Shoulder labrum tears

In a majority of cases, a shoulder labrum tear may not cause you pain all the time - only when you use your shoulder for a task, lifting something above your head. Common symptoms of a shoulder labrum tear include:

• A catching, locking, or grinding feeling
• Instability in your shoulder
• Loss of strength
• Loss of motion
• Shoulder dislocation
• Pain (during activities and/or at night)

There are three main reasons why you may experience a shoulder labrum tear.

Overuse

If you have a job such as working in construction that involves lifting objects above your head, or play sports like tennis that mean you lift your arm on a regular basis, it places constant pressure on the protective tissue around your shoulder. Because of the way your labrum is linked to your bicep muscle, lifting your arms and placing pressure on them through lifting and/or holding objects puts constant strain on this area, which can cause a tear to occur.

Impact trauma

It is possible for a shoulder labrum tear to occur by accident through an impact injury, either while playing sports, driving your car, or simply falling. A hard pull on your arm, falling directly onto your outstretched arm, or a direct hit to your shoulder are all ways that you may experience a shoulder labrum tear.

Wear and tear

Over the course of time, your labrum does plenty of work. Everyday tasks like lifting objects or reaching for items in your cupboards involves the use of your labrum. So, by the time you reach the age of around 50, this cartilage in your shoulder may have naturally become worn out and slightly torn, causing stiffness, pain, and discomfort.

You may experience one of three different kinds of shoulder labrum tear, which will influence the type of treatment prescribed to you by your consultant.

SLAP lesion

A SLAP tear involves your superior glenoid labrum - where the top of your bicep inserts into your shoulder, so the injury usually happens at the head of your biceps and is common among tennis players, baseball players, or anyone who constantly uses overhead arm motions. The severity of your SLAP lesion can vary, with some cases involving complete detachment of your superior labrum and your bicep, and others being degenerative fraying with no detachment from your bicep.

Bankart lesion

When you have a tear at the bottom of your shoulder socket, it is known as a bankart lesion, which occurs when your humeral head (the top of your arm bone) comes out of the front of its socket. This type of shoulder labrum tear usually occurs among young people in their twenties and often comes as a result of high-energy trauma, such as sports injuries, car accidents, or falls.

Posterior labrum tear

A posterior labrum tear is when you receive an injury to the back of your shoulder. It is most commonly seen after a fall onto your arm or through a direct blow (such as a rugby tackle). While SLAP lesions occur when a rim of tissue is pulled at your bicep side, a posterior labrum tear is when it happens to your bone at the back, on the other side. This type of tear is rare, making up only around five to 10 percent of cases.

Making a diagnosis for a shoulder labrum tear is difficult to do with a physical examination alone. This is because the symptoms you may be feeling can be similar to other shoulder and/or arm-related problems, such as inflammation or a pinched nerve (when one of your nerves presses against a surrounding tissue), so your consultant will be sure to conduct a thorough examination.

They will start by asking about your symptoms, learning how the injury occurred and whether your pain has decreased or grown over time, along with seeing if you've received any treatment for your shoulder before. This shall then be followed by a physical examination, during which your consultant will move your arm and shoulder into different positions to see where and when your pain shows up.

After doing these tests, which should enable your consultant to rule out inflammation or pinched nerve, your consultant may order an X-ray. Although X-rays cannot show images of soft tissues (cartilage, muscles, ligaments, tendons), it allows them to see if you have any damage to your shoulder bone, which may indicate a different problem.

Having completed an X-ray, your consultant may order an MRI scan, which uses magnetic fields and radio waves to produce detailed images of your cartilage, including your labrum and its surrounding soft tissues. In most cases, this shows your consultant if you have a shoulder labrum tear and how severe it is.

The treatment that your consultant recommends will depend on the kind of shoulder labrum tear you have. If your tear is not too severe, they will recommend a series of non-surgical options, which include:

Home remedies

To start with, your consultant will most likely recommend rest. Keeping the area as inactive as possible, along with applying ice for 20 minutes three or four times a day, can often be enough to bring down your pain levels. This may be accompanied by anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, along with a cortisone injection - an injection that puts strong anti-inflammatory fluid to the affected area.

