Shoulder Labral Tear / Instability Treatment Options

What is shoulder labral tear / instability?

Shoulder instability and labral tears are common conditions affecting the shoulder joint, often characterized by pain, weakness, and a sensation of the shoulder giving way or slipping out of place. Shoulder instability refers to the inability of the shoulder joint to maintain its normal position and stability, leading to recurrent dislocations or subluxations. This instability can result from traumatic injury, repetitive overuse, or underlying structural abnormalities such as ligament laxity or bony defects. Labral tears, on the other hand, involve injury to the fibrocartilage ring (labrum) that surrounds the glenoid socket of the shoulder joint. Labral tears can occur due to acute trauma, repetitive overhead activities, or degenerative changes, leading to pain, clicking or popping sensations, and limited shoulder range of motion. Diagnosis of shoulder instability and labral tears typically involves a combination of physical examination, imaging studies such as MRI or CT arthrography, and possibly diagnostic injections. Treatment options may include conservative measures such as rest, physical therapy, and anti-inflammatory medications, as well as surgical intervention such as arthroscopic labral repair or stabilization procedures to address underlying structural issues and restore shoulder function. Early diagnosis and appropriate management are essential to alleviate symptoms, prevent long-term complications, and optimize outcomes for individuals with shoulder instability and labral tears.

How is shoulder labral tear / instability treated?

Treatment for shoulder labral tear/instability aims to address the underlying pathology, alleviate symptoms, and restore optimal function to the shoulder joint. The chosen treatment plan depends on factors such as the severity of the injury, the patient’s age, activity level, overall health, and specific characteristics of the injury.

What non-operative options are available?

• Rest: Avoiding activities that exacerbate shoulder pain and instability.
• Physical Therapy: Specific exercises to strengthen the muscles surrounding the shoulder joint, improve shoulder stability, and restore range of motion.
• Anti-inflammatory Medications: Over-the-counter or prescription medications to alleviate pain and inflammation.
• Activity Modification: Modifying activities to reduce stress on the shoulder joint and prevent further injury.
• Corticosteroid Injections: Injections of corticosteroids into the shoulder joint to reduce pain and inflammation.

What non-operative options are available?

If conservative treatments fail to provide adequate pain relief and improve stability, surgical intervention may be necessary. Common surgical procedures for shoulder labral tear/instability include:

• Arthroscopic Labral Repair: Minimally invasive surgery to reattach or debride the torn labrum using sutures or anchors.
• Capsular Shift: Surgical tightening of the shoulder capsule to improve stability and reduce the risk of recurrent dislocations.
• Bankart Repair: Surgical repair of a specific type of labral tear (Bankart lesion) that occurs with recurrent shoulder dislocations.

What does rehabilitation look like?

Following surgery, rehabilitation is essential to optimize recovery and restore shoulder function. Dr. Shane J. Nho and your physical therapist will design a customized rehabilitation program, which may include:

• Immobilization: Initially, the shoulder may be immobilized in a sling to protect the repaired tissues.
• Gradual Range of Motion Exercises: Gentle stretching and mobility exercises to restore shoulder range of motion.
• Strengthening Exercises: Progressive exercises to rebuild shoulder strength and stability, focusing on the rotator cuff and shoulder girdle muscles.
• Functional Training: Activities and exercises aimed at improving proprioception, balance, and coordination to reduce the risk of re-injury.
• Gradual Return to Activities: Controlled progression of activities and sports, guided by your medical team, to ensure a safe and successful return to previous levels of function.

In conclusion, shoulder labral tear/instability can significantly impact shoulder function and quality of life, but with proper diagnosis and treatment, most patients can achieve significant improvement in symptoms. Whether through conservative measures or surgical intervention, the goal is to restore shoulder stability, alleviate pain, and help patients return to their desired level of activity. If you’re experiencing shoulder pain, instability, or limitations in shoulder function, don’t hesitate to seek evaluation and treatment.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of shoulder labral tears and instability. If you believe you are affected by shoulder labral tears and instability, schedule a consultation today with our experienced orthopaedic care team.