Labral Tears of the Shoulder | South Florida
Until the wide adoption of arthroscopic diagnostics, labral tear injuries often went unidentified, allowing for associated pain and discomfort to persist. Today, your orthopaedic surgeon can easily provide the treatment needed for relief from the symptoms associated with this common injury.
The shoulder joint is comprised of three bones: the scapula (shoulder blade), clavicle (collarbone), and humerus (upper arm bone). The head of the humerus rests in the glenoid, a shallow socket of the scapula, which is rimmed by a soft fibrous tissue called the labrum. This cushioning component provides support to the joint, deepening the socket by up to 50% to provide a better fit for the humeral head. A labral tear occurs when the rim of the glenoid is damaged, impacting overarching joint performance.
Causes and Symptoms
Labral tears often result from an acute traumatic event; however, ongoing wear-and-tear, such as that caused by exhaustive use, may also be accountable. Amongst athletes, pitchers and weightlifters are especially prone to this injury due to an emphasis on both force and repetition of action. In the case of sports-related labral tears, the prevention of future re-injury is especially important and will be a focus of your long-term treatment plan.
If you have experienced a sudden injury to your shoulder or exhibit any of the following symptoms, you should plan a visit to your orthopaedic surgeon. Signs of a labral tear include:
- Pain and discomfort (especially when lifting or reaching)
- Locking, popping, catching, or grinding
- Limited range of motion
- Decreased strength
- General sense of instability
In many cases, these symptoms will lead to an inability to comfortably complete basic day-to-day activities. Following a thorough assessment, your orthopaedic surgeon will likely prescribe a combination of anti-inflammatory medication, physical therapy, and in some cases, minimally invasive surgical intervention.
One of the first steps in assessing your labral tear will be to (if possible) identify the initial cause of damage. Your orthopaedic surgeon will document the history of your condition, including when symptoms started and whether pain has worsened over time. A series of stability, sensitivity, and range of motion tests will be completed to determine the severity of your case. For some patients, an x-ray, CT scan or MRI may be ordered to assess whether any additional physical factors are contributing to the symptoms observed.
If your orthopaedic surgeon determines that a labral tear is present, final diagnosis and treatment will be completed through arthroscopic intervention. Depending on the severity and location of your injury, special attention may be applied to specific ligaments and tendons, as well as to the prevention of full or partial shoulder dislocation.
Treating Labral Tears
During initial treatment, your orthopaedic surgeon will prescribe non-invasive measures, including anti-inflammatory medications, at-home exercises, and physical therapy. If these efforts do not produce optimal pain relief, arthroscopic surgery will be used to repair your shoulder damage.
The arthroscopic approach allows for successful examination of the labrum, bicep, and other shoulder structures. In some cases, damage is restricted to the rim, allowing for the joint to maintain general stability. However, in cases of tendon damage or detachment, instability will be a concern and your surgeon will apply the use of tacks, wires, or sutures for successful reconstruction.
Following completion of the operation, your orthopaedic surgeon will outline a comprehensive rehabilitation program for your use. Following 3-4 weeks in a sling, your shoulder will be ready for the completion of basic exercises, increasing flexibility and building strength. Areas for attention will include not only the joint area, but also your bicep and upper back muscles. While many individuals can return sport-related exercises after 6-8 weeks, your shoulder will not be fully healed for 3-4 months. Before returning to any specific physical activities, contact your orthopaedic surgeon regarding risks and best ways to prevent re-injury.
Dr. Biggs specializes in minimally invasive joint treatment techniques. To schedule an appointment, contact the Naples office at (239) 261-BONE (2663).