An unstable shoulder joint can be the cause or the result of a labral tear.

“Labral” refers to the ring of cartilage (glenoid labrum) that surrounds the base of the shoulder joint. Injuries to the labrum are common, can cause a great deal of pain, and may make it hard to move your arm. A labral tear can occur from a fall or from repetitive work activities or sports that require you to use your arms raised above your head. Some labral tears can be managed with physical therapy; in severe cases, surgery may be required to repair the torn labrum.

The physical therapists at West Park Rehab are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. West Park Rehab has been successfully treating shoulder related injuries for over 20 years. Help is available.

You can request an appointment using the following link: https://sites.webpt.com/1660/reactivation-offer.

Or — call our offices at Franklin: 814-437-6191 or Seneca: 814-493-8631.

What Is a Shoulder Labral Tear?

The ring of cartilage called the glenoid labrum provides extra support for the shoulder joint, helping to keep it in place. A shoulder labral tear occurs when part of this ring is disrupted, frayed, or torn. Tears may lead to shoulder pain, an unstable shoulder joint, and, in severe cases, dislocation of the shoulder. Likewise, a shoulder dislocation can result in labral tears.

When you think of the shoulder joint, picture a golf ball (the head of the upper-arm bone, or humerus) resting on a golf tee (the glenoid fossa, a shallow cavity or socket located on the shoulder blade, or scapula). The labrum provides a rim for the socket (golf tee) so that the humerus (golf ball) does not easily fall off. If the labrum is torn, it is harder for the humerus to stay in the socket. The end result is that the shoulder joint becomes unstable and prone to injury.

Because the biceps tendon attaches to the shoulder blade through the labrum, labral tears can occur when you put extra strain on the biceps muscle, such as when you throw a ball. Tears also can result from pinching or compressing the shoulder joint, when the arm is raised overhead.

There are 2 types of labral tears:
– Traumatic labral tears usually occur because of a single incident, such as a shoulder dislocation or an injury from heavy lifting. People who use their arms raised over their heads—such as weight lifters, gymnasts, and construction workers—are more likely to experience traumatic labral tears. Activities where the force occurs at a distance from the shoulder, such as striking a hammer or swinging a racquet, can cause a traumatic labral tear. Falling on an outstretched arm also can cause this type of tear.

– Non-traumatic labral tears most often occur because of muscle weakness or shoulder joint instability. When the muscles that stabilize the shoulder joint are weak, more stress is put on the labrum, leading to a tear. People with nontraumatic tears tend to have more “looseness” or greater mobility throughout all their joints, which might be a factor in the development of a tear.

How Does It Feel?

A shoulder labral tear may cause you to feel:
– Pain over the top of your shoulder
– “Popping,” “clunking,” or “catching” with shoulder movement, because the torn labrum has “loose ends” that are flipped or rolled within the shoulder joint during arm movement, and may even become trapped between the upper arm and shoulder blade
– Shoulder weakness, often on one side
– A sensation that your shoulder joint will pop out of place

How Is It Diagnosed?

Not all shoulder labral tears cause symptoms. In fact, when tears are small, many people function without any symptoms. However, healing may be difficult due to the lack of blood supply available to a torn labrum. The shoulder with a labral tear may pop or click without being painful, but if the tear progresses, it is likely to lead to pain and weakness.

If your physical therapist suspects that you have a labral tear, they will review your health history and perform an examination that is designed to test the condition of the glenoid labrum. The tests will place your shoulder in positions that may recreate some of your symptoms, such as “popping,” “clicking,” or mild pain, to help your physical therapist determine whether your shoulder joint is unstable. The accuracy of the evaluation can be improved with the addition of a Musculoskeletal Ultrasound. These tests can be performed and interpreted by the highly-trained specialists at West Park Rehab.

Magnetic resonance imaging (MRI) also may be used to complete the diagnosis. Some labral tears may be difficult to diagnose with certainty without arthroscopic surgery. Your physical therapist may consult with an orthopedic surgeon if necessary.

How Can a Physical Therapist Help?

When shoulder labral tears cause minor symptoms but don’t cause shoulder instability, they usually are treated with physical therapy. Your physical therapist at West Park Rehab will educate you about positions and activities to avoid, and tailor a treatment plan for your recovery. Your treatment may include:
– Manual therapy
– Strengthening exercises
– Stretching exercises
– Postural exercises
– Education
– Home-exercise program

If Surgery Is Needed

In more severe cases, when conservative treatments are unable to completely relieve the symptoms of a labral tear, surgery may be required to reattach the torn labrum. Following surgery, your physical therapist will design a treatment program based on your specific needs and goals, and work with you to help you safely return to your daily activities.

A surgically repaired labrum takes 9 to 12 months to completely heal. Immediately following surgery, your physical therapist will teach you ways to avoid putting excessive stress or strain on the repaired labrum.

Can This Injury or Condition Be Prevented?

Forceful activities performed with the arms raised overhead may increase the likelihood of developing a labral tear. To avoid putting excessive stress on the labrum, you need to develop strength in the muscles that surround the shoulder and scapula. Your physical therapist at West Park Rehab can:
– Design exercises to help you strengthen your shoulder and shoulder blade muscles
– Show you how to avoid potentially harmful positions
– Train you to properly control your shoulder movement and modify your activities to reduce your risk of sustaining a labral injury
– Provide posture education to help you avoid placing unnecessary forces on the shoulder
– Help you increase your shoulder and middle-back flexibility

Don’t let this kind of physical problem go on without getting the help you need. In many cases, you do not need a referral to start physical therapy.

You can request an appointment using the following link: https://sites.webpt.com/1660/reactivation-offer.

Or — call our offices at Franklin: 814-437-6191 or Seneca: 814-493-8631.

West Park Rehab has an opening for a physical therapist to join our Franklin team. If you enjoy working in a collaborative environment where patient care is the center of focus, would like to share in the 5 star reputation of a practice, would like to receive a competitive salary with bonuses and finish your work week at noon on Fridays, then please send your resume’ to:

West Park Rehab, Attn: Eddie St.Clair, DPT, CHT
571 Pone Lane
Franklin, PA 16323