SHOULDER LABRAL TEARS

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A PERSONALIZED APPROACH TO SHOULDER INJURIES IN RICHMOND, VA

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WHAT IS A SHOULDER LABRAL TEAR?

The labrum is cartilage tissue that holds the “ball” (humeral head) in the “socket” (glenoid) of your shoulder. A shoulder labral tear can occur due to a lifting injury, a fall on the arm, a sudden pull on the arm or having the arm twisted at the shoulder joint.

SYMPTOMS OF SHOULDER LABRAL TEARS

Like many injuries that occur within the shoulder, a labral tear is often accompanied by pain and reduced mobility in the joint. Because we use our arms and shoulders for daily activities, it can be difficult to ignore the symptoms of a labral tear, and many patients find they can pinpoint the moment a tear occurs.

The most common symptoms of a labral tear are as follows:

  • A locking, clicking or catching sensation in the joint
  • Pain, though the location may depend on where exactly the tear has occurred
  • Stiffness or a limited range of motion in the joint.

TYPES OF SHOULDER LABRAL TEARS

There are three primary types of labral tears, each of them affecting the same cartilage tissue in a slightly different way or location. The most common types of labral tears are:

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SLAP TEARS

A Superior Labrum from Anterior to Posterior tear, or SLAP tear, is most commonly seen in athletes who regularly throw or use athletic equipment from overhead, such as baseball and tennis players. Other common causes of this tear include falling on an outstretched arm, falling directly on the shoulder or lifting heavy objects repeatedly or too suddenly.

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BANKARAT LESIONS

A Bankart lesion occurs when the shoulder becomes dislocated, coming fully out of the joint. When a dislocated shoulder occurs, the labrum is torn and makes the shoulder more susceptible to future dislocations. This type of labral tear is especially common in young athletes playing a wide variety of sports.

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POSTERIOR LABRAL TEARS

Posterior labral tears are less common, though they can sometimes be seen in athletes who play a sport requiring them to push with their arms in front of them, such as an offensive lineman in football.

SHOULDER LABRAL TEAR DIAGNOSIS & TREATMENT

“Appropriate rehabilitation is critical to achieving a successful outcome. I work closely with the physical therapist to develop a specific rehabilitation program for every patient. For athletes, we also include the athletic trainer(s) and coaches in our ‘team’ approach to treatment.” — Dr. Vic Goradia

Because a history of shoulder injuries can make the joint more susceptible to further damage, your doctor may suspect a labral tear based on your medical history. At your consultation, you will be asked questions about your pain and past injuries to your shoulder that may suggest labral damage. Labral tears are very difficult to see even with an MRI, so the first step to confirming a diagnosis is often to order an arthrogram known as an MRA. In this process, a dye is injected into the shoulder prior to an MRI for improved visibility.

The proper treatment for a labral tear will depend on your particular injury, activity level, age and orthopedic surgery needs. You will not know what the doctor will recommend in your particular case until you sit down for your consultation, but there are certain general guidelines that many patients fall under.

FIRST-TIME DISLOCATIONS IN PATIENTS UNDER 25

If a patient has a first-time dislocation and is under 25 years of age, Dr. Goradia will discuss options for immediate surgery or trying a period of immobilization. The latest research shows that immobilization in external rotation wherein the arm is rotated outwards is best if nonsurgical treatment is also attempted. However, there is still a 75-90% risk of recurrent dislocations, so your personal needs and injury will be discussed in-depth to determine the best treatment for you.

DISLOCATIONS IN PATIENTS BETWEEN AGES 25 AND 40

It can be hard to group together the most common treatment plans for the middle group of patients between the ages of 25 and 40 without a consultation to discuss their particular case. Again, it is important to note their activity level, how loose their shoulder feels during the examination and how large the tear appears on the MRA.

FIRST-TIME DISLOCATIONS IN PATIENTS OVER 40

For individuals over 40 years of age that have a first-time dislocation, Dr. Goradia bases his recommendations on the patient’s activity level and work requirements. Barring those with hobbies or careers that involve strenuous physical activity, many patients can be treated without need for surgery.

Regardless of age, if patients have recurrent dislocations or are apprehensive about participating in activities because of their shoulder, Dr. Goradia will discuss surgical options to repair the tear. If you think you or someone you know may require treatment for a labral tear, contact G2 Orthopedics and Sports Medicine today. Whether you’re a recreation athlete, injured worker or simply an individual looking for a second professional opinion on your injury and treatment options, Dr. Goradia is passionate about providing each patient with the quality of care given to professional athletes. Request an appointment online or give us a call at 804-678-9000 to get started.

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