Your shoulder is made up of a ‘ball and socket’ joint, where the ball part at the top of the upper arm bone (‘humerus’) connects to the shoulder socket (known as the ‘glenoid’). This area is cushioned by a rim of cartilage called the ‘labrum’, which supports the whole joint and stabilises the shoulder.
A tear to your labrum can occur from repetitive motions, or as a result of trauma, such as:
- A direct physical blow to your shoulder,
- Falling onto outstretched arms,
- A sudden overhead gesture,
- Complications from a shoulder dislocation.
Possible symptoms of a labral tear in the shoulder you may experience include:
- An aching pain deep inside your shoulder,
- Difficulty and pain experienced with overhead movements,
- Shoulder weakness and instability,
- Popping or clicking sensations in your shoulder,
- Loss of mobility.
During your initial appointment with one of our consultants, you will undergo a physical examination where your doctor will perform a series of tests to check your range of motion, stability, and the level of pain in the affected shoulder. They may also request an x-ray to rule out any other concerns.
Tissue damage isn’t visible on an X-ray, so your doctor may also refer you for a CT or MRI scan, possibly injecting contrast dye during the scan to help clearly highlight a tear.
There are two main types of tear:
- A SLAP tear (which stands for ‘Superior Labrum Anterior to Posterior’) – a tear above the middle of your shoulder socket,
- A Bankart tear – a tear below the middle of your shoulder socket.
These tears tend to be treated in different ways. SLAP tears can usually heal through non-surgical means, and if this is appropriate, our physiotherapy team will guide you through a course to bring full mobility back to your shoulder, with pain and anti-inflammatory medication used to ease your discomfort. Non-surgical methods are also preferred for older patients who tend not to have regular physical activity or engage in sports.
Bankart tears and some more severe SLAP tears will likely require surgery to correct.
If you have been diagnosed with a Bankart labral tear, or the course of physiotherapy to deal with your SLAP tear has not been successful, your consultant may suggest that surgery is your best option.
This surgery will be performed under general anaesthetic, with a local anaesthetic also applied directly to your arm, and our highly proficient Circle anaesthetists will be intensively monitoring you throughout. The procedure typically takes around an hour and a half.
Depending on the severity of the tear, the surgery can be either be performed as open surgery or arthroscopically (keyhole surgery), with arthroscopic procedures usually being preferred due to being less invasive. In the case of open surgery, an incision is made at the front of your shoulder, whereas multiple small incisions are made around the shoulder if you and your surgeon decide on an arthroscopy.
Ultimately, your surgeon will be aiming to reattach the labrum and ligaments within your shoulder joint to their natural position. This is done by using ‘anchors’ which connect the labrum to the socket, stitching the anchors in place for added security.
Once surgery is complete, you will usually need to keep your arm in a sling for three to six weeks while you recover, and your stitches will be removed a week or two after surgery. Our physiotherapy team will gradually introduce exercises to build up strength and range of motion, working with you in a dedicated rehabilitation programme. Ordinary use of your shoulder should be regained by eight to ten weeks, and at this point you are normally able to resume some light sporting activities, as long as they do not place heavy stress on your shoulder.
You will normally continue to work with our physiotherapists for four to six months, alongside some follow up appointments with your surgeon, who will monitor your progress and can adjust your rehabilitation programme accordingly. Many of our patients feel reassured by this level of guidance and care, contributing to a positive recovery period.
If your shoulder pain has been preventing you from carrying out daily activities, why not get in touch with our team today and book an appointment to see one of our expert orthopaedic specialists? Circle hospitals are home to some of the leading surgeons in the UK, and with a multi-disciplinary team focused on putting your needs first, your diagnosis, treatment, and recovery couldn’t be in safer hands.