Shoulder Joint Tear
The glenoid is the socket into which the head of the upper arm bone (humerus) fits into create one of the shoulder joints. The glenoid is lined with a fibrocartilaginous supporting structure called the labrum, which could be compared to a “gasket” between the two bones. With advancements in technology tiny arthroscopic cameras can take an up close look at the joints, including the labrum, to identify injury.
Acute trauma or repetitive shoulder motions cause injuries to the labrum. These tears may be classified by the position of the tear in relation to the shoulder socket (glenoid). Examples include falling on an outstretched arm, a direct blow to the shoulder, sudden pull or a violent overhead reach, such as occurs when trying to stop a fall or slide. Throwing athletes and weight lifters can experience tears due to repetitive shoulder motion.
As mentioned, labral tears are classified by the position of tear relative to the shoulder socket. A Bankhart tear is a tear in the labrum located in the front, lower (anterior, inferior) part of the shoulder socket. This type of tear occurs most commonly during a shoulder dislocation, and makes the shoulder more prone to recurrent dislocations. A SLAP tear is a tear in the labrum that covers the top part of the shoulder socket from front to back (Superior Labral tear from Anterior to Posterior). A SLAP tear occurs at the point where the long head of biceps tendon attaches. This type of tear occurs most commonly during falls on an outstretched arm.
Signs and symptoms of glenoid labrum tears include:
- Pain, usually with overhead activities
- Catching, locking, popping or grinding
- Occasional night pain or pain with daily activities
- A sense of instability in the shoulder
- Decreased range of motion
- Loss of strength
Diagnosis of a glenoid labrum tear cannot be made with X-ray. Your doctor may order a Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI), however the definitive diagnosis of the tear can only be made with arthroscopic surgery.
Treatment of a suspected glenoid labrum tear will consist of anti-inflammatory medications and rest to relieve symptoms. Rehabilitation and strength exercises will also be recommended. If relief with this conservative therapy is inadequate, it is likely that the doctor will recommend arthroscopic surgery.
Depending on the extent and location of injury and its relation to tendons, which attach to areas of the labrum, there are options for repair that your doctor will have when viewing the joint with the scope.
Rehabilitation after surgery usually takes 3-4 months, the first 3-4 weeks requiring a sling. During the period of rehabilitation, the physician will prescribe passive range-of-motion exercises, and with progress, motion and flexibility exercises to build strength will follow. Athletes may participate in sports-specific exercises after six weeks, even though the injury is not completely healed until after 3-4 months.