Physiotherapy

Your consultant may suggest physiotherapy to help you regain strength, stability, and motion in your shoulder joint. Your physiotherapist will work with you to correct movement patterns that put stress on your labrum. This may involve soft tissue and joint mobilisation to decrease pain and restore movement, along with stretching your shoulder, chest, and back muscles. This increased level of flexibility helps your body rotate and twist more easily without overstretching your shoulder. Some strengthening exercises may be involved as well: strengthening your shoulder joint decreases the stress around your torn labrum, and strengthening your core offers a solid base from which your arm and/or shoulder can function.

In situations where your shoulder labrum tear is severe and you haven't responded to any conservative treatments, your consultant may recommend surgery. For shoulder labrum tears, this means you are likely to undergo a shoulder arthroscopy.

What is a shoulder arthroscopy?

A shoulder arthroscopy is a procedure used to diagnose and treat a variety of shoulder joint problems, with your surgeon making a tiny (keyhole) incision to insert a miniature camera (known as an arthroscope) and look inside your shoulder joint. They can see inside your shoulder joint through a monitor that shows what's happening in your shoulder in real time, check if any issues are present, and, using tiny surgical instruments, make any repairs, such as removing loose cartilage.

Shoulder arthroscopy for shoulder labrum tear

The procedure is usually performed under general anaesthetic, which means you'll be asleep for the full operation and won't feel any pain. However, if you prefer, your surgeon can use a regional nerve block that numbs your shoulder for around six to eight hours. The precise form of arthroscopy given will depend on the nature of your shoulder labrum tear.

Arthroscopy for shoulder labrum tear without dislocation

In less serious cases, your tear may only be on the rim (edge) of your labrum, leaving your tendon unaffected. If this is the case, your surgeon will remove the torn flap on the rim of your labrum and use specialised instruments to correct any other associated problems.

Arthroscopy for SLAP lesion

If your shoulder labrum tear has extended into the biceps tendon, or if your biceps tendon has been completely detached from your shoulder, your surgeon may just need to trim and/or reattach the tendon to the top of your socket. They will do this using absorbable tacks, screws, and minor stitching.

Arthroscopy for posterior shoulder labrum tear

For tears in your labrum located in the bottom half of your shoulder socket, your surgeon will make an incision above the area where the tear took place. They shall then reattach the labrum and ligaments and tighten your shoulder tissue by folding it over and using a technique known as 'pleating' - correcting an imbalance in the tissue length on both sides of your affected labrum.

How quickly you recover from your shoulder labrum tear surgery depends on a range of factors, including:

• Where your tear was located
• The severity of your tear
• The type of surgery performed
• Your age
• Your general fitness levels
• The nature of your job

It takes around four to six weeks for your labrum to reattach itself to the rim of your bone, followed by another four to six weeks to regain full strength through a series of physiotherapy exercises. If your job is sedentary (such as a desk job, where you don't need to lift objects or move around), you should be able to return after a week, but be careful to rest the area and allow your shoulder to receive stress very gradually, otherwise you may experience a fresh tear.

For a full explanation of your recovery timeline from shoulder arthroscopy surgery, please view our dedicated page on the procedure, which explains how much it costs and gives you a complete recovery timeline.

Like with any operation, some complications may occur, but these are incredibly rare. Your consultant will discuss all the risks with you beforehand, along with answering any questions you might have.

General complications of any operation

• Pain
• Bleeding
• Infection in the surgical wound
• Unsightly scarring
• Blood clots
• Difficulty passing urine
• Chest infection
• Heart attack or stroke

Specific complications of a shoulder arthroscopy

• Bleeding in your joint
• Damage to blood vessels and nerves
• Wound oozes and/or bleeds
• High fever and/or temperature

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to suit your routine
• The autonomy to choose which hospital and consultant best aligns with your needs
• Personalised, consultant-led treatment plans tailored to your exact preferences
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standards and delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about shoulder labrum tear treatment, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in November 2022. Next review due November 2025.

1. Shoulder labrum tear, John Hopkins
2. What is a labrum SLAP tear?, WebMD
3. SLAP Lesion, Physiopedia
4. Arthroscopic Repair of Posterior Labral Tear with Paralabral Cyst Decompression, Jomi
5. Shoulder Labral Tear Physical Therapy Treatment, Mangiarelli Rehabilitation
6. Shoulder joint labral tear, OrthoInfo