A labrum tear is a tear involving the cartilage in the shoulder joint. The labrum is one of the important structures located in the shoulder that enables the joint to move along its range of motion.
The shoulder joint has three bones including the humerus or upper arms, clavicle or the collarbone and scapula or the shoulder blades. The humerus is connected to the head of the shoulder blade to form the whole shoulder joint. The head of the humerus called the humeral head fits to the glenoid fossa in the shoulder blade forming the ball and the socket. However, the socket is not as large as the head of the humerus making it less likely to stabilize the ball. Because of this, the labrum, located along the rim of the socket, is a fibrous tissue that keeps the humeral head in place.
The labrum that lies along the rim of the glenoid makes the socket deeper so that the humeral head can fit completely and prevent it from coming out of the socket. The labrum is also the anchoring point for some ligaments in the area.
In labrum tear, the labrum can be damaged increasing the risk of the humerus to disconnect to the shoulder blade. Labrum tears can be located superior or inferior to the mid line of the glenoid fossa.
What Causes a Labrum Tear?
Tearing of the labrum can be caused by trauma to the shoulder area, which affects the fibrous structure. Trauma to the labrum can result from the following:
- Direct blow to the shoulder tearing the labrum apart
- Falling with the arm outstretched
- Lifting a heavy object suddenly pulling the shoulder joint
- Overreaching with a strong impact
- Repetitive shoulder motion as in weight lifters or throwing athletes leading to labrum tears
What are the Symptoms of a Labrum Tear?
Labrum tear usually affects the shoulder area, which makes the symptoms similar to other shoulder injuries. Manifestations include:
- Popping, grinding or locking sound in the shoulder
- Shoulder pain that intensifies with overhead activities and at night
- Instability in the shoulder area
- Decreased strength in the shoulders and arms
- Reduced shoulder range of motion
How is a Labrum Tear Diagnosed?
A thorough health assessment is done to determine any history of injury. The doctor usually conducts a physical assessment focusing on the shoulder joint. To ascertain that a tear has happened along the labrum, a CT scan or MRI is usually performed. X-rays are not routinely done because X-rays cannot detect any damage in soft tissues.
How is a Labrum Tear Treated?
Treatment modalities for labrum tears involve medical as well as surgical managements. Following the acute stage of injury, rest is initiated to prevent further injury and to prevent shoulder dislocation. Anti-inflammatory medications may also be given initially to relieve pain and inflammation.
Physical therapy is also employed to strengthen the rotator cuff muscles to hold the humeral head in place. However, when all these measures are insufficient, surgery may be recommended.
Surgical managements involve arthroscopic surgery wherein the surgeon will directly examine the shoulder joint, specifically the labrum. If tears are present, the surgeon may remove the torn flap and stabilize the joint.
Labrum tears usually only involve the rim itself, so the joint still remains to be stable. However, when the biceps tendons are already torn, the shoulder becomes unsteady and may require more surgery.