Labral Tear

The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable. This means that the bones of the shoulder are not held in place adequately, and therefore extra support is needed.

The Labrum

To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within. The labrum circles the shallow shoulder socket (the glenoid) to make the socket deeper. This cuff of cartilage makes the shoulder joint much more stable, and allows for a very wide range of movements (in fact, the range of movements your shoulder can make far exceeds any other joint in the body).

The labrum is made of a thick tissue that is susceptible to injury with trauma to the shoulder joint. When a patient sustains a shoulder injury, it is possible that the patient has a labral tear. The labrum also becomes more brittle with age, and can fray and tear as part of the aging process.

Symptoms of a Torn Labrum

Symptoms of a labral tear depend on where the tear is located, but may include:

• An aching sensation in the shoulder joint
• Catching of the shoulder with movement
• Pain with specific activities

In addition, some types of labral tears, specifically a Bankart lesion, can increase the potential for shoulder dislocations.

Types of Labral Tears

The most common patterns of labral tears are:

• SLAP Tears
  A SLAP tear is a type of labral tear most commonly seen in overhead throwing athletes such as baseball players and tennis players. The torn labrum seen in a SLAP tear is at the top of the shoulder socket where the biceps tendon attaches to the shoulder.

• Bankart Tears
  A Bankart tear is a labral tear that occurs when a shoulder dislocates. When the shoulder comes out of joint, the labrum is torn, and makes the shoulder more susceptible to future dislocations.

• Posterior Labral Tears
  Posterior labral tears are less common, but sometimes seen in athletes in a condition called internal impingement. In this syndrome, the rotator cuff and labrum are pinched together in the back of the shoulder.

Treatment of a Torn Labrum

The treatment of a torn labrum depends on the type of tear that has occurred. Most labral tears do not require surgery; however, in patients who have persistent symptoms despite more conservative treatments, surgery may be necessary. For more information about the treatment of a labral tear, read about the specific type of tear listed above.