Glenoid Labrum Tear
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Apr 3, 2024
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Mendeley
Glenoid labrum tear
aka Shoulder Joint Tear
Emma + Kaiying
1.
Name of the injury, common and medical term (if applicable)
Medical term: glenoid labrum tear
Common name: Shoulder Joint Tear
2.
Signs and symptoms of the injury
-
Pain with overhead movement
-
Decreased range of motion
-
Loss of strength
-
Locking, popping or grinding sensation
3.
Possible causes of the injury
-
Cause: Injuries to the tissue around the shoulder socket can happen in two main ways: either from
a sudden injury
o
r repeatedly doing the same shoulder movements
.
-
Swimming involves repetitive shoulder movements for example strokes like freestyle and
butterfly.
The repetitive motions can eventually lead to a tear on the glenoid labrum
.
-
Sudden movements like forceful movements in the water like rapid changes in
direction can also lead to labral tears.
4.
A description of the muscles, tendons, ligaments and bones that are affected by the injury
SLAP tear (superior labral anterior to posterior tear)
-
The biceps tendon is located in the front of the shoulder.
-
Affects the function and causes pain in the long head of the biceps tendon.
Bankart lesion (a tear of the front part of the labrum at the bottom of the socket)
-
Humeral bone (dislocation when the humeral head comes out of the font of the socket)
Glenoid:
Rotator Cuff Muscles: plays a key role in moving shoulder joint. It can affect the attachment of these
tendons to the labrum leading to pain and weakness.
superior glenohumeral ligament (SGHL)
middle glenohumeral ligament(MGHL)
inferior glenohumeral ligament(IGHL)
-
The labral is connected to these ligaments, the injury may disrupt the stability of these ligaments.
***rmr to differ between labrum tear vs rotator cuff
#5-
3 rehabilitation exercises (when demonstrating, connect to how the rehab exercise helps, and
how it relates back to the sports)
https://www.joionline.net/trending/content/exercises-torn-shoulder-labrum
https://www.verywellhealth.com/exercise-program-after-shoulder-labrum-tear-4020936
https://www.rehabhero.ca/blog/exercises-for-glenoid-labral-tear
https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/rehabi
litation-protocol-for-superior-labrum-anterior-and-posterior-slap.pdf
-
Biggest focus on physical therapy is improving range of motion, strengthening the surrounding
rotator cuff muscles and shoulder blade (scapular) muscles
Rehab Exercise
Description
Pendulum Exercise
https://www.youtube.com/watch
?v=-37fDuC83DQ
To improve/regain range of motion after removal of the sling 1-2 weeks after the surgery
-
It involves minimal isometric contraction, since it’s a passive motion of the
supraspinatus, infraspinatus, subscapularis, and teres minor muscles which make
up the rotator cuff.
Lateral raises
The goal is to strengthen the deltoid muscles surrounding the shoulder. By strengthening
the muscles around the shoulder, burden around the torn labrum is lessened which allows
it to heal without reinjuring. The muscles contract concentrically (shortens) going up and
eccentrically (lengthens) going down, meaning this exercise is an isotonic contraction.
It’s helpful for swimmers as they use the shoulder muscles extensively.
Standing Forward Shoulder
Flexion
Strengthen surrounding muscles (Pectoralis major and deltoid) to lessen the burden on
the shoulder joint to protect the labrum. It involves the isotonic contraction of the
pectoralis major and deltoid muscles.
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Treatments: (and of course, you will need to stay away from swimming after diagnosis to prevent
further damage to the labrum)
https://www.sciencedaily.com/releases/2012/10/121003141410.htm
https://www.sciencedaily.com/releases/2012/08/120801143726.htm
https://nyulangone.org/conditions/shoulder-labral-tears/treatments/nonsurgical-treatment-for-shoul
der-labral-tears
https://openorthopaedicsjournal.com/VOLUME/12/PAGE/303/
https://www.sports-health.com/sports-injuries/shoulder-injuries/labrum-tear-treatments
https://www.hss.edu/conditions_shoulder-labrum-tears-overview.asp#nonsurgical
https://www.usms.org/fitness-and-training/articles-and-videos/articles/can-i-swim-through-a-torn-la
brum#:~:text=Symptoms%20of%20a%20torn%20labrum,and%20weakness%20in%20the%20sho
ulder
.
https://cambridgeshoulder.co.uk/shoulder/slap-tears/
Most swimmers prefer to stick with non-surgical methods first as surgical methods are an extensive
procedure
●
Surgery
○
Shoulder arthroscopy: this operation involves the surgeon making a small incision in the
shoulder to insert a tiny camera attached to an arthroscope to view the damage. Then the
surgeon will trim out the frayed areas of the labrum or reattach the labrum back to the rim
of the joint socket. After the surgery the arms and shoulders will be required to be placed
in a sling to immobilize the shoulder for the first few weeks, then rehab exercises are
required.
●
Medication:
○
Anti Inflammatory medications help to reduce the swelling and pain in the shoulder area.
