- advancedorthopedics
Shoulder Labrum Tears
Shoulder labrum tears can often be the cause of an unstable shoulder. The labrum is a cartilage ring that surrounds the shoulder joint forming the capsule or “socket” portion of the joint. Injuries to this structure can either be caused by some sort of trauma or by tearing due to repetitive motions.
Cause
There are two main categories for injuries to the labrum: traumatic and nontraumatic. Traumatic labral tears are usually the result of a single incident, usually a shoulder dislocation or injury due to heavy lifting. This usually happens when there is a great deal of weight or force on the arms while it is extended away from the body putting a lot of strain on the shoulder itself. It is also common to injure the labrum as the result of falling on an outstretched arm. A specific type of labrum tear called a “SLAP tear” is very common in baseball and softball players as well as in other sports which involve overhead activities. SLAP stands for Superior Labrum Anterior to Posterior; this means this type of tear occurs at the top of the shoulder labrum and runs from front to back. To learn more about how these injuries can be prevented click here to read an article from Johns Hopkins Medicine. Nontraumatic labral tears are typically the result of muscle weakness or pre-existing joint instability. The muscle weakness puts added strain on the capsule. Often people with nontraumatic labrum tears report “looseness” or increased mobility in their joints.
Signs and Symptoms
Common signs and symptoms of a labral tear include:
Pain at the top of your shoulder
A “popping,” “clunking,” or “catching” feeling with arm movement
One-sided shoulder weakness
The feeling that your shoulder will pop out of place
Treatment
Conservative treatment like physical therapy can be effective when the labral tear is minor. Physical therapy treatments may include:
Manual treatment: this may be useful to decrease pain
Strengthening routine: strengthening muscles around the shoulder will help decrease stress to the labrum. Your physical therapist will focus on prescribing exercises that target the muscles of the shoulder blade, rotator cuff, and surrounding muscles of the shoulder.
Stretching routine: Your physical therapist may prescribe certain stretches to help with movement imbalances which can put added strain on the shoulder joint.
Postural education: certain postures such as a forward head and/or rounded shoulders put you at an added risk for a shoulder injury.
Education: patient education is an important part of treatment. Your physical therapist will help explain your injury, any activity modifications if necessary, as well as the reason and importance of your exercises.
Home exercise program: The exercises prescribed for at home are an important part of the physical therapy process. Strength and tissue changes take time and being consistent with your exercises both in the clinic and at home is the key to success.
Surgical Intervention
Sometimes, if the labral tear is extensive, surgery is required to repair it. Recovery time depends on the type and severity of the tear but usually a surgically repaired labrum takes 9-12 months to heal completely. Your physical therapist will work closely with your surgeon and follow a protocol that will allow the tissues to heal while also helping you regain strength and function as quickly as possible.
How Can Physical Therapy Help?
If you have pain or discomfort in your shoulder a physical therapist can help diagnose your injury and make recommendations for imaging or orthopedic consultations if necessary. Physical therapy is also a vital part of the recovery process post-surgically. Your PT will be able to help you through the recovery process and get you back to all the activities you love! If you would like to talk to one of our physical therapists about how PT can help, schedule a free screen with our office today!
References
Retrieved from https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-shoulder-labral-tear Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/slap-tear-prevention-tips-for-baseball-and-softball-players