Many of our patients have heard the story of my college softball career. I am not here to go into details about it, but I do like for patients to know that I have also had shoulder surgery. A labral repair to be exact--and during my junior year of college softball no less.
Of all the structures in the shoulder, I think the labrum is most difficult to visualize. We refer to the shoulder as a "ball and socket" joint. Describing the humerus (upper arm bone) as the ball, and the glenoid of the scapula (shoulder blade) as the socket. (Figure #1) If one thinks about the ball of the humerus sitting like a golf ball on a tee, the labrum would be a ring around the tee to deepen it keeping the ball more stable. If this system worked 100% of the time we would all be very happy and I would be out of a job. Unfortunately injuries happen and force that humerus off the glenoid either partially or completely.
Injuries can include falls, pulling, pushing, repetitive injuries like throwing, impact directly to the shoulder, and motor vehicle accidents. Events like falls may cause the shoulder to fully dislocate in that case there is often injury to the labrum. Repetitive overhead throwing can pull on the top (superior) labrum where the biceps attaches.
The labrum is surgically described like the face of a clock with 12, 3, 6, and 9 o'clock positions. Look at Figure #2. The center picture shows the labrum looking straight on, at the 12 o'clock position you see a tendon attaching. This is the biceps tendon and is an important landmark for labral tears. Labral tears involving the superior portion of the labrum and or the biceps are called SLAP tears. There is an entire classification system for them, if you would like to see if check here.
Tears of the labrum do not heal. However, small tears may not feel as symptomatic and can stay stable for a period of time. Larger tears should be repaired to prevent instability, pain and degeneration of the shoulder. Surgery is an outpatient scope procedure that involves placing sutures through the torn labrum. These sutures are then anchored to the bone. Depending on your level of activity most people return to recreational activities around 4 months post operative and competitive sports closer to 6 months.
Speaking from experience, shoulder surgeries are not fun! But with diligent physical therapy and rehabilitation labral repair surgery can be a success.
The information on this blog is intended for informational and educational purposes only. It is not intended to be used in place of medical advice. If you have orthopedic issues that need to be addressed please contact your physician.