The labrum of the shoulder is a thick cartilage structure that helps holds the head of the humerus to the shoulder. Together with the glenoid portion of the scapula, the labrum contributes to the cup-like socket that the head of the humerus rests in. As this is the case, the labrum contributes to and supports shoulder motions.
Tears of the labrum can be very painful and limit mobility and use of the involved shoulder. Some symptoms of labral tears may include pain, sharp catching sensation, crepitus or grinding, pain with overhead and throwing motions, difficulty raising the shoulder, and weakness.
In younger athletes, repetitive overhand throws can contribute to labral tears. Common sports that are prone to labral tears include baseball, volleyball, swimming, and football.
Two common types of labral tears include superior labrum from anterior to posterior (SLAP) and Bankart tears. SLAP tears involve the upper portion of the labrum from the front to the back as the name indicates. These tears are often caused by repetitive motion and activity, such as those with sports, but may be caused by falling on an outstretched hand as well. Many SLAP tears involve wear over time and are age related. Over time the labrum can wear and degenerate, increasing the chances of a tear.
Bankart tears occur in the anteroinferior or front-bottom area of the shoulder labrum. Common causes of Bankart tears include auto accidents and falls. Bankart tears tend to occur more frequently in younger patients.
Orthopedic tests such as those performed by a Chiropractor can help in diagnosis of a labral tear. MRI imaging, which is able to visualize soft tissues such as cartilage may be used to visualize a labral tear. While x-rays are not able to visualize the soft tissues and cartilage of the labrum, they are helpful to rule out other conditions and are often taken prior to more expensive MRI images.
Shoulder dislocations often involve tearing of the shoulder labrum. When the labrum is torn, the humerus is able to move beyond the bounds of the shoulder joint by way of the tear in the labrum. More severe labral tears can allow for repeated shoulder dislocations to occur.
Labral tears are common after auto accidents as well. Sudden forces applied to the body during an auto collision can be quite significant. In some cases, as the body is thrown forward with the arms supported by the steering wheel, enough force can be directed and applied to the shoulder to result in injuries and tears. The seatbelt, though lifesaving, can contribute to redirecting force into the shoulder.
Conservative treatment for shoulder tears is available. Exercises and stretches can help improve shoulder function and decrease pain while the shoulder is healing. Common exercises in the early stages of recovery from a labral tear include passive and active range of motion exercises. When symptoms are improving, shoulder resistance band, light weight, and proprioception exercises are added. These exercises are largely focused on improving strength and function of the rotator cuff muscles. These rotator cuff muscles provide muscular support and movement of the shoulder.
Shoulder surgery may be necessary for more severe tears. While this is often done arthroscopically, resulting in a smaller incision, recovery from labral repairs can take some time.
Your Chiropractor will be able to instruct you in exercises and stretches that can help reduce pain and improve function as you heal. Contact your Chiropractor if you are experiencing shoulder pain after an injury or auto accident.