Shoulder pain is relatively common, especially among very active people and older men and women. With a wide range of motion, the shoulder bears a heavier burden than you might think, especially in motions and activities that involve lifting or “swinging” your arms. When most people think of shoulder injuries, they think of the rotator cuff, and it’s true, we do hear a lot more about rotator cuff injuries, especially among athletes. But labrum tears are another cause of shoulder pain, and without prompt medical treatment, your symptoms and your injury can become much worse.
What is the labrum?
Your shoulder is a ball-and-socket joint, with the head of your upper arm bone (the humerus) forming the “ball” part of the joint and another bone called the scapula forming the socket portion. The labrum is an especially tough ring of fibrous cartilage that encircles the rim of the socket part of your joint, helping hold the joint in place and forming a kind of “seal” for the joint. The labrum helps “deepen” the socket of your shoulder so the joint is more stable and secure. Attached to the bone of your shoulder joint, the labrum also provides an attachment point for the ligaments (fibrous bands that attach bone to bone) that hold your shoulder joint together. When the labrum is torn, it can affect not only the ball-and-socket part of the joint, but these other structures as well, making your shoulder “loose” and unstable.
Causes of labrum tears
Among younger people, labrum tears occur most often as a result of falls or sports-related injuries. Falls and overuse or strain also cause tears in older people, but often, these injuries are preceded by a weakening of the ligaments or other parts of the shoulder joint that develop over time as a result of years of wear and tear on the joint which make the shoulder more prone to injuries. Falling on your outstretched arm or a direct impact to the joint are among the most common causes of labrum tears. Frequently, the tear to the labrum occurs when the attached ligaments are stretched, placing excess strain on the labrum and tearing it away from the bone.
Symptoms of a labrum tear
The symptoms of a labrum tear can be similar to the symptoms that occur with other shoulder injuries, including rotator cuff tears. But there are a few key differences. When the labrum is torn, it has a direct impact on the stability of your shoulder. That means your shoulder is more likely to feel loose and unstable. In some cases, it may become dislocated. Often when the labrum is torn, there’s a distinct popping sensation inside the shoulder when you try to move the joint. The popping is often followed by a deep pain or ache in your shoulder that can persist. Other times, you may have very little pain or discomfort in the joint, but your shoulder may feel loose or unstable when you try to use it. Plus, because the labrum can be torn in different ways, your symptoms can vary significantly based on the type of tear you have.
While a physical examination of the shoulder is an important part of identifying a labrum tear, in nearly all cases, the exam won’t provide enough data to make a conclusive diagnosis. Dr. Gombera will probably order an MRI to see the inside of the joint, including the softer structures surrounding the shoulder. Depending on those results, he may recommend a minimally invasive procedure called shoulder arthroscopy to see inside the joint. In a shoulder arthroscopy procedure, Dr. Gombera makes a very small incision near the joint and inserts a tiny camera which captures images of the joint and projects them to a monitor for viewing. Arthroscopy can be especially helpful in diagnosing smaller tears of the labrum or tears that are difficult to see because of the shoulder anatomy.
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Shoulder pain is never "normal," and without prompt medical care, your injury could result in serious disability. If you're having pain or other symptoms in your shoulder, don't delay care. Book an appointment online today.