What is a shoulder labral tear or strain?
A shoulder labral tear or strain is an injury to the rim of the shoulder socket. The labral helps keep the ball of the joint in place.
Types of shoulder labral tear or strain
Labrum torn completely off bone
When the cartilage is torn completely off the bone, it is often in conjunction with a shoulder dislocation. Some patients may not even realize their shoulder has slid out of the socket.
Labrum partial tearing
The edges of the labrum may fray so they are not smooth. These types of shoulder labral tears may not cause symptoms.
SLAP lesion, superior labrum, anterior (front) to posterior (back)
A SLAP lesion is a tear of the rim above the middle of the socket that may involve the biceps.
Causes of shoulder labral tear or strain
Shoulder labral tears can be caused by direct injuries or overuse. By far, the most common cause of a shoulder labral tear is a sports-related injury.
Causes can include:
- Falling on an outstretched hand
- Participating in direct contact sports such as football or basketball
- Wear and tear from overuse, potentially from sports that require repetitive movements
- Natural aging process
Risk factors for shoulder labral tear or strain
- Age — people over 40 are at higher risk for a shoulder labral tear.
- Sports that require repetitive movements — participating in sports that require repetitive overhead movements (swimming, weightlifting, softball or baseball) put you at higher risk for developing a shoulder labral tear.
Symptoms of shoulder labral tear or strain
Symptoms of a shoulder labral tear or strain include:
- Pain when moving your arm above your head
- Instability in the shoulder
- Feeling of catching, popping, grinding or locking in the shoulder
- Decreased range of motion
- Loss of strength
Diagnosis of shoulder labral tear or strain
A shoulder labral tear or strain is challenging to diagnose. Your doctor will need to perform a physical exam with your doctor, take your medical history and perform diagnostic testing to truly understand the severity of the condition.
Your doctor will perform a variety of physical tests to evaluate your shoulder range of motion, pain level and stability in the shoulder joint.
Your doctor may perform the following diagnostic tests:
- X-ray — your physician may also order an x-ray to see if there are other conditions that are causing your symptoms.
- MRI or CT scans — these tests can show abnormalities in the soft tissues but may not be able to confirm a shoulder labral tear diagnosis.
- Arthroscopic surgery — arthroscopic surgery may be the best way to diagnose a shoulder labral tear.
Treatment of shoulder labral tear or strain
For mild to moderate shoulder labral tears or strains, your doctor may prescribe anti-inflammatory medication and rest. He or she may also recommend physical therapy to strengthen the rotator cuff muscles in the shoulder.
If nonsurgical therapies are not effective, your physician may recommend more advanced therapies such as PRP injection or arthroscopy.
- Plasma rich protein (PRP) injection — a PRP injection can promote healing by injecting concentrated growth factors from your own blood into the torn tendon.
- Arthroscopic surgery - during surgery, your orthopedic surgeon will examine other muscles around the shoulder, including the biceps tendon, to determine if the injury occurred on the rim and remove the torn flap and correct any problems.
Recovery from shoulder labral tear or strain
After a surgical repair for a shoulder labral tear, you will need to keep your shoulder stabilized in a sling for three to four weeks. Your physical therapist will also develop a treatment plan that will include pain-free range of motion exercises.
As you gain strength and you no longer need the sling, your physical therapist will increase the intensity of your rehabilitation program. Many athletes can return to their sport within six to eight weeks following surgery. It is important to gradually return to your sport; it will take three to four months for the shoulder to fully heal.
Recovery from PRP therapy is quicker, so you can return to your activities sooner. You will feel sore, and the shoulder tendon may be inflamed for a few days. But, you will start experiencing pain relief within a week. Healing may take four to six weeks.