Labral Tears
Description
The
"Labrum" is the lining around the socket of the shoulder
joint. It is the attachment site for most of the important
ligaments that stabilize the shoulder. It is also the
attachment site for part of the biceps - the strong muscle
in your arm.
The labrum can develop various different problems. Some people develop 'wear & tear' types of injuries to their labrum. Weather it was from athletics when they were younger or a lifetime of use & abuse of the shoulder, the labrum can progressively tear and eventually become symptomatic. Another way people injure their labrum is with a traumatic event. A fall, a car accident, a very hard throw of a ball...all of these and many more things can cause an sudden tear of the labrum which can be very painful
Symptoms
Typically labral tears cause pain. Sometimes the pain occurs with activities such as overhead or throwing activities. Often patients also complain of night pain in the shoulder or arm. Certain activities become more difficult to perform. Occasionally patients complain that they feel their shoulder 'slipping'. Sometimes people even describe this as a dislocation.
Treatment Options
Like most other shoulder conditions there are several options in treating the Labrum.
- Do nothing and live with the pain: This is not cancer and will not kill you but living with the discomfort can be quite difficult. Doing nothing is always an option.
- Anti-inflammatory medication / cortisone (steroid) injections: This can help you live with your shoulder. The goal is to reduce your pain. This option will not increase your strength or repair the torn labrum however.
- Physical Therapy: PT can help maximize your strength. By strengthening the muscles around the shoulder it provides what we call 'secondary stability' to your shoulder. The labrum is the 'primary' stabilizer but sometimes by maximizing these secondary stabilizers we can get you a shoulder that is more comfortable and functional...but you MUST continue to keep it strong for this to work.
- Arthroscopic Labral Repair: This option repairs the torn labrum back down to the bone. After sufficient rehabilitation, the goal is both to eleviate pain and to restore full function...including overhead throwing. This is a very safe and effective surgery but does require some time for rehabilitation.
Treatment Options: Arthroscopic Labral Repair
Labral tears can be fixed arthroscopically. Dr. Brady uses small bio-absorbable anchors (screws) which go down into the bone. Attached to each anchor are two sutures. He then uses arthroscopic instruments to pass these sutures through the torn tissue and then he ties the sutures down. In so doing, this secures the torn labrum back down to the bone where it can heal over time. The picture on the right is an excellent representation of how these tears are fixed.
Like most other repairs - patients must go through postoperative rehab in order to make a full recovery. Thankfully the success rate is extremely high after arthroscopic labral repairs.