What is a Labral Tear?
The shoulder joint is made up of the large humeral head (at the top of the upper arm), and its joint with the very shallow glenoid fossa on the scapula (shoulder blade). Its main function is to provide as much movement as possible, and therefore sacrifices a lot of its stability.
In order to increase its stability, the labrum forms a cartilaginous ring around the glenoid fossa to increase its depth. It also creates a ‘negative pressure’ seal to keep the humeral head in the glenoid fossa. Injury or tear to the labrum, through trauma or degeneration, will impact the shoulders stability and can cause pain.1
What are the different types of labral tear?
Bankart lesions typically occur in a younger, sporting population. They involve damage or tearing to the labrum, caused by the humeral head in a shoulder dislocation. Anterior Bankart Lesions are when the shoulder dislocates out the front of the shoulder, and posterior Bankart lesions are when the shoulder dislocates backwards. These types of injuries can lead to ongoing instability at the shoulder, if not appropriately managed.
SLAP lesion refers to a “Superior Labrum, Anterior to Posterior” tear. These tears occur at the superior, top part, of the labrum where the biceps muscle tendon attaches. These injuries can include damage to the bicep tendon also. They are often caused by natural degeneration, but are also seen frequently people who perform repetitive overhead activity and sports.
What caused my Labral Tear?
There is an increased likelihood of experiencing labral injury as you get older, this is because the labrum naturally will experience degeneration. However, in the younger sporting populations they are still a common cause of shoulder pain and instability. Rotator-cuff pathology is seen in approximately 40% of people who have a labral tear. Your physiotherapist will be able to assess your shoulder and inform you as to what the likely cause of your labral tear was and what any pre-disposing factors might be.
Does my Labral tear need surgery?
It depends. If your labral tear is contributing to significant instability and you are unable to perform your specific work tasks or sport, then surgery may be considered as an option. However, most are able to be managed conservatively with the appropriate physiotherapy and rehabilitation program. Your physiotherapist will be able to discuss with you what the best management plan is.
How can you help me with my Labral Tear?
Your physiotherapy plan will be specific to your individual presentation. Your physiotherapist will conduct a thorough and detailed assessment of your condition and will tailor a personalised plan to return you to full fitness. Typically, your treatment will involve techniques to decrease your pain and return you to a normal range of movement. From there you will be working with your physiotherapist in order to improve the strength and stability of your shoulder. The right physiotherapy program should incorporate a rehabilitating plan that gets you back to the specific activities that you enjoy doing.
What should I do to avoid aggravating my Labral Tear?
- AVOID overhead activities, particularly during the acute phase.
- DO concentrate on maintaining good, posture
- Talk to your pharmacist about using anti-inflammatories.
- REMAIN ACTIVE, but avoid aggravating activities.
- RECEIVE physiotherapy care to get your joints, ligaments and working to their optimum level.
Keep good care of your body and your physiotherapist will continue to monitor your condition. Once your Labral Tear has resolved you will be able to resume your full activities without worrying about future flare-ups.