Athletes and dancers are quite familiar with the labrum within the hip. However, the labrum in the shoulder pretty much goes unnoticed – until it is injured. In fact, it is the glenoid labrum – the glenoid is the socket of the ball-and-socket joint within the shoulder and the labrum is the cartilage that supports it – that keeps your shoulder stable and allows for fluid movement. If you experience a glenoid labrum tear, it certainly can put a damper on your day. Here is more about glenoid labrum tears, symptoms, and how to treat them.
The labrum serves two purposes: first, it deepens the shoulder socket (glenoid) so the humeral head stays put; second, it serves as a sort of hub to which the ligaments attach to keep the joint together. If one of these ligaments separates, it can also pull the labrum off the rim of the bone. Glenoid labrum tears can happen in an instant – trying to break a fall or trying too hard to grab something. They can also occur over time, the same as other wear-and-tear and repetitive use injuries.
Many people confuse a labrum tear to a rotator cuff tear or a dislocated shoulder. With a glenoid labrum tear, you may hear a “pop” or experience a clunking sensation; people also report their should feels like it is catching on loose ends, or that the shoulder joint itself is rolling around. Weakness, oftentimes at night or when lying down and usually to one side, are common symptoms of a glenoid labrum tear, as is a general weakness and lack of stability in the shoulder joint. Applying any overhead or direct pressure on the shoulder can cause additional symptoms or worsen the condition.
A SLAP of Pain
There are a number of shoulder injuries that are classified as glenoid labrum tears, however, the most common is the SLAP – “superior labral tear from anterior to posterior.” It is the SLAP tear that covers a very specific area, most often where both the front and back of the labrum attach to the bicep tendon. With SLAP tears, the pain is not chronic, rather, it is acute but only when the labrum is relied upon to do certain tasks. Otherwise, the pain may be somewhat dull but not debilitating.
Oftentimes a doctor can rule out other conditions simply by getting a better of understanding of the location of the pain, when it started and how, and how the pain is described. Words like “dull,” “pop,” “grinding,” and “achy” can rule out myriad other conditions, to include dislocation. Certain range of motion and strength tests can also help the doctor zero in on potential causes. Once initial evaluation has concluded, your doctor likely will conduct an MRI or a CT-arthrogram test. Your doctor will want to rule out arthritis, inflammation, and strains as well before embarking on treatment. However, the precarious location of the cartilage, which is in the very center of the shoulder joint, slightly complicates diagnosis.
The treatment your doctor takes depends on the type, location and severity of the tear. For tears that are caused by dislocation, the labrum will need to be reattached to the rim of the socket. For larger tears a portion of the labrum may need to be smoothed out or trimmed before repair. In worse cases the tear may require reattachment to the top of the socket. The position of the labrum makes it ideal for arthroscopic surgery since even with a large incision it can be difficult to reach. After surgery, it takes approximately 4-6 weeks for the labrum to reattach itself to the rim of the bone, and another 4-6 weeks for it to strengthen back to where it can take any pressure, however, each case is unique and will vary per patient.
Your GREATER BALTIMORE Shoulder Specialists
If you live in the Greater Baltimore area and are tired of shouldering pain, look no further than Greater Chesapeake Hand to Shoulder. With seven locations across Maryland, there is a hand to shoulder specialist ready to serve you. Call us today at (410) 296-6232 or request an appointment online and place your shoulder in the best hands in the region.