Glenoid Labrum Tear

OVERVIEW

A glenoid labrum tear is an injury where the cartilage that lines and reinforces the shoulder tears, causing pain as well as a variety of other symptoms. This injury can either happen from an impact injury (such as a fall or direct blow to the shoulder) or gradually over time from playing sports that involve lots of shoulder movement. Fortunately, there are both surgical and nonsurgical treatments available to help you fully recover. Surgical procedures are only recommended if your symptoms do not go away after going through nonsurgical treatments, or if your tear is severe.

ANATOMY

Your shoulder has three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The head of your upper arm bone fits into a rounded socket (known as the glenoid) in your shoulder blade. A combination of muscles and tendons (known as the rotator cuff) keep your arm bone centered in your shoulder socket. The rotator cuff covers the head of your upper arm bone and attaches it to your shoulder blade.

DESCRIPTION

A glenoid labrum tear, also known as a shoulder joint tear, is when the cartilage that lines and reinforces the shoulder joint, the glenoid labrum, is torn

Injuries to the tissue surrounding the shoulder socket can be caused by acute trauma or repetitive shoulder motions. Some examples include falling on an outstretched arm, a direct blow to the shoulder, a sudden pull, or a violent overhead reach. Throwing athletes and weight lifters are also susceptible to tears due to the repetitive shoulder motions that their sport requires.

Tears can be located either above (superior) or below (inferior) the middle of the glenoid socket. The glenoid labrum can also tear partially or entirely. Regardless of the type of tear, they all result in the same symptoms and all need treatment.

SYMPTOMS

The symptoms of a glenoid labrum tear are as follows: A sense of instability in a shoulder.

• Shoulder dislocations.
• Occasional night pain or pain with daily activities.
• Decreased range of motion.
• Loss of strength.
• Pain, usually with overhead activities.
• Feeling like your shoulder is catching, locking, popping, or grinding.

DIAGNOSIS

Your Florida Orthopaedic Institute physician will consider your symptoms and take a history of your shoulder pain. After, your physician will do several physical tests to check your range of motion, stability, and pain. Also, your doctor will request x-rays to see if there are any other reasons for your symptoms.

Your physician may also order a CT scan (computed tomography) or MRI scan (magnetic resonance imaging) to help determine if you have torn your glenoid labrum. Both of these tests produce images of the soft structures inside your body, such as tissues and ligaments. During these tests, your physician will also be on the lookout for other shoulder injuries, such as a dislocated shoulder, since other injuries typically occur with glenoid labrum tears.

TREATMENT OVERVIEW

There are both surgical and nonsurgical treatments to help heal a glenoid labrum tear. Nonsurgical treatments are typically always tried first, unless your injury is severe or if they are ineffective. Regardless of the type of treatment, both will help you fully recover.

NONSURGICAL TREATMENTS

Until the final diagnosis is made, your physician may prescribe anti-inflammatory medication and rest to relieve symptoms. Rehabilitation exercises may also be recommended to strengthen your rotator cuff muscles.

Often, nonsurgical methods are effective in relieving symptoms and healing the injured structures. But if these nonsurgical measures are insufficient, your doctor may recommend surgery.

SURGICAL TREATMENTS

Depending upon your injury, your physician may choose a traditional open procedure or an arthroscopic procedure, in which your surgeon uses small incisions and miniature instruments. During either surgery, the doctor will examine the rim and the biceps tendon. If the injury only involves the rim and not the tendon, the shoulder is still stable. If the shoulder is stable, the torn flap is removed and any other problems fixed.

If the tear extends into the biceps tendon or if the tendon is completely detached, the biceps tendon may be considered unstable. If this is the case, then the tendon will need to be repaired or possibly even transferred using absorbable tacks, screws or sutures.

Tears below the middle of the socket are also associated with shoulder instability. During the procedure for this particular tear, the ligament is reattached, and the shoulder is tightened by folding over and “pleating” the tissues.

NEXT STEPS

Talk to your Florida Orthopaedic Institute physician to learn more about glenoid labrum tears.