Labrum tear is one of the common injuries of shoulder joint. Labrum tear is quite a debilitating condition that may affect movement of an arm and daily activities of an individual. In order to know what a labrum tear is it is necessary to understand the anatomy of labrum and its importance for the shoulder joint.
Labrum is a type of cartilage found in the shallow glenoid cavity of the shoulder joint. Shoulder joint just like hip joint is a ball and socket joint. It is area where the arm attaches itself to the body.The shoulder joint is made up of three bones; shoulder blade (scapula), arm bone (humerus) and the collar bone (clavicle).
The hollow socket is made up of scapula bone. The socket is called glenoid cavity. This cavity is very shallow and the head of humerus is not able to fit and slide inside the cavity. Here comes the role of labrum. Labrum is a type of soft tissue attached at the rim of socket and covers the inside of the glenoid cavity. It makes a cup like structure inside the socket to give space for the head of the arm bone to fit itself comfortably in the socket.
An injury to the shoulder joint can tear the labrum. The head of shoulder bone may slide slightly out of the socket. This condition in medical terminology is called subluxation. If the whole head of humerus comes out of the socket as a result of labrum tear, we call it as dislocated shoulder joint. Labrum tear may cause pain and discomfort in shoulder joint as well as difficulty in movement of arm.
In most cases, labrum tear needs surgical repair especially in younger age group who play sports. In older age group above 50, labrum tear if mild may not require surgery. Physical therapy enables the patient to establish wide range of motion after surgery and if he is of older age group.
What Causes A Torn Shoulder Labrum?
A direct traumatic injury to shoulder joint can damage and tear the labrum; or example falling on shoulder with overextended arm. Labrum tear is also common in people who overuse their arm. It is common in athletes, especially people playing sports which require throwing movement, example; javelin, swinging tennis racket, throwing a ball in cricket etc.
The risk of labrum tear is more when the person takes his arm upwards and backwards. Repeated stretching can damage the labrum in the anterior aspect of the socket. Small damages and tear of labrum can make the shoulder extremely unstable. The ball of humerus may slip out of the socket, the condition we call dislocation.
Weightlifters, baseball players and people playing golf are also at risk of suffering from torn labrum in shoulder. It is because the action needed in such sports makes the tendon of biceps muscle overstretched. It may pull the labrum as the tendon is attached to it.
Symptoms Of Torn Labrum In Shoulder
A person may experience a sharp pop and catching sensation when the labrum is torn. It usually occurs when he is doing some sort of arm movement. After a while the patient may feel pain in his shoulder joint, especially when he lifts his shoulder over his head or to throw something and takes his arm backwards. Sometimes the tear may remain silent without causing any pain.
The shoulder becomes weak and lax because the stability provided by labrum is lost. With lifting weight or overuse of arm, it may lead to subluxation or total dislocation of shoulder joint.
Treatment For Torn Shoulder Labrum
Sometimes labrum tear is difficult to diagnose only from the symptoms as they are not adequate to establish the diagnosis. In such cases CT scan may be helpful. However, this may also require special dye to be injected at the site for better recognition. Lastly the most appropriate method is arthroscopy. It is an invasive method to detect the condition.
- After diagnosing, the first aim is to relieve pain and swelling in the joint. Physicians prescribe anti inflammatory analgesics to alleviate pain. Corticosteroids may sometimes be recommended by the doctor if pain and swelling in severe.
- Alternate hot and cold fomentation provides relief from pain and allows the injured area to heal quickly.
- Once the swelling and pain becomes less, physical and occupational therapy is recommended after few days to improve the range of motion of shoulder joint.
- After few weeks the therapist may begin more extensive strength training exercises to strengthen the muscles of shoulder joint. The intention is to provide stability to shoulder joint. It may take six to eight weeks to recover.
When the symptoms persist even after conservative treatment is over. Surgical intervention may be evaluated for alleviating the condition.