The shoulder joint relies on structures for stability and function. The labrum, a ring of specialized cartilage, deepens the shoulder socket. Damage to this tissue can lead to pain and instability. This article explores how a torn labrum can be addressed, from conservative management to surgical interventions.
What is a Labrum Tear?
The labrum is a cup-shaped rim of cartilage that lines the shoulder socket (glenoid). This tissue deepens the socket, enhancing the fit between the humerus and shoulder blade, contributing to joint stability. It also anchors shoulder ligaments and the biceps tendon.
Labrum tears can result from acute trauma, such as falls, direct blows, or sudden forceful pulls. Repetitive overhead motions, common in sports, can cause tears from overuse. The labrum can weaken with age, making it susceptible to injury. Symptoms include deep, aching shoulder pain, worsening with overhead movements. Clicking, popping, grinding, or instability may occur.
Non-Surgical Treatment Options
Non-surgical approaches are often the initial treatment for labrum tears without major instability. These methods reduce pain and inflammation, restoring shoulder function. Initial management involves rest, avoiding aggravating activities, and ice.
Non-steroidal anti-inflammatory drugs (NSAIDs) alleviate pain and reduce joint inflammation. Physical therapy strengthens shoulder muscles (including the rotator cuff), improving range of motion and stability. A physical therapist guides exercises to restore muscle balance and joint mechanics. Corticosteroid injections into the shoulder joint provide immediate pain relief and reduce inflammation, facilitating physical therapy. These treatments successfully manage symptoms and improve shoulder condition without surgery.
Surgical Repair Procedures
Surgery is considered when non-surgical treatments fail or if the labrum tear is severe, causing instability. Surgery reattaches the torn labrum or removes damaged tissue. Most labrum repairs use arthroscopic techniques, a minimally invasive procedure with small incisions for a camera and specialized instruments.
A common repair is for a SLAP (Superior Labrum Anterior to Posterior) tear, affecting the upper labrum where the biceps tendon attaches. During this procedure, the torn labrum and, if involved, the biceps tendon are reattached with sutures or small anchors. Another repair is for a Bankart lesion, typically occurring after a shoulder dislocation where the labrum tears from the front or lower shoulder socket. This procedure reattaches the torn labrum to the front rim of the glenoid, restoring stability and preventing recurrent dislocations. Surgical technique depends on the tear’s location, extent, and associated injuries.
The Recovery Process
A structured recovery process is important for optimal outcomes after non-surgical or surgical repair. Immediately after surgery, the shoulder is immobilized in a sling for several weeks to protect healing tissues and prevent movement that could disrupt the repair. Pain management, often with prescribed medications, is a priority for comfort and rest during this initial phase.
Rehabilitation progresses through phases, beginning with gentle passive range-of-motion exercises where the arm moves without engaging shoulder muscles. As healing advances, active range-of-motion exercises are introduced, followed by strengthening exercises for the shoulder and surrounding muscles. Physical therapy sessions are tailored to the individual’s tear and surgical repair, gradually increasing intensity to restore strength, flexibility, and function. Recovery timelines vary, from a few weeks for minor non-surgical cases to several months (often four to six) for surgical repairs before a gradual return to activities, including sports. Consistent adherence to the rehabilitation program is important for regaining shoulder strength and stability.