Labrum Tear

As with all joints, there is a certain amount of cartilage that is present to help keep the bones from wearing on each other.  For the shoulder, there are two main areas of cartilage, the white cartilage, which is the cartilage cover the end of the bones themselves, and the labrum, which helps to keep the shoulder joint and the entire arm in place.  The labrum forms a ring around the ball and socket joint itself, and provides a number of ligaments a place to attach to.  It also helps make the joint deeper, allowing for a more secure fit between the two bones.  The development of a labrum tear means the arm will have a more difficult time staying in the proper place, leading to severe pain and discomfort.  There are several different ways that this type of cartilage can tear, each of which tends to have its own specific cause and treatment course.

The first major type of labrum tear is the labrum completely separating from the bone itself.  In this case, the cartilage has been pulled so much, common from a dislocation or hyper extension, that the labrum has actually been torn off the bone.  This disrupts the alignment of the arm, and removes a key piece of support for this part of the body.  Another main type of labral tear involves the sudden shock or trauma to this piece of cartilage that leads to it tearing away from either the joint or tearing during its tethering of the shoulder joint and the bicep, where the piece comes to attach to the arm. 

In many cases, a labrum tear can be caused by;

• Dislocation
• Forced movement of the arm in a variety of different ways
• A fall of trauma on an extended arm
• Repetitive motion that strains the area
• Lifting heavy objects
• Trauma in other parts of the shoulder or upper arm.

A torn labrum can lead to several very serious complications, including the need of additional support for the arm.  Since the labrum is the primary anchor point for the shoulder joint, when this piece becomes detached from the joint of the arm, the bones structure tends to pull down on the area, causing extreme pain and a restriction of motion.  Moving the arm in certain direction will become almost completely impossible, with the patient needing to have the arm held in a sling or similar support apparatus to allow for common motion.  The weight of the arm itself will continually pull the arm down, causing the patient extreme pain.  Allowing for compensation for that weight will help to keep the pain to a manageable level.

Treating and diagnosing a labrum tear can be an involved process.  Due to the fact the damaged area is buried deep within the shoulder, normal physical exams will provide little information.  To discover where and how severely the labrum is torn, diagnostic imaging techniques will need to be performed to determine the nature of the injury.  In most cases, a CAT Scan, MRI, or ultrasound will be used to find the location of the tear.

To treat the labrum tear, surgery is almost required.  When the labrum rips or tears, it can fray, leading to a more severe injury.  Most cases of this will cause the shoulder to become unstable, which will also be a part of the surgery.  While arthroscopic surgery may be an option for certain minor tears, most cases will require open surgery to repair and reattach the ligaments and cartilage.  Arthroscopic surgery is common used for a labrum tear at the bicep.  This area can be extremely difficult to reach using conventional surgery, while other areas have a much easier access route. 

The recovery time for a labrum tear and the resulting surgery will vary greatly from patient to patient.  Since the primary goal of the surgery is to put the cartilage and ligaments back in place so they can heal, there will be an initial period where the healing takes place, then an additional period of time for the strength in the area to return to normal.  It generally take 4 to 6 weeks for the areas to reattach, then an additional 4 to 6 weeks for them to gain strength.  It is possible to re-injure the area during both of these periods of time, and general physical therapy is common used to prevent such injuries.

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