The labrum is a c-shaped rim of cartilage found in the shoulder joint surrounding the glenoid (socket). The labrum serves two important functions – an attachment site for the biceps tendon and the glenohumeral ligaments, as well as to deepen the socket so the shoulder remains in place during movement. The labrum may become peeled off the rim of the socket during a shoulder injury, such as a dislocation. When this occurs, the shoulder may experience instability and lead to a partial or complete dislocated shoulder. A labral tear, otherwise known as a torn labrum, is a common injury and is typically caused by a fall on an outstretched arm or repetitive overhead motion. The two most common types of labral injuries seen by Dr. Aaron Bates, orthopedic shoulder specialist located in Jacksonville, Orange Park, Fleming Island, and Middleburg are SLAP and Bankart tears.
A SLAP (Superior Labrum Anterior to Posterior) tear is a specific type of labral tear to the superior (uppermost) area of the labrum that can involve the attachment site of the biceps tendon (long head), typically located at the top of the shoulder joint. A Bankart tear describes a labrum tear that forms a pocket toward the back or front of the socket where the humeral (upper arm bone) head can dislocate into. .
SLAP and Bankart tears are generally caused by a traumatic event, such as a fall or collision, or from overuse. SLAP tears are quite common in the overhead athletic population, such as volleyball, baseball and tennis players.
A labral tear causes a number of symptoms, including:
SLAP and Bankart tears usually make it difficult for a patient to perform normal, everyday shoulder movements. Patients who have sustained a Bankart tear may also feel a sensation that the shoulder may dislocate or “slip” out of place.
Dr. Bates will perform a physical examination to diagnose a labral tear. If a SLAP tear is present, it is important he determines if the torn labrum is connected to pre-existing shoulder instability or if the tear occurred from trauma to the joint. Dr. Bates may also perform a series of x-rays and an MRI scan to rule out other potential shoulder injuries. A dye is often injected into the injured joint before the MRI scan to help Dr. Bates identify the exact location of the labral tear.
Treatment of a labral tear, such as SLAP and Bankart tears, takes several factors into consideration. Dr. Bates will factor patient age, patient activity level, severity of tear, type of tear, and previous shoulder instability into his treatment recommendation.
If the torn labrum is mild, Dr. Bates will usually recommend non-surgical treatment. Non-surgical measures include rest, ice, medication and a physical therapy program designed to strengthen and stretch the injured shoulder.
Shoulder surgery may be necessary if non-surgical measures are unsuccessful or if the labral tear is too severe. Dr. Bates will determine the type of torn labrum surgery based on type of tear, severity of tear, condition of the biceps tendon and any other shoulder injuries present at the time of surgery.
Common surgical options include:
For more resources on a labral tear, such as SLAP and Bankart tears, or to learn more about torn labrum treatment, please Dr. Aaron Bates, orthopedic shoulder specialist located in Jacksonville, Orange Park, Fleming Island, and Middleburg.