The shoulder is made up of three separate bones. The top portion of the humerus (arm) bone is capped with rounded bone, forming a ball-like object that is housed in a socket formed by the scapula (shoulder blade) and the clavicle (collarbone). The actual part of bone that forms the socket is the glenoid of the scapula, with a lining of tissue called the labrum (labral tissue) on it to give the bone a cup-like shaping to house the humerus.
What is a Labral Tear?
There are several ways that the labrum tissue can be torn, with the most significant being the entirety of the labrum being torn off the scapula. This is an injury closely associated to injury of the shoulder, commonly seen with dislocated or separated shoulders. When the labral tissue is torn in this fashion, the shoulder may slip out of the socket and lose some degree of function.
The second commonly seen tear is where the labral tissue has decayed, often in the form of the tissue edges becoming frayed. As this can occur from general wear and tear, many patients may have this damage and not even be aware as it presents no symptoms.
If left untreated, portions of the labral tissue can fray to the point of interfering with shoulder function. The tissue itself can become lodged between the other bones of the shoulder, leading to a ‘clicking’ or ‘catching’ of the shoulder, reducing function and causing pain for the patient.
How is a Labral Tear Diagnosed?
Due to the deepness of labral tissue inside the shoulder, it can be very difficult to make an accurate diagnosis with physical examination alone. There are a number of tests that the Los Angeles orthopedic doctor may use to learn if there is a tear, but these are not always as accurate as other diagnostic techniques.
This is largely in part due to the different forms the tears can take, as each test is only able to find certain types of tears. A better method of diagnosing the labral tear is through the use of imaging techniques, primarily through an MRI or CT scan of the shoulder. Injecting dye into the shoulder prior to an MRI may be very helpful, this is called an MRI arthrogram.
The most accurate diagnostic method is an arthroscopy of the shoulder which is an invasive procedure requiring anesthetic for the patient. During an arthroscopy, a small incision is made into the tissue of the shoulder. Following this, a lighted tube containing a camera will be inserted. This allows the shoulder surgeon in Los Angeles to personally examine the area and see first hand whether a tear is present or not.
Treatment for Labral Tears
The treatment for the tear will depend on the type of tear present, and the severity of the tear itself. Labral tears where the tissue has been separated from the bone will normally require an operative procedure with a sports medicine doctor to re-attach the tissue. This restores function to the shoulder, and should prevent subsequent slippage.
Tears resulting from degradation of the labral tissue may cause significant pain. Typically the tears are not easy to repair, so the Los Angeles sports medicine doctor will shave away the torn portion to relieve pain.