Thursday 7 March 2013

Glenoid Labrum Tear

Glenoid Labrum Tear

The glenoid labrum in the shoulder which can be torn from repetitive movements or accidents such as falls.

The glenoid labrum is a fibrous ring of tissue which attaches to the rim of the glenoid (shallow depression of the scapula or shoulder blade where the ball of the humerus sits).

Symptoms of Glenoid Labrum tears

  • Shoulder pain which cannot be localized to a specific point.
  • Pain is made worse by overhead activities or when the arm is held behind the back.
  • Weakness Instability in the shoulder.
  • Pain on resisted flexion of the biceps (bending the elbow against resistance).
  • Tenderness over the front of the shoulder.

What is the Glenoid Labrum?

The glenoid labrum is a fibrous ring of tissue which attaches to the rim of the glenoid (shallow depression of the scapula or shoulder blade where the ball of the humerus sits). The glenoid labrum increases the depth of the shoulder cavity making the shoulder joint more stable. The glenohumeral ligaments (which secure the upper arm to the shoulder) and shoulder capsule attach to the glenoid labrum.

How is the Glenoid Labrum injured?  

  • Repetitive overhead throwing.
  • Lifting heavy objects below shoulder height or catching heavy objects.
  • Falling onto an outstretched arm.
Glenoid labrum injuries are classed as either superior (towards the top of the glenoid socket) or inferior towards the bottom of the glenoid socket. A superior injury is known as a SLAP lesion (superior labrum, anterior (front) to posterior (back) and is a tear of the rim above the middle of the socket that may also involve the biceps tendon. A tear of the rim below the middle of the glenoid socket is called a Bankart lesion and also involves the inferior glenohumeral ligament. Tears of the glenoid labrum may often occur with other shoulder injuries, such as a dislocated shoulder.

Treatment of Glenoid Labrum tears

  • Rest.  
  • Cold therapy to reduce pain and inflammation.
  • Doctor may prescribe NSAID's (non steroidal anti inflammatory drugs such as ibuprofen) - don't take if you have asthma.
  • A full and gradual rehabilitation programme to restore full function.
  • Unstable injuries will require surgery to re-attach the labrum to the glenoid.
  • Bankart lesions will require surgery.
  • Any underlying causes which contributed to the injury such as shoulder instability should be addressed.
  • Following surgery the shoulder will usually be kept in a sling for 3 or 4 weeks.
  • After 6 weeks more sports specific training can be done although full fitness may take 3 or 4 months.