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Shoulder

Shoulder Labral Tear

The shoulder labrum is made of fibrocartilage. This cartilage serves as an anchor for several ligaments and the tendon of the biceps muscle, and it deepens the socket to create a snug fit for the head of the upper arm bone (humerus), which facilitates complex shoulder movements and enhances joint stability. Labrum tears are common in athletes, especially male athletes who participate in overhead and contact sports. Younger individuals are more prone to traumatic tears and older individuals are more prone to degenerative tears.

A shoulder labral tear is a common injury that affects the shoulder joint. When the labrum suffers trauma or wear and tear, it can become partially or completely torn, creating instability in the joint. Labral tears can range in severity from minor to complete detachment.

Shoulder labrum tears can result from various causes including:

  • Traumatic injury: Such as a fall onto an outstretched arm, direct impact, or a sudden pull when trying to lift a heavy object, or a violent overhead reach.
  • Repetitive shoulder motions: Athletes, particularly those in overhead sports like baseball pitching, swimming, weightlifting or tennis, are at risk due to repetitive motions.
  • Shoulder dislocations: Can cause tearing of the labrum.
  • Age-related degeneration: As people age, the labrum can become more brittle and prone to tearing.

Labrum tears can be classified based on their location and the pattern of the tear. Common types include:

  • SLAP Lesions (Superior Labrum from Anterior to Posterior): These involve the top part of the labrum where the biceps tendon attaches and are common in overhead athletes.
  • Bankart Lesions: Often associated with shoulder dislocations, these affect the lower part of the labrum. Bankart tears result from trauma, cause instability and predisposed to future dislocations. Bankart tears are common in people under age 30 who suffer a shoulder dislocation.
  • Posterior Labrum Tears: Less common, these occur at the back of the shoulder socket and can be caused by trauma or normal wear and tear in a degenerated labrum.

  • Catching or grinding: Labral tears can cause a “catch” in the shoulder during movement
  • Pain: Deep pain within the shoulder or the top of the arm, night pain, pain with daily activities
  • Weakness: Loss of strength affects sports performance as well as daily life activities
  • Limited range of motion: Difficulty moving the arm in certain directions
  • Instability: a sense of instability or looseness within the joint.
  • Shoulder dislocation: A labral tear can also increase the risk of shoulder dislocation.

Your Silicon Valley Orthopedic surgeon will review your medical history, take a history of the injury and symptoms, when they began, your sports activities and any history of shoulder dislocations. They will conduct a comprehensive orthopedic exam testing range of motions, strength and use special physical tests to check range of motion stability and pain. X-rays will be ordered to evaluate the bones, and a CT scan or MRI to view the soft tissues including the labrum.

In the context of shoulder labrum tears, arthroscopic surgery plays a dual role as both a diagnostic and therapeutic tool. While non-invasive methods like physical examination and imaging techniques (MRI or CT scans) are essential first steps in diagnosing a labrum tear, they sometimes may not provide conclusive results. In such cases, arthroscopic surgery becomes the definitive method for diagnosis.

Schedule a shoulder consultation

When you or a loved one has a shoulder injury or dislocation, contact Silicon Valley Orthopedics to schedule a consultation. We have offices in Fremont, Los Gatos and Menlo Park. At Silicon Valley Orthopedics we strive for compassionate, personalized care and treatment options geared to your needs.