Shoulder Labrum Tear

Medically Reviewed By William C. Lloyd III, MD, FACS

What is a shoulder labrum tear?

A shoulder labrum tear is a type of soft tissue injury. The labrum is a ring of cartilage surrounding the socket of a ball and socket joint, such as the shoulder. Three bones make up the shoulder joint—the shoulder blade, upper arm bone, and collarbone. The ball of the upper arm bone fits into a socket in the shoulder blade. This socket is the glenoid. The glenoid labrum forms a strong rim, or cup around the socket that deepens the socket by about 50%. This stabilizes the joint. It also provides an attachment site for shoulder ligaments and a biceps tendon.

There are two types of shoulder labrum tears:

  • Bankart tears, or lesions happen when the ball of the upper arm bone dislocates out of the socket, forward or backward, and tears the labrum. These tears can completely separate the labrum from the bone. They occur below the middle level of the labrum.

  • SLAP (superior labrum from anterior to posterior) tear occurs at the top of the labrum where the biceps tendon attaches. These labral tears can also damage the biceps tendon.

Acute trauma often causes a shoulder labral tear. The labrum can also tear from repetitive motions that cause an overuse injury. Athletes who regularly use overhead movements have an increased risk of shoulder labrum tears. Aging can also increase the risk of fraying or tearing the labrum.

Tearing the shoulder labrum can result in joint pain, joint looseness, and changes in range of motion. You may also notice sounds or sensations, such as popping, clicking, catching or locking. With acute injuries, symptoms appear suddenly. Symptoms tend to develop over time with overuse injuries. 

Shoulder labrum tear treatment usually starts with nonsurgical therapies. This usually involves anti-inflammatory medicines and physical therapy. If these measures are not effective, doctors may recommend shoulder labrum tear surgery.

See your doctor promptly if you have shoulder pain or other problems that persist or worsen with time. Seek immediate medical care if you have an injury or trauma that affects the shoulder.

What are the symptoms of a shoulder labrum tear?

Shoulder labrum tears that only involve fraying along the edge often do not cause any symptoms. Symptoms of an overuse injury of the labrum tend to develop gradually. However, acute tears of the shoulder labrum are usually immediately noticeable. Regardless of the type of injury, shoulder labrum tear symptoms are like many other shoulder injuries.

Common shoulder labrum tear symptoms include: 

  • Clicking, grinding, popping, catching or locking

  • Decreased range of motion

  • Looseness or instability, which may result in frequent dislocations

  • Pain, which can be worse with movement, especially overhead movements, or in certain positions

  • Weakness

Ongoing shoulder pain or other symptoms should prompt a visit to your doctor. After a physical exam, your doctor will likely order some tests. There is no specific shoulder labrum tear test, such as by moving your shoulder a certain way. Instead, doctors rely on imaging exams and sometimes, arthroscopy, to diagnose the problem. X-rays can show your doctor if bones or other dense structures are damaged. To view the labrum, CT (computed tomography) or MRI (magnetic resonance imaging) are necessary. These tests are better able to show soft tissue injuries.

What causes a shoulder labrum tear?

Trauma or injury causes a shoulder labrum tear. This trauma can be acute or due to overuse. Acute injuries include motor vehicle accidents, shoulder dislocations, falls on an outstretched arm, sudden pulls on the arm, or other violent forces, such as a blow to the shoulder. Another common cause is rapid or forceful overhead motions. Overuse injuries result from repetitive overhead shoulder motions.

What are the risk factors for a shoulder labrum tear?

There are several factors that increase the risk of sustaining a shoulder labrum tear. Risk factors include:

  • Aging, which causes the cartilage to become more brittle and more likely to tear with trauma or fray with time and use

  • Being an athlete in a sport involving overhead motions, including throwing athletes and weightlifters

Reducing your risk of a shoulder labrum tear

It’s hard to prevent a shoulder labrum tear, as many of them are the result of accidents or injuries. If you are an athlete at risk of a tear, talk with your doctor and trainers about ways to protect your shoulder. Learn about warning signs of a problem and seek care if you notice them.

How is a shoulder labrum tear treated?

In most cases, conservative treatment with nonsurgical therapies is the first step in treating a shoulder labrum tear. This includes rest, anti-inflammatory medicines, and sometimes cortisone injections. Cartilage does not heal quickly, so try to be patient. Physical therapy can help increase range of motion and strengthen and stabilize the joint. This is often successful in relieving pain, promoting healing, and preventing further injury. Physical therapy can take up to six months.

For large tears or when conservative treatment fails, doctors may recommend surgery to reattach the labrum to the glenoid (the socket). Arthroscopy is a common technique for shoulder labrum repairs. It is minimally invasive and often involves a faster recovery and less pain than open surgery. In some cases, open surgery is still the best choice. Surgery is usually necessary if other structures are damaged too, such as ligaments and tendons.

What are the potential complications of a shoulder labrum tear?

Many older adults who are not physically active will heal with nonsurgical treatments. Athletes and active adults can have recurrent or persistent problems without surgery. 

After surgery, it is usually necessary to wear a sling for six weeks. Physical therapy and rehabilitation are important for recovery. This may continue for 10 weeks after surgery. Most people recover with more strength and stability and less pain. However, it can take some time. In general, it can take 4 to 6 months for a full recovery. For complicated injuries and for some athletes, full recovery may take up to a year.

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  1. Bankart Repair for Unstable Dislocating Shoulders. University of Washington. https://orthop.washington.edu/patient-care/articles/shoulder/bankart-repair-for-unstable-dislocating-shoulders.html 
  2. Shoulder Joint Tear (Glenoid Labrum Tear). American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-joint-tear-glenoid-labrum-tear 
  3. Shoulder Labral Tears. UConn Health. https://health.uconn.edu/orthopedics-sports-medicine/conditions-and-treatments/where-does-it-hurt/shoulder/shoulder-labral-tears/ 
  4. Shoulder Labrum Tear. Johns Hopkins University. https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-labrum-tear 
  5. Shoulder Labrum Tears: An Overview. Hospital for Special Surgery. https://www.hss.edu/conditions_shoulder-labrum-tears-overview.asp 
  6. SLAP Tears. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/slap-tears
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jan 23
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