Torn Labrum Frequently Asked Questions

The shoulder is the most mobile joint in the human body with a complex arrangement of bone and
soft tissue (ligaments, tendons, and muscles) that work together to produce shoulder movement.
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The labrum is a disk of cartilage on the glenoid, or “socket” side of the shoulder joint. The labrum
helps stabilize the joint and acts as a “bumper” to limit excessive motion of the humerus, the “ball”
side of the shoulder joint. Click here for more information.

Tears of the labrum can be a result of a direct fall or blow to the arm or receptive trauma of the
greater tuberosity and rotator cuff on the posterior labrum. Click here for more information.

The primary symptom of a labral tear that is not associated with instability is pain in the are of the
injury. Labral tears that involve the biceps tendon can make using the biceps tendon painful. Patients
with labral tears from internal impingement will complain that they have pain with throwing. Click here for more information.

In diagnosing a labral tear, a physician will take the patient’s history and perform a physical
examination. X-rays will rule out other problems such as arthritis, fracture, impingement, or
malignancy. The confirming test for a labral tear is an MRI preceded by an arthrogram. This
procedure greatly enhances the diagnostic accuracy by allowing tears of the labrum to be seen more
clearly. Click here for more information.

Physical therapy is helpful in certain cases and may include changing the throwing mechanism,
strengthening and stretching muscles. Click here for more information.

Arthroscopic treatment is the standard of practice for most labral injuries not associated with
instability. The majority of these can be treated with simple debridement (removal of abnormal,
damaged, or excess tissue). Certain painful and unstable SLAP tears, in which the biceps is
detached, need special attention. If the biceps tendon anchor is no longer firmly attached to the
glenoid, it must be re-attached to the bone. Click here for more information.

Complication rates after surgery are generally low. Pre-operative antibiotics are given to reduce the
slight risk of infection after surgery. Stiffness after surgery is unlikely since debridement allows early
arm movement. Failure of healing can occur due to technique, biology, or the patient’s unwillingness
to follow post-operative instructions and the prescribed rehabilitation program. Click here for more
information.

Incisions must be kept dry for two or three days after surgery, sutures are removed 7 – 10 days after
surgery. Physical therapy and range of motion depend on the specifics of the surgery and can be four
to six weeks or longer. Click here for more information.

There are no good natural history studies on labral injuries. There are acute (sudden) labral tear
injuries that are likely to heal without surgery. In chronic (longstanding) cases, however, there are no
successful non-operative treatments. Click here for more information.

The causes of SLAP tears are a subject of debate among orthopaedic surgeons. There are several
injury patterns that can lead to a tear. The most common causes are thought to be:
A fall on the outstretched hand that drives the humerus upward and causes the superior labrum to
tear.
A sudden and often unexpected load applied to the biceps, which can cause a tear.
extremes of external rotation and abduction (movement away from the body) during throwing that
causes the labrum to “peel back” from its attachment.
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The decision to perform a tenodesis is based upon the location of the tear, the amount of biceps
involved, and the quality of the remaining tendon. The more degenerative the tissue, the more likely it
is that a tenodesis will be a successful treatment. Click here for more information.