Shoulder Joint Labral Tear
Treatment by Dr. Senthilvelan – Shoulder, Elbow & Wrist Specialist
Advances in minimally invasive arthroscopic surgery now allow precise diagnosis and treatment of shoulder labral tears — injuries that were often missed decades ago.
A glenoid labrum tear (labral tear) affects the soft tissue rim that stabilizes the shoulder socket. This injury is common in athletes, active individuals, and patients with shoulder dislocations.
Understanding Shoulder Anatomy
The shoulder is a ball-and-socket joint formed by:
- Humerus (upper arm bone)
- Scapula (shoulder blade)
- Clavicle (collarbone)
The head of the humerus sits in a shallow socket called the glenoid.
Because the socket is shallow, stability depends on a soft fibrous rim called the labrum.
Functions of the Labrum:
- Deepens the socket by up to 50%
- Enhances joint stability
- Provides attachment for ligaments
- Anchors the long head of the biceps tendon
Damage to this structure compromises shoulder stability and function.
Types of Labral Tears
1. SLAP Tear (Superior Labrum Anterior to Posterior)
A tear at the top of the socket where the biceps tendon attaches.
Common in:
- Throwing athletes
- Weightlifters
- Overhead workers
Symptoms:
- Deep shoulder pain
- Clicking or locking
- Pain during overhead activity
- Loss of strength
2. Bankart Lesion (Anterior Labral Tear)
A tear of the lower front part of the labrum, usually caused by shoulder dislocation.
Typically occurs after:
- Falling on an outstretched arm
- Sports injury
- Traumatic anterior dislocation
Often associated with recurrent instability.
3. Posterior Labral Tear
A tear at the back of the socket.
Causes:
- Direct trauma
- Repetitive stress
- Degenerative changes
Causes of Labral Tears
Labral injuries may result from:
Acute Trauma
- Fall on an outstretched arm
- Direct blow to the shoulder
- Sudden heavy lifting
- Violent overhead movement
Repetitive Overuse
- Throwing sports
- Weightlifting
- Overhead occupations
Symptoms of a Labral Tear
Patients may experience:
- Feeling of shoulder instability
- Recurrent dislocations
- Pain with overhead activity
- Catching, popping, or grinding sensation
- Night pain
- Reduced range of motion
- Weakness
Symptoms can mimic other shoulder conditions, so expert evaluation is essential.
Evaluation at Dr. Senthilvelan’s Clinic
Diagnosis involves:
Clinical Examination
- Detailed injury history
- Range of motion testing
- Instability assessment
- Special labral tests
Imaging
- X-rays (to rule out fractures or bone issues)
- MRI scan
- MR arthrogram (contrast study for subtle tears)
- CT scan (in specific cases)
Definitive diagnosis is often confirmed during arthroscopy.
Treatment Options
Non-Surgical Management
Many labral tears improve with conservative treatment.
- Rest and activity modification
- Anti-inflammatory medication
- Structured physiotherapy
- Rotator cuff strengthening
- Scapular stabilization
- Flexibility exercises
This approach is particularly effective when instability is minimal.
Arthroscopic Surgery
If symptoms persist or instability is significant, arthroscopic repair may be recommended.
Surgical Approach:
- Small keyhole incisions
- Miniature camera (arthroscope) inserted
- Torn labrum reattached using anchors or sutures
- Biceps tendon repaired or repositioned if unstable
For instability (Bankart lesion), the capsule may be tightened and folded (capsular plication).
Both arthroscopic and open procedures can be performed depending on the case.
Rehabilitation After Surgery
Recovery depends on tear type and repair performed.
General Timeline:
- Sling immobilization: 2–6 weeks
- Gentle passive motion: Early phase
- Strengthening exercises: 6 weeks onward
- Sports-specific training: Around 12 weeks
- Full recovery: 4–6 months
Strict adherence to physiotherapy is essential for optimal outcome.
When to Consult Dr. Senthilvelan
Seek evaluation if you experience:
- Recurrent shoulder dislocation
- Persistent pain despite rest
- Instability during activity
- Clicking or locking sensation
- Loss of athletic performance
Early intervention improves stability, function, and long-term joint health.
