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The shoulder joint
is a ball and socket joint.

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A 'ball' at the top
of the upper arm bone

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or the humerus fits
neatly into a 'socket',

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called the glenoid,
which is part of the shoulder blade (scapula).

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The labrum is a ring of fibrous cartilage

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surrounding the glenoid
which helps in stabilizing

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the shoulder joints.
The biceps tendon is attached

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inside the shoulder joint
at the superior labrum of the joint.

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The biceps tendon
is a long cord-like structure

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which attaches the biceps muscle
to the shoulder and helps

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to stabilize the joint.

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Causes.

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Traumatic injury to the shoulder
or overuse of the shoulder

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by excessive throwing or
weightlifting can cause a labral tear.

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In addition, the ageing process
may weaken the labrum

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leading to injury
secondary to wear and tear.

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Symptoms.

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A shoulder labral tear injury
can cause symptoms such as pain,

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a catching or locking sensation,
decreased range of motion

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and joint instability.

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Types of labral tears:

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The most common types
of labral tears include:

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SLAP tear:
The term SLAP or superior -labrum

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anterior-posterior refers
to an injury of the superior labrum

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of the shoulder,
at the attachment of the biceps tendon.

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Bankart tear:
Bankart tear is an injury

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to the labrum
that leads to recurrent dislocations

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and arthritis of the shoulder.

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Posterior labrum tears:
This type of labrum tear is rare,

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but may be caused
by repeated internal impingement,

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where the extreme extension
and external rotation of the shoulder

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joint causes pinching
of the bulged part of the arm bone

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against the lining
of the shoulder joint cavity.

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Diagnosis.

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Your doctor may suspect
a labral tear based on your symptoms

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and medical history.
The doctor will inquire

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about your pain
and history of injury.

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Several physical tests
will be performed

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by your doctor
to evaluate the range of motion

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and stability of your shoulder.

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X-rays may be used
to rule out other conditions.

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Your doctor may also order
a computed tomography (CT scan)

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or magnetic resonance imaging (MRI scan) ,

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with a contrast medium,
to determine the presence of tears.

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Diagnosis of a labral tear
can also be confirmed

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through shoulder arthroscopy.

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Conservative treatment.

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Your doctor may start
with conservative approaches

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such as prescribing
anti-inflammatory medications

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and advise rest to relieve symptoms.
Rehabilitation exercises

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may be recommended
to strengthen rotator cuff muscles.

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If the symptoms
do not resolve

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with these conservative measures,
your doctor may

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recommend arthroscopic surgery.

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Surgical treatment.

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During arthroscopic surgery
for SLAP tears,

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your surgeon examines
the labrum and the biceps tendon.

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If the damage is confined
to the labrum without involving

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the tendon,
then the torn flap of the labrum

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will be removed.
In cases where the tendon

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is also involved
or if there is detachment of the tendon,

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absorbable wires or sutures
will be used to repair

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and reattach the tendon.

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Bankart lesion is repaired
by a Bankart operation.

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In this procedure,
the bankart tear is repaired

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by reattaching the labrum
and the capsule to the anterior margin

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of the glenoid cavity.

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Post -operative care.

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Following the surgery,
your shoulder is immobilized

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with a sling for a few days.
To control pain and swelling

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your physical therapist
may use ice, electrical stimulation,

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massage therapy,
and other hands-on -treatments.

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Passive range of motion
exercises are also initiated

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in the post-operative phase.
Active range of motion exercises

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are started about 6 weeks
after the repair,

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to regain your shoulder movement.
Athletes can return to sports

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in about three months.

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Risks and complications.

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Risks associated with a labral repair
include nerve injury,

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wound infection,
tear of the repair, shoulder stiffness,

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recurrence of instability,
poor positioning of anchor suture

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and failure of the repair.

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Shoulder labrum reconstruction
is a surgical technique

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recommended for
treating labral tears.

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Labrum repair can be done
using minimally invasive technique

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or open surgery.
In this procedure, the torn labrum

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is reattached
to the rim of the bone

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using anchor sutures
along with tightening

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of the capsules and ligaments.