Glenoid Labrum Tears
The glenoid labrum is designed to deepen the socket of the shoulder joint, provide shock absorption and serve as an attachment point for the shoulder ligaments, the shoulder capsule and the tendon of the long head of biceps. The biceps tendon blends into the top of the glenoid labrum, an area that is known to have a poor blood supply thus making it vulnerable to degenerative changes. These degererative changes are caused by repetitive activities and can make the shoulder susceptable to further injury.
The most common way to tear the glemoid labrum is through compressive forces or through traction forces. A compressive force may occur from a fall on an outstretched arm. An inferior traction force may occur while catching a falling object or while carrying a heavy weight. This force will pull on the long head of biceps and may tear the labrum where the biceps attaches. The other traction force is a superior traction force. This occurs while lifting or stabilising an object above your head.
Tears to the labrum are sometimes named SLAP tears (Superior Labral Anterior Posterior tear). These are most commonly seen in overhead throwing athletes such as baseball pitchers or tennis players.
Others are called a Bancart tear, this occurs when the inferior glenohumeral ligament (a major stabilising ligament of the shoulder) is torn, this is often associated with shoulder dislocations.
Posterior labral tears are less common but are frequently caused by an condition called internal impingement syndrome, where the tightness of posterior rotator cuff/restricted internal rotation causing excessive force to be placed on the posterior labrum in a pinching type mechanism causing fraying and tears to the labrum.
Serious tears will require surgery to reattach the loose parts of the labrum.
Signs and symptoms of a glenoid labrum tear include:
- Tenderness over the anterior aspect of the shoulder that can radiate down the front of the arm.
- Pain with contraction of the biceps muscle.
- Shoulder pain aggravated by general shoulder movements or exercises including overhead lifting or reaching behind the back.
- Popping, catching or grinding may also be present.
- Labral tears will commonly be associated with instability of the shoulder.
- A feeling of clicking in and out of place with throwing.
Treatments for labrum tears include:
- Rest from aggravating activity.
- Stretching of tight muscles.
- Massage to loosen the biceps and surrounding muscles.
- Strengthening as able.
- Postural retraining.
- Restoring movement to the shoulder.
- Correcting abnormal shoulder biomechanics.