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Shoulder Labral Tears

Comprehensive guide to understanding, treating, and recovering from shoulder labral tears with evidence-based rehabilitation protocols.

15-20%
Athletes affected
3-6
Months recovery
85%
Success rate with surgery
25-35
Peak age range
Understanding Shoulder Labral Tears

What is the Labrum?

The labrum is a ring of cartilage that surrounds the shoulder socket (glenoid), deepening it and providing stability to the shoulder joint.

Functions of the Labrum:

  • Deepens the shoulder socket
  • Provides joint stability
  • Attachment point for ligaments
  • Helps distribute joint forces

Common Symptoms

  • Deep shoulder pain
  • Clicking or popping sensation
  • Shoulder instability or "giving way"
  • Pain with overhead activities
  • Decreased throwing velocity
  • Night pain disturbing sleep

Types of Labral Tears

SLAP Tear (Superior Labrum)

Tear at the top of the labrum where the biceps tendon attaches

Common Causes:

  • Overhead throwing motions
  • Fall on outstretched arm
  • Repetitive overhead activities
  • Age-related degeneration

Symptoms:

  • Deep shoulder pain
  • Pain with overhead activities
  • Clicking or popping sensation
  • Weakness in throwing motions

Treatment Approach:

Often requires arthroscopic repair, especially in athletes

Bankart Lesion (Anterior Labrum)

Tear at the front of the labrum, often with shoulder dislocation

Common Causes:

  • Anterior shoulder dislocation
  • Contact sports injuries
  • Traumatic falls
  • Recurrent instability

Symptoms:

  • Shoulder instability
  • Fear of dislocation
  • Pain with certain movements
  • Weakness with external rotation

Treatment Approach:

Surgical repair recommended for recurrent instability

Posterior Labral Tear

Less common tear at the back of the labrum

Common Causes:

  • Posterior shoulder dislocation
  • Repetitive internal rotation
  • Contact sports
  • Direct trauma to front of shoulder

Symptoms:

  • Posterior shoulder pain
  • Pain with internal rotation
  • Weakness with pushing motions
  • Instability feeling

Treatment Approach:

Conservative management often successful initially

Treatment Phases

Phase 1: Acute Management (0-2 weeks)

Initial pain and inflammation control

Goals:

Reduce pain and inflammationProtect healing tissueMaintain pain-free range of motion

Key Interventions:

Rest from aggravating activities
Ice therapy 15-20 minutes, 3-4 times daily
Anti-inflammatory medications as prescribed
Gentle pendulum exercises
Passive range of motion within pain limits
Sleep positioning modifications
Phase 2: Early Mobilization (2-6 weeks)

Gradual restoration of mobility and function

Goals:

Restore full range of motionBegin strengtheningImprove daily function

Key Interventions:

Progressive stretching exercises
Scapular stabilization exercises
Isometric strengthening
Manual therapy techniques
Postural correction exercises
Activity modification education
Phase 3: Strengthening (6-12 weeks)

Progressive strengthening and functional training

Goals:

Build rotator cuff strengthImprove shoulder stabilityPrepare for return to activity

Key Interventions:

Progressive resistance exercises
Functional movement patterns
Sport-specific training (if applicable)
Plyometric exercises (advanced)
Return to activity planning
Biomechanical assessment

Rehabilitation Exercise Program

Early Phase Exercises (0-6 weeks)

Pendulum Swings

Lean forward, let arm hang, gently swing in small circles

Sets: 2-3 sets
Reps: 10-15 each direction
Frequency: 3-4 times daily

Passive External Rotation

Use unaffected arm to gently rotate affected arm outward

Sets: 2-3 sets
Reps: 10-15 repetitions
Frequency: Daily

Cross-body Stretch

Pull affected arm across body with opposite hand

Sets: 3 sets
Reps: 30-second holds
Frequency: 2-3 times daily
Strengthening Phase (6-12 weeks)

External Rotation with Band

Resistance band external rotation with elbow at side

Sets: 2-3 sets
Reps: 12-15 repetitions
Frequency: Daily

Scapular Squeezes

Squeeze shoulder blades together, hold briefly

Sets: 2-3 sets
Reps: 15-20 repetitions
Frequency: Daily

Wall Push-ups

Modified push-ups against wall, progress to incline

Sets: 2-3 sets
Reps: 10-15 repetitions
Frequency: Daily
Prevention Strategies
Proper warm-up before sports activities
Gradual progression in training intensity
Maintain good shoulder flexibility
Strengthen rotator cuff and scapular muscles
Use proper throwing mechanics
Avoid repetitive overhead activities when fatigued
Address shoulder instability early
Consider protective equipment in contact sports
When to Seek Medical Attention
Sudden severe pain or "pop" in shoulder
Complete inability to move arm
Visible shoulder deformity
Numbness or tingling in arm or hand
Signs of infection (fever, increased warmth)
Progressive weakness despite treatment
Recurrent shoulder dislocations
No improvement after 6-8 weeks of conservative treatment
Recommended Products for Recovery

Shoulder Braces

Supportive braces for stability during recovery

Resistance Bands

Essential for progressive strengthening exercises

Ice Therapy

Cold therapy for pain and inflammation control

AC Joint SeparationBack to Shoulder ConditionsBiceps Tendonitis

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