Labral Tears

Labral tears can be a source of shoulder pain in anyone, but most often occur in the younger athletic population.  They can result from shoulder dislocations or other traumatic pulls to the shoulder, but can also come from degenerative wear.  They can also occur from motor vehicle accidents or falls.  After an initial evaluation by the orthopedic surgeon and MRI arthrogram may be ordered to visualize a tear if one is present.  Sometimes they can and should be fixed, and sometimes they just need to be debrided (shaved and ‘cleaned up’). Unfortunately there are times they can’t be fixed.  Typically, the younger the patient the more likely we are to fix the labrum.

The labrum is a gasket of tissue that surrounds the socket of the shoulder called the glenoid.  It serves to deepen the typically shallow socket, and also serves attachment points for other structural supporters of the shoulder.  Most notably, the top end of the biceps tendon attaches at the most superior part of the labrum.

Keeping Bodies in Motion (352) 596-0900

When the shoulder is rapidly jerked in a direction, or if the shoulder is pulled out of joint the labrum can tear and cause swelling, bleeding and pain.  Patients may complain of instability in the shoulder (the feeling of popping in and out of the joint), or they may complain of popping, clicking and catching as if something were loose in the joint.  Sometimes the tear is small and may not initially cause problems; however, as the shoulder begins to resume its normal motion that abnormal part of the labrum can cause issues and become degenerative, leading to later problems.  Most labral tears are anterior – called a Bankart tear, or superior – called a SLAP tear.

“Surgery for labral tears has evolved tremendously over the years.”  In the past, large incisions were made to explore the joint and fix what could be seen.  Nowadays however we can explore the joint with an arthroscope.  This gives us direct visualization of the entire joint and tears can be immediately identified and fixed through small portals.  With advanced instrumentation and skillful precision the labrum can be captured with suture and anchored into the glenoid.  Sometimes the labrum is torn in multiple places, or even circumpherentially.  Never-the-less it can be repaired arthroscopically.  In general the worse the tear the longer the rehabilitation. Contact my office today so you can receive an expert consultation and a plan to relieve your discomfort.

Dr. Jared Salinsky – Orthopedic Surgeon