Labral Tear

Labral Tears

Like other cartilage in the body, the labrum can be subject to injury and tearing. Traumatic injury to the shoulder, such as shoulder dislocations, often result in labral tears. Additionally, overuse of the shoulder by excessive throwing or weightlifting can cause a labral tear. The aging process may also weaken the labrum, leading to injury secondary to wear-and-tear. A shoulder labral tear injury can cause symptoms such as pain, feelings of instability, a catching or locking sensation, and decreased range of motion

The most common types of labral tears include:

• SLAP tear: The term SLAP (superior-labrum anterior-posterior) refers to an injury of the superior labrum of the shoulder at the attachment of the biceps tendon.
• Bankart tear: A Bankart tear is an injury to the labrum that leads to recurrent dislocations and arthritis of the shoulder.
• Posterior labrum tear: Posterior labral tears are often underappreciated and underdiagnosed, but can cause significant pain and functional limitation.

Shoulder Instability

Shoulder instability may occur by injury, overuse, or other genetic factors like joint hypermobility or connective tissue disorders such as Ehlers-Danlos.

The most common form of instability is anterior instability, in which the humeral head predominantly dislocates towards the front of the body. Posterior instability, on the other hand, is experienced when the humeral head predominantly dislocates towards the back of the body. Finally, multidirectional instability is denoted by the dislocation of the humeral head in multiple directions. Given the wide range of factors that may induce shoulder instability, symptoms may include popping, catching, looseness, pain, numbness, or a feeling of “giving way” of the joint.

Biceps Tendon Tear

Biceps tendon tears are relatively common injuries that can occur in any of the three tendons of the bicep. Most commonly, tears occur in the two tendons that attach the biceps to the shoulder blade. These tears can be partial thickness or full thickness (tendon is fully detached from the bone). Acute injuries can cause these tears, but they can also arise due to degeneration of the tendon over numerous years.

There are many symptoms that might suggest a biceps tendon tear:

• Sharp pain with lifting or performing overhead movements
• Limited range of motion
• Bruising to upper arm or shoulder
• Weakness in arm or shoulder
• Tenderness and swelling
• Snapping or popping
• “Popeye” deformity (bulge in upper arm)

Treatment Options

Your doctor may initially suggest conservative approaches such as anti-inflammatory medications and advise rest to relieve symptoms. Rehabilitation exercises may be recommended to strengthen the muscles around your shoulder. If the symptoms are not resolved with these conservative measures, your doctor may recommend shoulder surgery.