The second type of labrum tear is tearing within the substance of the labrum itself. The edge of the labrum over time may get frayed so that the edge is not smooth. This type of tearing is quite common and rarely causes symptoms. It is seen frequently in the shoulder as people get older over 40 years of age.
Sometimes the labrum may have a large tear where a portion of the labrum gets into the joint and causes clicking and catching as the ball moves around in the socket. This type of tear is very rare, and most labrum tears do not cause these symptoms.
A third type of labrum tear is in the area where the biceps tendon attaches to the upper end of the socket. The socket can be divided into four regions: anterior front , posterior back , superior the upper end near your head or inferior the lower end, which is toward the elbow.
The biceps tendon attaches at the superior end, where it blends in with the labrum. The labrum runs from there around the joint, both in an anterior and in a posterior direction. Due to injury in this area where the biceps tendon attaches, the labrum also can get injured. The injury in this area can be mild or it can be severe. Because the injury typically involves the biceps tendon and the labrum, because it is at the superior end of the socket and because it can affect the labrum attachments anterior and posterior to where the biceps attaches in this region, the acronym or abbreviation for this injury is a SLAP lesion.
This stands for an injury that is superior labrum anterior and posterior. There have been several grading systems or classification systems of this injury. In a lesser injury, the labrum is only partially detached in this area. In a more severe injury, the whole labrum is pulled off of the bone along with the biceps tendon. The most common classification divides SLAP lesions into four types. Because this cartilage is deep in the shoulder, it is very difficult to make the diagnosis of a torn labrum upon physical examination.
There are several tests that the physician can perform that may indicate a torn labrum, but these tests are not always accurate. The other problem is that labrum tears take different forms as described above, and certain tests will detect one kind of tear but not another. Some physicians feel very confident that they can make the diagnosis of a labral tear upon physical examination, but this is controversial.
There are not many scientific studies that show that physical examination is reliable for making the diagnosis of a labral tear. As a result of this uncertainty, other studies can be done to confirm the diagnosis if it is suspected. The best tests available to make the diagnosis of a labral tear are magnetic resonance imaging MRI scans or a test called a CT-arthrogram the latter is a CAT scan preceded by an arthrogram where dye is injected into the shoulder.
Both of these tests are relatively good at defining a labrum tear due to a subluxation or dislocation, but they are only around 80 percent to 85 percent accurate. For that reason, some physicians believe that tests are not always needed if the diagnosis of subluxation or dislocation can be made by history and physical examination. Neither of those tests is currently very good at making the diagnosis of a SLAP lesion.
This area is very complex and it is difficult to reliably get good pictures of this area with MRI. However, if the MRI definitely shows a tear then frequently it will be present. The problem is that the MRI may miss smaller tears and cannot reliably make the diagnosis in larger tears of the labrum. The best way to make the diagnosis of labrum tearing is with arthroscopy of the shoulder. Unfortunately this is an operative procedure and requires some form of anesthesia.
Making the diagnosis also takes some experience on the part of the surgeon, since the anatomy of the inside of the shoulder can be quite complex. The relationship between labrum tears and symptoms has not been totally figured out, so it is not clearly known which ones should be repaired and which ones can be left alone.
The treatment depends upon which kind of tear there is in the labrum. Your physical therapist will likely design a program around building and regaining strength, flexibility, and range of motion. It can take anywhere between weeks to build up enough strength in the shoulder to go back to regular every day activity.
All in all, if you are just trying to get back to a normal routine, it takes about weeks to recover from a labral tear. If you are trying to get back to a more physical routine including athletics, recovery time is usually between months. Looking for a physical therapy center to recover from labrum surgery?
MedAmerica Rehab can help — reach out to us today about your first consultation. You should always consult your doctor before making decisions about your health. Posted by Revere Health. Day of Surgery Depending on the type of labral tear you experienced, surgery may be minimally invasive or more aggressive. Week of Surgery The week following surgery is likely to be the roughest for you.
Total Heal Time: What to Expect Once your labrum has had adequate time to heal, your doctor may recommend physical therapy.
Larsen chose to become an orthopedic surgeon after growing up watching his father work in the same profession. He observed the love his father had for taking care of people and improving lives by fixing problems with their knees and shoulders.
Larsen enjoys communicating with his patients and working together to find a solution, either through surgery or lifestyle changes. Meaghan Dishman. Learn more about Telehealth. From the blog See more posts. October 27, Why your next clinical breast exam should include a 3D mammogram Cancer Center Imaging.
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