The bones of the shoulder cannot be held in place without the labrum. A ring of rubbery tissue called fibrocartilage, it is attached to the edge of the shoulder socket, allowing the ball of the joint to be kept in place. Though the tissue is thick, the labrum is very susceptible to tearing if the shoulder joint experiences a trauma. The shoulder socket is a shallow and unstable cavity. The cartilaginous labrum makes the socket deeper, creating space for the bones to move. The scapula, or 'wingbone', is surrounded by the labrum, allowing the bone of the upper arm the humerus to fit into the joint.
The cuff of cartilage increases the surface area of the shoulder joint, enabling the range of motion for the arm. In anatomy and physiology, the term 'labrum' is used to refer to an edge or a brim. The labrum surrounding the shoulder socket is called the 'the glenoid labrum'.
It coats the surface of the socket area with a soft cartilage, enabling the shoulder to move more freely and painlessly. A labral tear occurs when the cartilage is torn. Tears typically result from an injury and are common among athletes. Chronic trauma to the area or strain through repetitive motions, such as pitching in baseball, can cause damage to the glenoid labrum. Sudden, violent jerking and pulling motions, such as when attempting to lift a heavy object, can also lead to the injury.
The glenoid labrum is a firm, white structure that form a ring around the glenoid cavity the cup of the ball and socket shoulder joint. The labrum is made of fibrous cartilage tissue, which is similar to the meniscus in the knee. The labrum is triangular in shape in cross-section and thus deepens the socket of the shoulder. It also provides a 'suction-cup' effect to the joint. These two functions means that it is extremely important in providing a form of stability to the shoulder joint.
If the labrum is torn the shoulder can become unstable. This is what happens in shoulder dislocations and instability. Shoulder labrum tears can happen anywhere around the glenoid socket. You may also feel a sense of instability in your shoulder, a decreased range of motion, and a loss of strength.
Pain at night or while doing daily activities is also common. All types of labral tears often occur with other shoulder injuries, such as dislocated shoulders, rotator cuff injuries , and torn biceps tendons. Your doctor will determine exactly what type of injury you have.
Traumatic injury and wear and tear from repetitive motion of the upper arm can both cause labrum tears. Be sure to tell the doctor about any event that may have caused the pain. The labrum tissue is too soft to show up in X-rays, but your doctor may order an X-ray to see if other injuries might be causing your pain.
Your doctor may also perform an arthroscopic examination by inserting a tiny camera called an arthroscope through a small cut. The camera will give your doctor a more detailed view of your labrum and any injuries to it. If you have a Bankart tear, your doctor or even your coach or trainer may be able to pop your upper arm back into place. This should be followed by physical therapy. Rest is the most important one. Your doctor may also decide to give you cortisone injections for pain relief.
Your doctor may recommend physical therapy to strengthen the muscles of your shoulder, especially the rotator cuff. You may also receive massages or manual therapy during visits. Your physical therapist will show you what positions and activities to avoid, as well as gentle stretches and exercises you can do at home. Because the CAT scan uses X-rays, the soft tissues do not show up. The special dye is necessary to show the outline of the labrum.
If there is a tear, the dye may leak into the tear and show up on the CAT scan. These two tests are not very accurate in detecting this problem. Diagnosing a labral tear can be extremely difficult, and the diagnosis may rely on looking into the shoulder with the arthroscope, which is a small TV camera that can be inserted into the shoulder joint.
The shoulder joint is viewed on a TV monitor. This allows the surgeon to look directly at the labrum and see if it is torn. Since the symptoms of a labral tear may be made worse by instability, a rehabilitation program to strengthen the rotator cuff muscles may be started by a physical therapist.
Anti-inflammatory medications, such as aspirin or ibuprofen, may help the pain. If the problem persists, surgery may be required to confirm the diagnosis and attempt to treat the problem. Surgical treatment for this condition is still evolving, since the problem has not been recognized for long enough to adequately evaluate the results of different treatments through surgery. The arthroscope can be used to treat the torn labrum in many cases.
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