Shoulder Labral Tear
What is the shoulder labrum?
The shoulder is a ball-and-socket joint where the top of the arm bone (humerus) fits into a shallow socket in the shoulder blade (glenoid). Because the socket is naturally shallow, the joint relies on soft tissues to stay stable while still allowing a wide range of motion. One of the most important of these tissues is the labrum.
The labrum is a ring of firm, rubbery cartilage that lines the rim of the socket. It deepens the socket, helping the ball of the arm bone stay in place. You can think of it like a gasket or bumper that improves the fit of the joint. The labrum also serves as an attachment point for ligaments and the tendon of the biceps muscle, which adds further stability to the shoulder.
A shoulder labral tear occurs when this cartilage ring becomes damaged or torn. Because the labrum helps stabilize the joint, a tear can make the shoulder feel loose, painful, or unreliable.
There are several types of shoulder labral tears, classified by where the damage occurs in the cartilage ring. Regardless of the type, any disruption to the labrum can affect how well the shoulder functions.
- SLAP tear: A tear at the top of the labrum where the biceps tendon attaches, often caused by repetitive overhead motions or sudden pulling injuries
- Bankart tear: A tear in the front (anterior) part of the labrum, commonly associated with shoulder dislocations and instability
- Posterior labral tear: A tear in the back of the labrum, which can result from trauma or repeated pushing activities
- Degenerative labral tear: General fraying or wear of the labrum over time, often related to aging rather than a single injury
Labral tears can develop from a single injury or from repeated stress over time. In many cases, it is a combination of both.
A common cause is trauma, such as falling onto an outstretched arm, lifting something heavy suddenly, or experiencing a direct blow to the shoulder. Shoulder dislocations are another major cause, as the ball can forcefully stretch or tear the labrum when it slips out of the socket.
Repetitive overhead motions can also lead to labral tears. Athletes who frequently use their arms above shoulder level—such as baseball players, swimmers, tennis players, and weightlifters—place ongoing stress on the labrum. Over time, this can lead to fraying or tearing.
Age-related wear and tear is another factor. As we get older, the labrum naturally becomes less flexible and more prone to injury. Even normal daily activities can eventually contribute to small tears in some individuals.
The symptoms of a shoulder labral tear can vary depending on the severity and location of the tear. Some people notice symptoms right away after an injury, while others experience a gradual onset.
Pain is the most common symptom. It is often felt deep within the shoulder rather than on the surface. The pain may worsen with overhead movements, lifting, or certain arm positions.
Many people describe a catching, locking, or grinding sensation when moving the shoulder. This can happen if the torn piece of labrum interferes with smooth joint movement.
A feeling of instability is another key symptom. The shoulder may feel like it could slip out of place or “give way,” especially during certain motions. This is more common in tears associated with dislocation.
Other symptoms can include reduced range of motion, weakness, and difficulty performing everyday activities like reaching, throwing, or even sleeping comfortably on the affected side.
Diagnosing a shoulder labral tear starts with a thorough medical history and physical examination. Your provider will ask about your symptoms, how the injury occurred, and what activities make the pain worse.
During the physical exam, the shoulder will be moved in specific ways to check for pain, instability, and mechanical symptoms like clicking or catching. Strength and range of motion are also evaluated. While these tests can strongly suggest a labral tear, imaging is often needed to confirm the diagnosis.
Magnetic resonance imaging (MRI) is the most commonly used scan. It provides detailed images of the soft tissues in the shoulder, including the labrum. In some cases, a special type of MRI called an MR arthrogram is performed. This involves injecting a small amount of contrast dye into the joint before the scan, which can make labral tears easier to see. X-rays may also be taken, but they do not show the labrum itself. Instead, they help rule out other issues such as fractures or arthritis.
In certain cases, if symptoms persist and imaging is inconclusive, a minimally invasive procedure called arthroscopy may be used. This allows a specialist to look directly inside the joint with a small camera and confirm the presence of a tear.
Understanding shoulder labral tears is the first step toward effective treatment. With an accurate diagnosis and the right care plan, many people are able to reduce pain, restore function, and return to the activities they enjoy. Contact Accelerate Orthopedics to schedule a consultation with one of our board certified and fellowship trained orthopedic surgeon to receive the care you deserve.
