-rich plasma, which is then injected into the shoulder joint. The platelets within the plasma stimulate the body to repair itself.
Surgical Options:
If non-surgical treatments fail to improve pain, Dr. Betz will discuss surgery as an option. Each patient and tear is different, but most tears can be treated arthroscopically. For more information on arthroscopic surgery please see “Arthroscopic Surgery”.