There are several buttons once hit, you know you have injured your labrum. For example, if you feel more pain when lifting objects or weights over the shoulder level, it is a warning sign. The other sign is a decrease in shoulder power, affecting your performance negatively. Also, when your shoulder produces grinding and snapping sounds under certain motions, it will also indicate that you might have reinjured your labrum, so you should see your physician.
Are you a sports participant? If yes, then you may have had an injury while participating in your sports activity.
Three out of hundred patients visiting hospitals seek practitioner’s aid on the shoulder pain and injuries. The research conducted last year lists shoulder pain as the second most common complaint after lower back pain.
One of the causes of this pain is a labral tear and is treated mainly by surgery or non-surgery methods.
After a successful surgery, you will undergo several protocols for a complete healing process through rehabilitation sessions. Your labral damage extent and repair complexity determines your recovery.
The shoulder acts as a junction for three bones, namely the scapula (shoulder blade), clavicle (the collarbone), and humerus (the upper arm bone). Shoulder injuries trickle down your performance and can alter your physical appearance if not attended.
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What is a shoulder labrum?
A labrum is an attachment site with a cup-shaped rim of cartilage that lines ligaments, rotator cuff tendons and supports the ball-and-socket shoulder joints.
Some ligaments and tough tissues that surround the cavity reinforce the glenoid labrum.
There are two sets of cartilage in the shoulder joint, the articular cartilage at the end of the ball and socket that enables the bone to move and glide over each other.
The labrum is the second cartilage that is more rigid and attached around the socket.
What is the primary function of the labrum?
There are two primary functions of labrum:
1. Deepening the socket for the ball to remain intact
The humerus ball is by far more extensive than the flat socket and to maintain the ball in place is either with the help of ligaments or labrum. Ligaments are tethers that circle the bones and can help in keeping the ball to the socket.
While the labrum is thick cartilage with attachments up to the socket’s rim, creating a bumper that deepens the socket holding the ball in place.
Due to an injury, a small or torn labrum makes the ball slide out of the socket, partly causing a subluxation. Suppose the ball slides out of the socket, and then it creates a dislocation.
Once excessive force is applied to the arm, the humerus slides over the scapula resulting in a shoulder dislocation.
2. Attachment for tissues and structures around the joint
Whether the ball moves in a posterior or anterior position causes the labrum to tear off the bone.
The biceps muscle is attached inside the shoulder joint through a hole in the rotator cuff, and it gets firm when bending the elbow.
Inside the joint, the tendon is firmly attached to the labrum’s top part and a portion of the bone close to the socket.
The tendon can be torn at the bone intersection or labrum in extreme cases detached on both locations.
What are the types of labrum tears?
These are the types of labrum tears:
Arthroscopic Bankart tear
Typically, ABR occurs in young patients with a dislocated shoulder.
Once the joint ball moves out of the socket, the rigid tissue that protects the joint pulls then tears the lower part of the labrum. The breach causes shoulder instability as it makes the shoulder dislocate again easily.
Bankart tears cause the shoulder to slip and dislocate at certain angles. When the humerus head falls to the front of the body, it causes anterior instability.
On the other hand, when the ball shifts towards the back of the body, creating posterior instability.
Superior labrum from anterior to posterior tear occurs at the upper front part where the biceps tendons join the shoulder. Patients with slap tears often complain of pain in the shoulder front near the biceps tendons.
Those prone to the injury include athletes, volleyball players, and baseball pitchers using the top shoulder for a quick snap and high-energy motions.
Common causes of a shoulder injury
Here are some common causes of a shoulder injury and possible reasons for reinjury.
These sudden traumas happen unplanned and take a more significant percentage in the labral injuries.
Examples include pulling heavy loads over the shoulder level or moving the arm quickly when in the same position, falling and outstretching your arm to get balance or support.
They commonly occur in sports participants who focus on overhead sports activities such as baseball, weightlifting, swimming, and softball.
Due to the repetitive actions, the labrum cartilage wears down progressively. Accidents from innocuous activities and serious falls are chronic traumas in section.
