What is a labral tear?
The shoulder labrum is a fibrous piece of cartilage that lines the glenoid socket of the shoulder. This tissue provides support and helps to keep the ball of the humerus (upper arm bone) securely within the socket. The labrum also serves as the connection point for the biceps tendon in the shoulder. A labral tear is a tear within the labrum, often resulting from a shoulder dislocation, athletic activities involving overhead throwing, or other trauma to the shoulder. Front (anterior) labral tears typically occur following shoulder dislocations. Back (posterior) labral tears typically occur from repetitive pushing activities, such as in offensive lineman. Upper (SLAP) labral tears typically occur in throwing athletes or after a traction injury in which the arm is pulled overhead.
What is a SLAP tear?
A SLAP tear is an acronym used to describe the location of a labral tear: A Superior Labrum Anterior-to-Posterior Tear. A SLAP tear involves a tear at the top of the labrum, where the connection point of the biceps tendon is found. This type of tear involves a tear of both the front (anterior) and back (posterior) of the portion of the labrum. Dr. Joseph Lamplot, orthopedic shoulder specialist, treats patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, who are experiencing symptoms associated with SLAP tears or labral tears of the shoulder.
What are the symptoms of a torn labrum in the shoulder?
- Pain during overhead shoulder movement
- Shoulder instability or dislocations
- Consistent shoulder pain often felt in top or back of the shoulder
- “Clicking” or “grinding” sensation in the shoulder
- Apprehension, or feeling as if the shoulder may pop out
- Decreased range of motion of the shoulder
How do you know if you have a SLAP tear or labrum tear in the shoulder?
First, Dr. Lamplot will review a detailed medical and activity history of the patient including any previous injuries, pain, or other abnormal sensations in the shoulder. He will also perform a detailed physical examination of the shoulder to determine the range of motion, strength, and the possible presence of a SLAP tear or labrum tear in the shoulder. Dr. Lamplot most frequently will recommend an MRI scan to help diagnose a SLAP tear or labrum tear, however other diagnostic imaging such as an X-ray may be required in some cases.
What are the treatment options for a SLAP tear or labral tear?
Non-Surgical:
Partial tears, or labral tears that do not require surgery can benefit from non-surgical treatments such as:
- Rest and application of ice to the shoulder
- Pain management through Nonsteroidal Anti-inflammatory Medications (NSAIDs)
- Physical Therapy to increase the strength of the shoulder joint
- Stretching and other exercises to improve range of motion
- Corticosteroid injections
Surgical:
Injuries resulting in shoulder dislocations often should be treated surgically. Conservative or non-surgical therapies that fail to alleviate pain and do not restore shoulder strength and stability may also need to be addressed surgically. Depending on the location and severity of the tear, as well as the goals of the patient post-operatively, Dr. Lamplot may use one or more the following treatment methods:
- Debridement: A surgery to remove the torn portion of the labrum if the biceps tendon is not involved in the tear
- Labral (labrum) Repair: The surgical reattachment of the labrum to the shoulder socket. This helps improve shoulder stability and prevent dislocations.
- Biceps Tenodesis: This procedure reconnects the biceps tendon to the humerus (arm bone) outside of the shoulder joint, removing the torn portion of the biceps and labrum. Most patients, including throwing athletes, are able to return to sport following this procedure.
- Bankart Repair: Alleviates shoulder instability and prevents dislocation by re-anchoring and fixing a labral tear
- Remplissage: Provides additional stability along with a Bankart repair by filling a bony defect on the humerus bone with a healthy shoulder tendon using strong suture anchors.
