What is a Labrum Tear?
As an athletic trainer and physical therapist, as well as a former national team swimmer, Mauricio Elizondo understands injured athletes. At 18 years old, he suffered a shoulder injury and had his appendix removed (yes, both happened at the same time!) that forced him to withdraw from his swimming national championship... more
What is a labrum tear?
About 30% of our patients come to the clinic with some type of shoulder injury. About half of that percentage have diagnosed “labrum tears” that their physicians recommended surgery as their first choice of treatment, and they come to see us for a second opinion. Most patients are confused about what the labrum is and why the physician jumps to surgery right away, as sometimes the pain isn’t limiting their function (either lifting weights, daily living, etc.) dramatically.
So, what is a labral tear and how significant is it? Let’s start by defining the labrum. The labrum is a ring of cartilage that surrounds a part of your shoulder blade called the glenoid and it provides depth in the socket where the moving part of your shoulder, called the humerus, moves around. The labrum is very thin, and unfortunately, because it is cartilage tissue, it is also avascular, which means it doesn’t get a lot of blood supply. This is important because once the labrum is torn, it won’t heal naturally as a muscle would. Therefore, doctors jump into surgery right away, because they know that the tissue won’t heal on its own and they want to fix it for you thinking that would alleviate your pain.
How does a labrum tear you may ask? The biggest cause of labrum tears is trauma. This can happen from a fall where you land on the arm, and overhead movement done the wrong way, a pull-up with poor technique, or repetitive trauma like throwing a baseball. Most of the time you can pinpoint exactly what motion caused the pain and when it happened. After that moment, you realize that the shoulder doesn’t feel quite the same as before that trauma and it doesn’t go away after a few days of rest. This is different than a tendonitis or tendinopathy in the shoulder (rotator cuff is the most likely one) where you do not know when it started, as tendonitis usually presents without a specific trauma to the tissue, and it usually gets better after a few days.
So, if I don’t have surgery, my shoulder will never feel like it did before because it doesn’t heal? You may be asking that question, and the answer is no. Labrum tears usually happen when there is too much motion in the joint because of muscle weakness, poor lifting/activity technique, or muscle imbalances. Because of this extra motion the labrum gets over-stretched and pinched that with time or a trauma, it can tear. Therefore, fixing the excess motion by addressing the weaknesses and imbalances present in the shoulder is the key to avoid stressing the labrum and therefore, decreasing pain. This can be done with Physical Therapy. The latest review of literature on shoulder labrum repair surgeries doesn’t give show a success higher than 50% of desired improved outcomes. Therefore, I would recommend starting your journey with a Physical Therapy assessment before jumping into surgery right away, as you can get back to the activity you would like without the secondary effects of surgery.
As always, we are here to help at PSP. If you suffer shoulder pain and you have been diagnosed with a labrum tear, call us for a free consultation at 727-826-7142 or email us at info@performancesportphysio.com and we will do a detailed shoulder evaluation to create a plan that is best suited for you.
Thank you for reading!
