Dealing with a torn rotator cuff or shoulder labral tear (also called a shoulder labrum tear) can be a painful and debilitating experience. Traditionally, surgical interventions have been the go-to treatment option for these injuries. However, alternatives to shoulder surgery are available. Here, we describe the nonsurgical options and their benefits.
What Is a Labral Tear?
A labral tear refers to a tear or injury in the labrum, a piece of soft tissue surrounding the shoulder joint socket. The bone of the “socket” of your shoulder is called the glenoid and is shaped much like a dinner plate. The labrum extends from the edges of the bone all the way around like the rim of a bowl, conforming to the shape of the ball of the shoulder. This provides stability and support to the shoulder – a healthy labrum is one of the factors that keeps the shoulder from dislocating. Labral tears commonly occur in athletes or individuals who regularly engage in repetitive overhead activities or experience traumatic shoulder injuries.
There is a wide variety of labrum tears (for example, SLAP lesions, Bankart lesions, and posterior labral tears) that result from the tearing of different parts of the labrum. Labral tears can cause shoulder pain, clicking and catching of the shoulder, locking of the shoulder or limited range of motion, and difficulty performing daily activities. Surgical intervention has been one of the primary treatment options for labral tears. However, more conservative treatments are also available and may be used first.
What Causes a Torn Labrum?
A labral tear can be quite painful and limit the stability, mobility, and functionality of the shoulder. The following are various factors that can lead to labral tears in the shoulder:
- Traumatic injuries. A traumatic injury is one of the most common causes of labral tears in the shoulder. This can occur due to a sudden impact or forceful movement that puts excessive strain on the shoulder joint. If the force on the labrum gets high enough, the labrum tears away from the bone of the glenoid.
- Shoulder dislocation. Dislocating the shoulder joint can cause a torn labrum. When the shoulder dislocates, it usually results from a labral tear. If the tear is large enough and/or doesn’t heal, the shoulder will be much more likely to continue dislocating.
- Repetitive overhead motions. Continuous and repetitive overhead motions, commonly seen in occupations such as painting and construction or impact and throwing sports, can gradually wear down the labrum over time and increase the risk of labral tears.
- Age-related degeneration. As we age, the cartilage in our joints naturally starts to deteriorate. The labrum is no exception. Over time, the labrum can become worn, thin, and more susceptible to tears.
Symptoms of a Labral Tear
A labral tear in the shoulder can result in various symptoms that can significantly impact daily activities and quality of life. It is essential to be aware of these symptoms to seek appropriate treatment. Here are some common symptoms of a torn labrum:
- Pain in the shoulder joint
- Limited range of motion
- Shoulder clicks or a popping sensation in the shoulder
- Instability or weakness of the shoulder joint
- Pain intensifies with certain movements
If you are experiencing any of these symptoms, it is recommended that you consult with a healthcare professional who can accurately diagnose a labral tear and determine the most appropriate treatment options.
Labral Tear Recovery Without Surgery
Labral tears are fairly common – studies show that about one out of every three athletes with no symptoms have a labral tear on MRI scans. Similarly, over half of patients with no symptoms over the age of 45 have findings of labral tearing on MRI scans. It’s very important, therefore to distinguish whether a labral tear is truly the source of your symptoms. While an orthopedist might evaluate you and determine that surgery is the best option, for many patients, there are alternatives. If these more conservative approaches do not provide relief, and there’s no other explanation besides a labral tear for your symptoms, you might consider undergoing labrum surgery.
RICE
The first option for most soft tissue injuries is RICE: rest, ice, compression, and elevation. Rest is often the most important factor. By limiting exercise and movement involving the shoulder, you give the joint time to heal naturally.
Icing the area temporarily helps relieve pain. Ice is generally preferred for the first few days after an injury because it helps reduce swelling. After those few days, ice or heat can be used—use whichever makes you feel better. Compression using a wrap or band (more difficult for the shoulder) and elevating the joint, when possible, will also reduce swelling and help manage pain and discomfort as the injury heals. Your doctor may also recommend over-the-counter anti-inflammatory medications.
Physical Therapy and Exercise
When rest and time are not enough to heal the injury, your orthopedist may suggest certain exercises or recommend physical therapy. The proper exercises, done at the right pace and progression, help strengthen surrounding muscles, taking some pressure off the torn labrum. This supports the natural healing process.
Steroid Injections
A corticosteroid shoulder injection delivers a powerful anti-inflammatory medication. The steroids are targeted right at the location of the injury for quick action. You may get lasting pain relief with minimal side effects. There are some possible long-term side effects that you should ask your doctor about before getting an injection.
See an Orthopedist for a Labrum Tear in the Shoulder
While surgical intervention has long been used to treat torn rotator cuffs and shoulder labral tears, conservative measures offer many patients nonsurgical alternatives. Get an evaluation from a skilled orthopedist for nonsurgical alternatives to relief from shoulder pain and immobility.
Request an appointment with one of EmergeOrtho-Triangle Region’s specialists or call us anytime at (919) 220-5255.