●
Injections
○
Platelet-rich plasma injections
■
The injection of platelet-rich liquid into the shoulder allows for faster healing of
the labrum tear as the liquid is composed of platelets that contain growth factors
which are what contributes to the stimulation of healing.
■
An important thing to note is to avoid anti-inflammatory medications after the
injection as they may impede inflammatory responses that are important in the
healing process.
○
Corticosteroid injections (short-term treatment)
■
Similar to anti-inflammatory medications but more effective, the purpose of
corticosteroids injection is to reduce pain and inflammation in the shoulder.
Doctors may recommend this treatment if other medications do not work to
relieve the symptoms.
●
Rehabilitation therapy: (last treatment option to transition to the 3 rehab exercises in presentation)
○
Therapists work with patients to design rehabilitation exercises to gradually strengthen
the surrounding muscles of the shoulder. This helps to lessen the burden on the torn
labrum, allowing it to heal without extra pressure exerted onto it which impedes with the
healing process. In addition, this also helps to stabilize the shoulder joint. The
rehabilitation therapy may take around 6 weeks or more, depending on the severity of the
tear.
References
Arthroscopic Labrum Repair of the Shoulder (SLAP)
. (n.d.). Massachusetts General Hospital. Retrieved
October 10, 2023, from
https://www.massgeneral.org/assets/mgh/pdf/orthopaedics/sports-medicine/physical-therapy/reha
bilitation-protocol-for-superior-labrum-anterior-and-posterior-slap.pdf
Common Swimming Injuries: Prevention and Treatment
. (n.d.). UPMC. Retrieved October 10, 2023, from
https://www.upmc.com/services/sports-medicine/for-athletes/swimming
Fealy, S. (2020, November 10).
Torn Shoulder Labrum: Causes, Symptoms, Treatment, Recovery
.
Hospital for Special Surgery. Retrieved October 10, 2023, from
https://www.hss.edu/conditions_shoulder-labrum-tears-overview.asp
Fealy, S. (2020, November 10).
Torn Shoulder Labrum: Causes, Symptoms, Treatment, Recovery
.
Hospital for Special Surgery. Retrieved October 10, 2023, from
https://www.hss.edu/conditions_shoulder-labrum-tears-overview.asp#nonsurgical
Gemas, T. (n.d.).
Labrum Tear Treatments
. Sports-health. Retrieved October 10, 2023, from
https://www.sports-health.com/sports-injuries/shoulder-injuries/labrum-tear-treatments
Getting athletes back in the game sooner following shoulder injuries
. (2012, October 3). ScienceDaily.
Retrieved October 10, 2023, from
https://www.sciencedaily.com/releases/2012/10/121003141410.htm
Glenoid Labrum Tear Symptoms, Diagnosis & Treatment
. (n.d.). Baptist Health. Retrieved October 10,
2023, from
https://www.baptisthealth.com/care-services/conditions-treatments/glenoid-labrum-tear
Lim, R. (n.d.).
Exercises for a Torn Shoulder Labrum
. Jacksonville Orthopaedic Institute. Retrieved
October 10, 2023, from
https://www.joionline.net/trending/content/exercises-torn-shoulder-labrum
Nonsurgical Treatment for Shoulder Labral Tears
. (n.d.). NYU Langone Health. Retrieved October 10,
2023, from
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https://nyulangone.org/conditions/shoulder-labral-tears/treatments/nonsurgical-treatment-for-shou
lder-labral-tears
O'Mara, K. (2019, December 30).
Can I Swim Through a Torn Labrum? | U.S. Masters Swimming
. US
Masters Swimming. Retrieved October 10, 2023, from
https://www.usms.org/fitness-and-training/articles-and-videos/articles/can-i-swim-through-a-torn-
labrum
Recurring shoulder instability injuries likely among young athletes playing contact sports
. (2012, August
1). ScienceDaily. Retrieved October 10, 2023, from
https://www.sciencedaily.com/releases/2012/08/120801143726.htm
Sears, B. (2022, October 14).
Shoulder Labrum Tear Exercise Program
. Verywell Health. Retrieved
October 10, 2023, from
https://www.verywellhealth.com/exercise-program-after-shoulder-labrum-tear-4020936
Song, D. (2022, November 21).
Exercises for Glenoid Labral Tear — Rehab Hero
. Rehab Hero. Retrieved
October 10, 2023, from https://www.rehabhero.ca/blog/exercises-for-glenoid-labral-tear
Superior Labral Anterior to Posterior Tear Management in Athletes
. (n.d.). The Open Orthopaedics
Journal. Retrieved October 10, 2023, from
https://openorthopaedicsjournal.com/VOLUME/12/PAGE/303/
Torn Glenoid Labrum Symptoms & Treatments | HSS Orthopedics
. (n.d.). Hospital for Special Surgery.
Retrieved October 10, 2023, from https://www.hss.edu/condition-list_labral-tears-shoulder.asp
Ward, T. (n.d.).
Shoulder Joint Tear (Glenoid Labrum Tear) - OrthoInfo - AAOS
. OrthoInfo. Retrieved
October 10, 2023, from
https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-joint-tear-glenoid-labrum-tear/