What is the Glenoid Labrum?

The shoulder joint is made up of the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the humerus rests in a socket in the shoulder blade called the glenoid. The head of the humerus is much larger than the socket, and a soft fibrous tissue rim called the labrum surrounds the socket and attaches to the socket to help stabilize the joint. The rim deepens the socket by up to 50 percent so that the head of the humerus fits better.

The glenoid labrum is fibrocartilaginous tissue within the glenoid cavity of the shoulder joint. The purpose of the glenoid labrum is to provide stability and shock absorption within the joint.

What is a Glenoid Labrum Tear?

A tear in the labrum can result from trauma or repetitive shoulder motion. 

A glenoid labrum tear is a tear in your labrum. A labrum is a thick line of cartilage surrounding the shoulder socket. Your shoulder socket is also known as your glenoid. A glenoid labrum tear can occur after an injury, trauma, or performing a repetitive movement with your shoulder. 

Types of Shoulder Labrum Tears

There are several types of glenoid labrum tears:

What is a bankart tear?

This tear is also called a Bankart lesion. A Bankart tear occurs on the bottom of your shoulder socket. A younger person with a dislocated shoulder is at higher risk for this type of tear.

What is a SLAP tear?

A SLAP tear occurs just above the center of your shoulder socket. SLAP is an acronym that means “superior labrum, anterior to posterior” or “front to back.” You might develop this kind of tear if you injure your bicep tendon. You are also at more risk if you play sports such as baseball, volleyball, or tennis, where you consistently move your arm over your head.

What is a posterior labrum tear?

This is the rarest type of glenoid labrum tear. This tear is to the rear of the shoulder.

Signs and Symptoms

Shoulder labrum tear symptoms can include:

• Pain with overhead movement
• Catching, locking, popping or grinding sensation
• Decreased range of motion
• Shoulder stiffness
• Shoulder instability
• Shoulder weakness, often on one side
• Shoulder dislocations 

How Do Labral Tears Occur?

Labral tears can occur from acute trauma or repetitive shoulder motion. This can include:

• Falling on an outstretched arm
• A direct blow to the shoulder
• A violent overhead reach, such as when trying to stop a fall or slide
• Activities where the force occurs at a distance from the shoulder, such as striking a hammer, swinging a racquet or throwing a baseball
• A sudden pull, such as when trying to lift a heavy object-- repetitively lifting heavy weights overhead, as in weight lifting, gymnastics, and construction work

What Causes a Bankart Tear?

Bankart tears usually result from high velocity trauma or sports injuries.

The causes of Bankart tears include:

• Repetitive arm motions during sports
• Falling during sports
• Collisions during sports
• Non-sports related falls
• Car accidents

What Causes a SLAP Tear?

SLAP tears are caused by a direct blow or a pull of the shoulder.

Causes of SLAP tears include:

• Being age 40 or older
• Quickly lifting heavy objects
• Falling with an outstretched arm
• Overuse of overhead arm movements

What Causes a Posterior Labrum Tear?

A common cause of a posterior labrum tear is repetitive microtrauma to the shoulder joint. Injury can also lead to a cyst that painfully compresses nerves in the shoulder.

Posterior labrum tear causes:

• Catching a heavy object
• Car accidents
• Fast and forceful shoulder movements
• Falling on your extended arm

Risk Factors

Risk factors that can contribute to glenoid labrum tear include:

Injury or trauma:

Force on the shoulder such as falling on an outstretched arm, grabbing an object to prevent a fall, or a sudden pull to lift a heavy object can result in glenoid labrum injuries.

Previous shoulder dislocation:

Once the labrum has been torn off the bone it does not heal back in the right location, making the joint unstable.

Age: 

Cartilage becomes more brittle with age and more prone to tear away from the shoulder joint.

Diagnosis

A physical examination will include checking shoulder range of motion, stability, and pain as well as specific questions about symptoms of a torn glenoid labrum tear. Advanced diagnostic procedures and technology can be utilized to confirm the diagnosis and determine treatment. Common diagnostic procedures can include:

Imaging studies:

A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan may be ordered for a glenoid labrum tear diagnosis. Both tests may involve the injection of a contrast medium.

Arthrography:

During this test, a contrast iodine solution is injected into the shoulder joint area to help highlight the joint structures, such as the ligaments, cartilage, tendons and joint capsule. Several X-rays of the joint are taken, using a fluoroscope, a special piece of X-ray equipment that immediately shows the image. 

X-rays:

This common imaging test of bones or joints will help rule out injuries involving bone, but does not show soft tissue injuries.

Arthroscopy:

During this minimally invasive procedure, small instruments that have a lens and lighting system are inserted via a small incision to allow the surgeon to see the labrum.

Prevention

While many risk factors cannot be controlled, you can help prevent a glenoid labrum tear in these ways:

Avoid certain athletics:

Sports that involve repetitive overhead motion or heavy overhead lifting are a primary cause of glenoid labrum tear.

Avoid icy, wet, or otherwise slick surfaces:

Falling on an outstretched arm or taking a direct blow to the shoulder is one of the leading non-athletic causes of a glenoid labrum tear.

Prognosis

The prognosis for people with a glenoid labrum tear depends upon where the tear is located and how severe it is. If fixed properly, most athletes should be able to return to at least 80 percent of their pre-injury level of play with few or no restrictions.

Treatment and Recovery

Advances in medical technology are enabling doctors to identify and treat injuries that went undiagnosed 20 years ago. For example, physicians can now use miniaturized cameras to see inside the shoulder joint to identify and provide shoulder labrum tear treatment.

Suggested glenoid labrum tear treatments are:

Restricted Rest:

At a minimum, patients can expect to ice the shoulder and rest it in a sling for four to six weeks to give the labrum time to re-attach itself to the rim of the bone and to regain strength. Anti-inflammatory medications, and in some cases an in-office cortisone injection, may be recommended for pain management.

Physical Therapy:

Physical therapy is an option for torn labrum shoulder recovery without surgery. Gentle, passive, range-of-motion, and strengthening exercises of the shoulder with a physical therapist for six weeks to two months are often recommended.

Surgery:

If physical therapy fails and the patient still can’t complete overhead motions, or the shoulder continues to dislocate, surgical treatment might be required to reattach the torn ligaments and labrum to the bone. Labral tear shoulder surgery involves either an incision on the front of the shoulder or an arthroscopic technique. After surgery, a sling is used for three to four weeks with gentle, passive, pain-free range-of-motion exercises. When the sling is removed, motion and flexibility exercises will be added gradually to strengthen the biceps. Athletes can usually begin doing sport-specific exercises six weeks after surgery, although it will be three to four months before the shoulder is fully healed.

Complications

Complications of glenoid labrum tear may include:

Pain while sleeping:

Pain usually occurs in the four to six weeks after injury.

Incomplete shoulder rotation:

Rehabilitation lessens the likelihood of permanent stiffness or loss of motion. 

Increased likelihood of a future tear:

The larger the tear, the higher the risk of re-tear.

Glenoid Labrum Tear Treatment at Baptist Health: Our Approach

Baptist Health is known for advanced, superior care for patients with orthopedic conditions and the diagnosis, treatment and management of a glenoid labrum tear. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns.

At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.