Once you have reached 40 years and above, the chances of fraying your labrum are high due to general aging. Staying active and healthy as you age is vital.
How do I know I have injured my labrum after surgery?
The rate of reinjuring your shoulder after successful surgery is very high. For your labrum to heal fully, you need to give the shoulder tethers enough time to heal before starting your normal activities.
Assuming your duties before tendons heal, you increase the chances of a fresh tear and can prolong your recovery. In addition, a reduced range of motions after surgery is a sign of a new injury.
If you feel your labral movement after a short stretch, you may be welcoming a new shoulder injury on your recovery journey.
After taking off the sling, try to raise your arm over the head, and if you feel more pain, you may injure your shoulder.
Suppose you feel shoulder locks or catches while moving your arm, meaning you are causing an injury.
Deep, achy pain felt inside the shoulder may extend to the back and front shoulder sections if the biceps tendon is involved.
Some patients, whereby some report clicking or grinding shoulder when rotating the arm, report Crepitus symptoms. This may result in shoulder instability that falls as a sign of shoulder injury.
Shoulder weakness makes it difficult to lift objects to or over the head. A decline in your exercise performance after therapy could be a sign of reinjuring.
Do you experience snaps and pops in your shoulder after taking out your sling? If yes, then you may have retorn your shoulder.
Treatment of labrum tear
Surgical and conservative (non-surgical) approaches are used when treating labrum tears.
The Conservative method can be used when the injury is not deep. Anti-inflammatory medications such as ibuprofen are used to reduce pain and swell.
You are to undergo physical therapy exercises to strengthen and increase motion for your shoulder.
Before undertaking the Arthroscopic surgery, the surgeon evaluates the biceps and labrum keenly. The technique uses small incisions that minimize the rate of swelling and discomfort as it speeds the recovery process.
Arthroscopy varies depending on the patient factors such as overall health, age, type of injury, and activity level. The surgery includes trimming the tear, cutting the biceps tendon attachment, aligning the torn portion, and stitching the tear.
After surgery, you are to put on a sling for the first four weeks, and you will be working on mild exercises.
Move to flexibility and shoulder strengthening exercises after some time.
Typically, it takes the labrum over six months to recover fully from the injury. The risk of arthroscopy is bleeding, stiffness, and blood vessel or nerve damage.
What is the recovery period for labrum tears after surgery?
Patients undergoing conservative repair expect less pain and short recovery time, unlike those in open surgery, which take a long time to recover and more pain. It usually takes six months to one year for full recovery in both scenarios.
It is advised to wear a sling for the first four weeks, and it takes four to six weeks for the labrum to re-attach to the cartridge bone. Another four to six weeks to strengthen the shoulder.
Can a labral injury heal without surgery?
Depending on the severity of the tear, the labrum can heal with physical therapy and rest. For example, SLAP tears are treated with a cortisone injection, rest, and anti-inflammatory medications followed by physical therapy for three months.
Similarly, bankart tears can follow the reduction process and physical therapy to strengthen the muscles.
How can physical therapy speed up the recovery process?
Physical therapy helps restore the labrum to the joint, and a few stretching exercises will help align your shoulder tissues.
Your therapist will shed light on the right way to conduct the practice and its importance in your recovery. Finally, the physical therapist will walk you through postural and strength exercises as a set of home exercise programs.
What is essential after surgery between heat and ice?
Instead of heat, surgeons recommend ice; apply an ice pack over the shoulder for twenty minutes, three times a day.
The importance of using a cold substance is to minimize the possibility of swelling and pain after surgery.
It is paramount to visit a hospital to determine the extent of your injury once you incur an accident. After a successful surgery, it is advised to wear a sling for three to four weeks to immobilize the shoulder joints for faster tissue recovery.
Take physical therapy seriously once you take off the sling, and always start with simple exercises. A retore is painful and takes more time to recover.
Remember, it is better to wait until your shoulder is fully healed before returning to your duties instead of rushing and ending up causing a retore.