• Shoulder Labral Tear

    (Glenoid Labrum Tear; Labral Tear, Shoulder)

    Definition

    A shoulder labral tear is an injury to the cartilage in the shoulder joint. The shoulder is a ball and socket joint. The ball is the end of the arm bone (humerus). This ball fits into the bowl-shaped socket of the shoulder (glenoid). Cartilage lines the socket to keep movement smooth. When the cartilage tears it is called a shoulder labral tear.
    Shoulder Joint
    Shoulder joint repair
    The tool and arrow point to the cartilage of the glenoid.
    Copyright © Nucleus Medical Media, Inc.
    If you suspect you have this condition, contact your doctor promptly.

    Causes

    Shoulder labral tears occur from an injury or through long-term wear and tear. Common causes include the following:
    • Dislocated shoulder
    • Falling onto shoulder
    • Repetitive movements of shoulder
    • Lifting heavy objects
    • Breaking a fall with arms
    • Direct blow to shoulder

    Risk Factors

    These factors increase your chance of a labral tear. Tell your doctor if you have any of these risk factors:
      Participation in certain sports, such as:
      • Baseball pitchers
      • Golf
      • Weightlifting
      • Tennis

    Symptoms

    If you have any of these symptoms do not assume it is due to a labral tear. They may be caused by other conditions. Tell your doctor if you have any of these:
    • Shoulder and/or arm pain
    • Catching or loosening feeling of shoulder
    • Loss of shoulder range of motion
    • Weakness to shoulder and/or arm
    • Pain with shoulder movement
    • Popping or grinding sensation
    • Achiness to shoulder

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will likely be referred to a specialist such as an orthopedic surgeon.
    Tests may include the following:
    • Thorough physical exam—including an evaluation of your shoulder range of motion and stability
    • X-ray —may be used to rule out a broken bone or other problem
    • MRI scan with contrast—test that uses magnetic waves and a contrast dye to make pictures of the body’s structures like the shoulder
    • CT scan with contrast—type of x-ray that uses computer and contrast to make pictures of the body’s structures like the shoulder

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include the following:

    Medical Treatment

    • Nonsteroidal antiinflammatory drugs (NSAIDs)
    • Rest, heat, and/or ice
    • Physical therapy to strengthen muscles
    Generally this treatment is tried for several weeks. If there is no improvement, surgery is considered. Your doctor may also inject a steroid directly into your shoulder to decrease inflammation and pain.

    Surgical Treatment

    In a shoulder arthroscopy , your surgeon inserts a thin, lighted tube through a small incision to view the injury and fix it. Small instruments are threaded through this tube. The torn cartilage may be removed or sewn together. Your surgeon may also use wires or tacks to reattach any torn tendons.
    In a shoulder arthroscopy , your surgeon inserts a thin, lighted tube through a small incision to view the injury and fix it. Small instruments are threaded through this tube. The torn cartilage may be removed or sewn together. Your surgeon may also use wires or tacks to reattach any torn tendons.

    Rehabilitation

    After surgery you will be given a sling to wear for three to four weeks. Once the sling is removed you will work with a physical therapist to gradually strengthen your arm muscles and increase your motion.

    Prevention

    There are no known guidelines to prevent a shoulder labral tear.

    RESOURCES

    American Academy of Orthopaedic Surgeons http://www.aaos.org/home.asp

    Arthroscopy Association of North America http://www.aana.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org/

    Canadian Orthopaedic Foundation http://www.canorth.org/

    References

    Labral Tear Shoulder. Arthroscopy Association of North America website. Available at: http://www.aana.org/LabralTearShoulder.aspx . Accessed November 3, 2008.

    Labral Tears. Internet Society of Orthopaedic Surgery & Trauma website. Available at: http://www.orthogate.org/patient-education/shoulder/labral-tears.html . Accessed November 3, 2008.

    Shoulder Joint Tear (Glenoid Labrum Tear). American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00426 . Accessed November 3, 2008.

    What is a labrum/labral tear? Johns Hopkins Medicine website. Available at: http://www.hopkinsortho.org/labrum%5Ftear.html . Accessed November 3, 2008.

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