Labral Tear (Degenerative)

The shoulder labrum, also known as the glenoid labrum, acts as a multi-use anatomical body part increasing contact area between humeral head (upper arm) and scapula (shoulder blade). Essentially, the labrum acts as a suction around the upper arm to maintain contact throughout range of motion at the shoulder. (Clavert)
Glenoid labrum injuries are commonly found in overhead throwing athletes and patients that typically participate in overhead activities (Cotter). These injuries occur either by trauma, such as shoulder dislocation, or by microtrauma obtained over a period of several years. These changes can also be noted as ‘normal aging’ of the shoulder.
Matthew et. al discuss the relationship between asymptomatic middle aged individuals and labral tears. It was found that a documented SLAP (Superior Labrum Anterior to Posterior) lesion was present in 55-72% of patients (Matthew).

Shoulder labral tears typically present with a history similar to overuse or rotator cuff pathologies. Due to this reason, physical examination is a critical part of a correct diagnosis. Patients will present with difficulty lifting overhead, especially with weight added on, and reaching across the body. The patient often reports the shoulder feeling “unstable”.
Advanced imaging, such as an MRI, is often ordered by your physician to evaluate the extent of the labral injury.

Shoulder injuries that compare in symptom presentation to a labral tear include posterior capsule inflammation, adhesive capsulitis, subacromial/subcoracoid bursitis, biceps tendinitis, and rotator cuff tendinitis.

When considering the treatment options for a degenerative (over time) labral tear, there are many factors to consider, such as age, activity level, symptoms and type of tear. Conservative treatment such as rest from overhead activities, physical therapy, anti-inflammatories, etc., is considered the first-line of treatment.
If symptoms do not improve after a trial of conservative treatment, more invasive treatments are considered. To determine if you are a candidate for non-surgical treatments for your degenerative labral tear, please contact our office to schedule an evaluation.

Clavert P. Glenoid labrum pathology. Orthop Traumatol Surg Res. 2015;101(1 Suppl):S19-S24. doi:10.1016/j.otsr.2014.06.028
Cotter EJ, Hannon CP, Christian D, Frank RM, Bach BR Jr. Comprehensive Examination of the Athlete's Shoulder. Sports Health. 2018;10(4):366-375. doi:10.1177/1941738118757197
Mathew CJ, Lintner DM. Superior Labral Anterior to Posterior Tear Management in Athletes. Open Orthop J. 2018;12:303-313. Published 2018 Jul 31. doi:10.2174/1874325001812010303

LABRAL TEAR