Kinematics Team FAQ: Labral Tear (Dislocated Shoulder)
October 16thThe labrum is a firm rim of cartilage round the edge of the shoulder socket. Because the socket is relatively shallow, the labrum helps deepen it and contributes to shoulder stability. It also provides attachment points for several ligaments and the long head of the biceps tendon.
A labral tear (or a dislocated shoulder) can happen after an injury, such as a shoulder dislocation, a fall onto an outstretched arm or a forceful pull on the arm. Some tears develop gradually with repeated overhead activity or wear over time.
Symptoms vary. Some people have pain or clicking, while others notice weakness or a feeling that the shoulder is unstable. These symptoms can also occur with other shoulder problems, so they do not confirm a labral tear on their own.
Where will I feel pain with a labral tear?
Labral-related pain is often felt deep in the shoulder, but its location can vary. Some people notice it with overhead or reaching activities. Others mainly notice clicking, catching, weakness or a feeling that the shoulder may slip.
The symptoms do not reliably show which part of the labrum is involved. Pain at the top, front or back of the shoulder can have other causes, so an assessment is needed to understand what is contributing.
Clicking or catching can happen with a labral tear, but it is also common in shoulders without a tear. The sound or sensation alone does not tell you what is happening inside the joint.
What movements will I struggle to perform if I have a tear in my labrum?
Shoulder pain or reduced confidence can make everyday activities harder. You might notice discomfort when reaching overhead, putting on a jacket, reaching behind your back or lifting and carrying objects.
Some people find that lying on the affected shoulder is uncomfortable. Sport and training may also bring on symptoms, particularly activities involving throwing, serving, swimming, pressing or repeated overhead movements.
If the shoulder feels as though it might slip or give way, you may naturally hold back from certain positions. That feeling can occur with instability, but it does not by itself confirm a labral tear.
Will I feel pain in any other regions of my body?
Shoulder problems can sometimes be accompanied by discomfort around the shoulder blade, upper back or neck. Muscles in these areas may feel tired or tight, especially if you are changing how you use your arm.
That discomfort is not specific to a labral tear, though, and it may have another cause. If you have persistent neck pain, tingling, numbness or symptoms travelling down the arm, mention them during your assessment.
How does a labral tear happen?
Labral tears can happen in different ways. A traumatic tear may occur with a shoulder dislocation, a fall onto an outstretched arm, a direct blow, a sudden pull on the arm or a forceful overhead movement.
Repeated overhead activity can also place stress on the shoulder and may contribute to some tears, including tears near the biceps tendon attachment. In other cases, the labrum may become worn or frayed gradually over time.
The type of tear and the circumstances around it matter. For example, a Bankart tear is commonly associated with an anterior shoulder dislocation, while a SLAP tear affects the upper part of the labrum near the biceps tendon attachment.
What things should I try initially once I’ve had a labral tear?
If your shoulder is sore after an injury, temporarily reduce or modify movements that clearly aggravate it. Keep your arm and hand moving gently within a comfortable range, unless a clinician has advised you otherwise.
Some people find gentle pendulum movements comfortable: let the arm hang loosely and allow it to sway without forcing the movement. You can also keep your elbow, wrist and hand moving.
Ice wrapped in a cloth may provide short-term pain relief for some people. It does not repair the labrum, and you do not need to use it if it is uncomfortable.
If your shoulder has dislocated, or you think it may have, seek prompt medical care. Do not try to force it back into place yourself. A clinician can check the joint and assess for associated injuries.
What things should I try to avoid in the initial stages of a labral tear?
While symptoms are settling, it may help to reduce heavy lifting and movements that repeatedly bring on sharp pain or a sense of instability. This might include certain overhead positions or the throwing position, where the arm is raised and rotated back.
You generally do not need to stop using the shoulder completely unless a clinician advises you to. Keeping it still for a prolonged period can lead to stiffness. The right amount of protection and movement depends on the injury and whether the shoulder has dislocated.
What type of exercises or movements do I need to control to rehab the labral tear?
Rehabilitation is tailored to your symptoms, the type of injury and what you want to return to. It often begins with comfortable movement, then builds strength and control in the rotator cuff and the muscles around the shoulder blade.
As your shoulder improves, exercises can gradually become more demanding. Overhead, rotational, lifting or sport-specific movements can be added when you can manage them with appropriate control and without a significant flare-up.
The aim is to build the capacity you need for your daily activities, work, training or sport. A physiotherapist can help choose and progress exercises that suit your situation.
What other considerations contribute to a labral tear?
Your recovery can depend on the type and severity of the tear, whether the shoulder has dislocated, any other shoulder injuries, your usual activities and how the shoulder responds to rehabilitation.
Repeated dislocations or ongoing instability may affect the plan. Joint flexibility can be relevant to some people’s shoulder instability, but flexibility, posture or shoulder-blade position alone do not establish the cause of a labral tear.
Labral changes can also be seen with normal wear over time. An imaging finding needs to be considered alongside your symptoms and assessment; it may not be the source of your pain.
What treatments can help relieve pain or speed up my labral rehabilitation?
The first step is working out what may be causing your symptoms. A clinician will ask how they began and what makes them better or worse, then assess shoulder movement, strength and stability. They may also check your neck or other nearby areas.
Clinical tests can help guide the assessment, but no single test confirms a labral tear or reliably identifies its exact location. Imaging, such as an MRI, may be considered when the results are likely to help guide treatment or further investigation.
Treatment may include adjusting activities and completing a progressive exercise programme. Hands-on treatment may help with comfort or movement for some people, but it does not repair the labrum. If symptoms or instability continue despite appropriate care, your clinician may discuss imaging or a specialist opinion with you.
What are the expected timeframes for rehabilitating a labral tear?
There is no single recovery timeframe for every labral tear. It depends on the type and severity of the injury, whether there are other injuries, your goals and whether surgery is recommended.
Non-surgical rehabilitation usually involves a gradual progression over weeks to months. For some SLAP injuries, a physiotherapy programme may continue for three to six months. Recovery after surgery follows a different plan and can also take several months.
Your clinician can help set milestones based on your progress and the activities you want to return to.
If shoulder pain, catching or a feeling of instability is interfering with sleep, work, training or everyday activities, arrange an assessment. A clinician can help work out what is happening and plan the next steps.
Book online today for a Kinematics consultation. We can assess your shoulder and build a rehabilitation plan around the activities you want to get back to.
This article is for general education only and is not a substitute for personalised medical advice.