The labrum is a cartilaginous (made of cartilage) rim that is attached to the bony cup of the shoulder. The shoulder, like the hip, is a ball and socket joint. However, unlike the hip, the shoulder’s socket is very shallow (nearly flat). The labrum acts to deepen the socket and provide more stability to the shoulder. Attached to the labrum near the top is the long head of the biceps tendon.
The labrum can tear in three different locations. It can tear up near the top where the biceps inserts (SLAP tear). It can tear at the front/bottom of the labrum (a Bankart tear) or it can tear in the back (posterior labral tear). Tears can occur in one region or in combination.
A SLAP tear, (tearing where the biceps inserts) is usually caused by the pull of the Biceps when it contracts eccentrically like during a fall or when trying to catch a heavy unexpected load. This can result in popping and shoulder pain.
A Bankart tear (tearing of the bottom front cartilage) is commonly caused by a shoulder dislocation. This can result in recurrent dislocations.
A posterior labral tear (tear in the back) usually occurs due to dislocation also or can be due to an extension of the SLAP tear.
None of these tears heal very well on their own. They almost always need a surgery to repair. The surgery can normally be done through a scope where small incisions are made in the skin and a camera and other specialized instruments are used (arthroscopically.) Suture anchors (a small screw with suture attached) is screwed into the bone and used to tie the labrum back to its appropriate position. It takes about 6 weeks for the labrum to fully heal back to the bone.
Physical therapy is needed after surgery to regain range of motion and strength.
– Dr. Pamela J. Petrocy
(images from The American Academy of Orthopaedic Surgeons website http://aaos.org)