Glenoid labrum tears may mostly occur in people involved in repeated overhead movements or athletes who play sports like throw ball, baseball or are weightlifters.  If you have a glenoid labrum tear you will experience weakness and intense pain in your shoulder, more so when you try to raise your arm or reach out to your back. Normal daily activities may seem difficult to you.

Shoulder Joint Anatomy

The upper arm bone (humerus), the shoulder blade (scapula) and the collarbone (clavicle) make your shoulder.  Your upper arm bone is fit into the shallow socket (glenoid) of your shoulder blade. It helps you to move your shoulder in multiple directions.

The head of the humerus is larger than the hollow socket. To enable the arm to fit comfortably in the socket, a soft fibrous cartilage rim (labrum) surrounds it. This fibrous tissue supports the ball and socket joint and makes it stable.

Explanation

You may experience glenoid labrum tears when the fibrous ring of cartilage (labrum) surrounding the hollow shoulder socket (glenoid) sustains an injury.  The labrum either tears above the middle or below the middle part of glenoid.  Depending on this, labrum tears may occur as:

SLAP tears- When the labrum tear is above the middle part of the glenoid socket, it is called SLAP tear (superior labrum anterior to posterior). It is usually associated with biceps tendon.

Bankart tears- When the labrum tear occurs below the middle part of your glenoid socket, it is referred to as bankart tear. It is associated with a dislocated shoulder.

Causes

Broadly there are two causes that may bring on a tear in your labrum. The causes may include:

Injury- Falling on your outstretched arm or onto your shoulder, bracing yourself against a violent fall with your arm over your head, or procuring injuries during a direct blow to your shoulder may result in labrum tear.

Activities-   Lifting heavy objects over your head, playing sports like throw ball or baseball, or being involved in activities where you use your shoulder repeatedly, may cause a tear in your labrum.

Risk Factors

You are more likely to suffer from glenoid labrum tear if:

• If you are in your elderly years, as age makes the cartilage more breakable.
• If you have had a previous shoulder dislocation, the labrum does not heal in the exact location once it has been dislocated.
• If you are a weightlifter or an involved in throwing sports

Symptoms

The symptoms of the labrum tear may include:

• Range of motion may reduce
• Weakness and instability in your shoulder
• Intense pain during daily activities, especially when you lift your arm over your head
• Previous shoulder dislocations
• Catching or grinding sensation in the shoulder (when torn labrum rubs against muscles)
• Pain when you sleep at night

Diagnosis

The diagnosis of glenoid labrum tear begins with a physical examination and concluded with some imaging tests.

Doctor’s examination– The doctor may ask you several questions about your activities. He may inquire if you have been involved in any injury before the pain began in your shoulder.  The doctor may proceed with your diagnosis by physically examining your shoulder for signs of weakness, movability, and pain.

Imaging tests- After the assessment, the doctor may ask you to undergo a few diagnostic tests that include:

X-ray- Even though the x-rays do not show the soft tissues inside the shoulder they will help your doctor in confirming the presence or absence of any other problems in it.

CT Scan & MRI- Your doctor may inject a contrast medium and perform a magnetic resonance imaging or computed tomography on your shoulder to confirm the presence of labrum tear.

Arthroscopy- Your labrum tear may be assessed by a minimally invasive technique called arthroscopy. In this imaging test, a small camera helps your doctor to see the injuries on the labrum in detail.

Treatment

There are different ways your doctor may consider treating your labrum tears.  The treatment method usually begins with conservational techniques and it is only after these techniques do not work that surgical intervention is implemented after considering your age, your health, and the severity of your tear into account.

Non-Surgical Treatment Techniques:

The doctors usually begin with the non-surgical methods that may include:

Non-steroidal anti-inflammatory medications- Your doctor may prescribe medicines to bring down the swelling and the pain in your shoulder.

Steroid injections- The specialist may prescribe cortisone injections if oral medications fail to give you relief.

Reduction- If you sustain a minor bankart tear with an associated dislocation, your doctor may gently maneuver your shoulder back to its appropriate position with a method called reduction.

Physical therapy- You may also be recommended some strengthening exercises to help increase stability in your shoulder.

In spite of the techniques, if you continue to have difficulties in raising your arm over your head or doing daily activities and your shoulder keeps getting dislocated,  you may be advised to undergo surgical intervention by your specialist.

Surgical Treatment Techniques:

There are several surgical procedures to repair your glenoid labrum tears.  The most suitable method is decided upon by the surgeon after considering the severity of the labrum tears and the damage to your ligaments. The surgical techniques may include-

Arthroscopic Repair- In this minimally invasive technique, your surgeon will make a small cut on your shoulder and repair your tear with the help of arthroscopy.

Open Repair- If the tear is large or there are other complications the surgeon may perform the repair with a much lengthier process. Your surgeon will reattach the torn labrum or ligament to your bone.

Mini-Open Repair- This technique is a combination of arthroscopic and open repair. After making a small incision, the tear is repaired arthroscopically and then the surgeon inspects the shoulder joint directly and takes action accordingly.

When the tear is associated with a biceps tendon, your surgeon may have to transfer the tendon to another part. He may perform this arthroscopically or through an open surgical repair.

When the tear is associated with shoulder instability, your surgeon may have to repair and re-stitch the torn ligament and perform a surgery that involves the method, ‘pleating of tissues’.