The glenoid, or socket joint of the shoulder, is surrounded by a fibrocartilaginous supporting structure called the labrum. Injuries to the tissue surrounding the shoulder socket can be caused by acute trauma or repetitive shoulder motions. Examples include falling on an outstretched arm, a direct blow to the shoulder, sudden pull or a violent overhead reach, such as occurs when trying to stop a fall or slide. Throwing athletes and weight lifters can experience tears due to repetitive shoulder motion.
Tears can be located either above (superior) or below (inferior) the middle of the glenoid socket. A SLAP lesion (superior labrum, anterior [front] to posterior [back]) is a tear of the rim above the middle of the socket that may also involve the biceps tendon.
Signs and symptoms of glenoid labrum tears include:
Diagnosis is made through taking a patient's medical history, performing a physical examination and taking X-rays.
Until the final diagnosis is made, your physician may prescribe anti-inflammatory medication and rest to relieve symptoms. Rehabilitation exercises to strengthen the rotator cuff muscles also may be recommended. If these conservative measures are insufficient, your physician may recommend arthroscopic surgery. An arthroscope is a miniature television camera on the end of a flexible tube that can be inserted directly into the joint through a tiny incision. The surgeon uses the broadcast images to guide his movement of miniature instruments, also inserted through tiny incisions. Because this type of surgery doesn't require a large incision, recovery time is much shorter.
During the surgery, the doctor will examine the rim and the biceps tendon. If the injury is confined to the rim itself, without involving the tendon, the shoulder is still stable. The surgeon will remove the torn flap and correct any other associated problems. If the tear extends into the biceps tendon or if the tendon is detached, the result is an unstable joint. The surgeon will need to repair and reattach the tendon using absorbable tacks, wires or sutures.
Reviewed by health care specialists at UCSF Medical Center.