Orthopedics

6 Questions About Shoulder Labral Tears Answered

If you’re an athlete and you’ve felt a pop or instability in your shoulder, especially if it required a trainer or doctor to move your shoulder back into place, you could have suffered a shoulder dislocation, and as a result, a torn labrum.

Now you're probably wondering: What is that?

Ian Rice MD, a sports medicine orthopedic surgeon with the TriHealth Orthopedic and Sports Institute, answers six common questions about shoulder labral tears.

Question #1: What’s a Shoulder Labral Tear?

Answer: A shoulder (glenoid) labral tear is damage to the ring of cartilage (called the labrum) in the shoulder socket, which causes pain and a feeling of instability with sport activities or overhead motion.

Question #2: Who’s at Risk for Shoulder Labral Tears?

Answer: They’re more common in overhead athletes and collision sports, including football, basketball, lacrosse, rugby, wrestling and volleyball.

Question #3: Can Shoulder Labral Tears Have Lasting Consequences?

Answer: Shoulder dislocations – particularly in young people and athletes – commonly result in a condition called a Bankart lesion, or anterior-inferior labral tear.

A Bankart lesion is damage to the labrum, joint capsule, and shoulder ligaments that occurs during a traumatic shoulder dislocation. If left untreated, this may lead to chronic or recurrent shoulder instability, pain, and weakness.

Question #4: Can I Still Play Sports?  When Can I Return?

Answer: I recommend an individualized, common sense approach. If you can regain full strength and function, perform well enough to be effective in your sport, and understand the risks of returning to play, it can be the right decision to return that season. 

These scenarios include athletes who have a scholarship on the line, or those who want to complete a senior season with no intention of playing sports in the future.

Question #5: How Are Labral Tears Identified?

Answer: To find out whether you have a labral tear, find an orthopedic sports medicine shoulder specialist. Shoulder instability occurs over a wide spectrum, including forms of bone damage, and each patient is unique.

It’s important to work with a sports medicine specialist because these specialists can help you decide how soon you can safely return to your sport, or whether a nonsurgical or surgical treatment approach is best.

A workup typically includes X-rays and may require additional testing such as an MRI or CT to fully define the injury.

Question #6: How Are Labral Tears Treated?

Answer: The first priority with a shoulder dislocation has always been to move the joint back in to place. The philosophy of long-term treatment has changed dramatically, however.

Twenty-five to thirty years ago, virtually all athletes were rehabbed and sent back on the field as soon as function returned. Today, we recognize that 80 to 90 percent of teenage athletes with a shoulder dislocation will dislocate again, if they remain active in sports. We know shoulder dislocations involve important ligaments and labrum tissue that are torn and often do not heal properly without surgery. 

Decades ago, the only surgical option required a large incision and stiffness after surgery. Now, we routinely perform surgery with minimally invasive arthroscopic techniques, and patients enjoy stability of their shoulder without sacrificing significant range of motion.

Tags Orthopedics

Last Updated: December 01, 2015