The shoulder labrum is a piece of soft cartilage in the socket-shaped joint in your shoulder bone. It cups the ball-shaped joint at the top of your upper arm bone, connecting the two joints.
A group of four muscles called the rotator cuff helps the labrum keep the ball in the socket. This allows your upper arm to rotate. Repetitive motion and injuries can tear the labrum, often causing pain.
You also have a labrum where your upper leg attaches to your hip, but it’s less likely to tear because it’s thicker than your shoulder labrum.
The shallow, socket-like opening of the shoulder where the labrum is located is called the glenoid. Shoulder labrum tears can happen anywhere around the glenoid socket.
There are three main types of labrum tears:
- SLAP tear or lesion: When the tear is above the middle of the glenoid, it’s called a SLAP tear or SLAP lesion. SLAP stands for “superior labrum, anterior to posterior,” which means front to back. This kind of labrum tear is common among tennis players, baseball players, and anyone who uses a lot of overhead arm motions. They also often occur with damage to the biceps tendon.
- Bankart tear or lesion: When the damage is to the lower half of the glenoid socket, it’s called a Bankart lesion or tear. Bankart tears are more common in younger people with dislocated shoulders.
- posterior labrum tear: Injuries to the back of the shoulder joint can cause a posterior labrum tear. These are rare and make up only 5 to 10 percent of all shoulder injuries.
A labral tear is usually painful. It may feel like your shoulder joint is:
You may also feel a sense of instability in your shoulder, a decreased range of motion, and a loss of strength. Pain at night or while doing daily activities is also common.
If you have a Bankart tear, it may feel like your shoulder will slip out of its joint.
All types of labral tears often occur with other shoulder injuries, such as dislocated shoulders, rotator cuff injuries, and torn biceps tendons. Your doctor will determine exactly what type of injury you have.
Traumatic injury and wear and tear from repetitive motion of the upper arm can both cause labrum tears.
Some specific causes of labrum tears include:
- a fall on an outstretched arm
- a direct hit to the shoulder
- a violent blow while reaching overhead
- a sudden tug on the arm
Your doctor will test your range of shoulder/arm motion, stability, and pain level. Be sure to tell the doctor about any event that may have caused the pain.
The labrum tissue is too soft to show up in X-rays, but your doctor may order an X-ray to see if other injuries might be causing your pain. To see the damage to the labrum, your doctor may order a CT scan or MRI scan.
Your doctor may also perform an arthroscopic examination by inserting a tiny camera called an arthroscope through a small cut. The camera will give your doctor a more detailed view of your labrum and any injuries to it.
Labral tears are often treated with rest, over-the-counter medications, and physical therapy.
If you have a Bankart tear, your doctor (or even your coach or trainer) may be able to pop your upper arm back into place. This should be followed by physical therapy.
If your doctor’s examination shows that the tear isn’t too severe, you may only need some home remedies. Rest is the most important one. Anti-inflammatories, such as ibuprofen (Advil, Motrin IB) or aspirin (Bufferin, Bayer Genuine Aspirin), may help relieve the pain. Your doctor may also decide to give you cortisone injections for pain relief.
Your doctor may recommend physical therapy to strengthen the muscles of your shoulder, especially the rotator cuff. You may also receive massages or manual therapy during visits.
Your physical therapist will show you what positions and activities to avoid, as well as gentle stretches and exercises you can do at home.
A physical therapy program might last six weeks to two months, depending on how bad the injury is.
Labrum tears requiring surgery are usually treated with minimally invasive arthroscopic surgery.
During surgery, the surgeon removes the damaged part of the labrum. This can include cutting off any flaps of damaged cartilage that prevent proper motion of the joint.
After surgery, you’ll likely be advised to wear a sling for the first four weeks to immobilize the shoulder.
Your doctor will recommend a physical therapy program for your specific needs. Sessions start with range-of-motion exercises and progress gradually to stretching and strengthening.
Labrum surgery takes 9 to 12 months to completely heal, but you can quickly return to many activities. If you play a sport, such as tennis or baseball, that requires overarm motions, you may need to wait up to six months to regain endurance and speed in these motions.
Most torn labrums are easily treated with rest, physical therapy, surgery, or a combination of all three. Work closely with your doctor and physical therapist to find the best treatment options for you. With proper treatment, your shoulder should return to its normal function within a year.