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Commonly asked questions about Labral tears in the shoulder

Q:

What is a labral tear of the shoulder?

A:

The shoulder joint consists of a ball (humeral) and socket (glenoid). The glenoid is lined by a lip of connective tissue which connects the ligaments in the shoulder to the glenoid rim.

Q:

What is the function of the labrum?

A:

The glenoid labrum serves to deepen the socket by 5-9mm thereby stabilises the humeral head within the glenoid. When the labrum is torn, the suction effect is lost and the shoulder subsequently clicks on certain movements of the shoulder.

Q:

How does a torn labrum occur?

A:

A tear of the glenoid labrum may occur following:

  • A traumatic dislocation of the shoulder
  • A fall onto the arm
  • Repetitive high velocity overhead activities such as cricket bowling, throwing
  • A rugby tackle when the arm is forcibly moved backwards and away from the body
  • Bench press in the gym
  • Heavy lifting

Q:

What are the symptoms?

A:

These include shoulder pain, arm weakness, clicking of shoulder, pins and needles in the hand.

Q:

How can you diagnose this condition?

A:

A careful history, detailed clinical examination, an x ray to exclude other conditions and an ultrasound scan to exclude a rotator cuff tear. For definitive diagnosis, a special type of MRI examination (arthrogram) is required whereby an injection of dye is given into the shoulder joint to allow a detailed assessment of the labrum and ligaments.

Q:

How can it be treated?

A:

A tear of the labrum very seldom heals on its own. If the tear is small, pain can be reduced by avoiding certain activities. If the tear is large, prompt surgical repair is recommended to avoid worsening of the condition and progression of the tear.

Q:

What does surgery involve?

A:

The entire operation is carried out arthroscopically (key hole surgery). Under a general anaesthetic, two to three little stab incisions (about 0.5 to 1cm each in size) are made around the shoulder. Through these arthroscopic portals, the camera as well as a variety of surgical instruments is inserted into the shoulder. Biodegradable suture anchors (these are plastic screw which dissolve with time) are inserted into the rim of the glenoid and the torn labrum is sutured back onto the glenoid using hand tied knots with an ultra-high molecular weight polyethylene suture.

Q:

Following surgery, when can I return to work?

A:

The period of time off work will depend entirely on the type of work that you do. For a sedentary type of job, there is no formal restriction although at least a few days is advisable. If your job involves heavy manual labour or strenuous physical activity, a period of up to 3 months may be required. The published reports in the literature suggest that in military patients, 96% of patients post operatively would be able to return to full duty at a mean period of 4.4 months.

Q:

Following surgery, when can I return to sports?

A:

Swimming and gentle jogging can start after 6 weeks. For contact sports such as rugby, this may be up to 12 weeks. The exact period may vary from person to person but generally speaking, once the shoulder has regained full range of movement and normal strength compared to the opposite shoulder, you can safely return to sports.

Arthroscopic view of labral detachment

Arthroscopic view of a tear in the glenoid labrum

Following arthroscopic repair of labral tear


View of a torn labrum inside the shoulder joint

View of the labrum being repaired with hand tied knots using ultra high molecular weight polyethylene sutures

View of the labrum after repair

The information on this website does not replace medical advice. If you have a medical problem please see your doctor or consultant.