Glenoid Labrum Tear

What is the glenoid labrum?

The glenoid labrum is a cup-shaped rim of cartilage that lines and reinforces the ball-and-socket joint of the shoulder. The head of the humerus (upper arm bone) is the "ball," which rests inside the glenoid (“socket"). The glenoid labrum supports and stabilizes the joint, rotator cuff tendons and muscles, and is also the site where various shoulder ligaments attach to the bones.

Illustration of the shoulder. The glenoid labrum is shown in blue.

What are the symptoms of a torn glenoid labrum?

Pain and instability at the shoulder are the most common symptoms. These are sometimes accompanied by a popping, catching or grinding sensation. A torn glenoid labrum can also lead to a dislocated shoulder. Precise symptoms, however, vary depending on which type of glenoid labrum tear a patient has.

Illustration of the shoulder with a glenoid labral tear.

Glenoid labrum tear types

SLAP tears and Bankart tears are the most common types. Both types are often associated with dull shoulder pain aching pain problems with moving the shoulder normally. SLAP stands for "superior labrum from anterior to posterior." This type of labral tear occurs where the labrum connects to the biceps tendon. In a Bankart tear, a dislocated shoulder causes the head of the humerus to tear the labrum as it pops out of the socket. The tear usually occurs at the front of the shoulder, but it can sometimes occur toward the back.

Do you need surgery for a glenoid labrum tear?

Not always. Some tears can heal with rest and physical therapy. Conservative, nonsurgical options are usually explored first. A sports medicine physician or orthopedic surgeon will do a physical exam and order imaging (X-rays and, often, an MRI) to identify the type of tear and extent of the damage.

Nonsurgical treatment

With rest and physical therapy, some minor glenoid labral tears may heel sufficiently in people who do not plan to engage in competitive athletics or heavy overhead arm motion. In a minor Bankart tear with a dislocation, it may be possible to pop the shoulder back into place and follow up with physical therapy. Conservative treatments include rest, nonsteroidal anti-inflammatory medications (NSAIDs) and, in some cases, a cortisone shot.

In general, nonsurgical treatment is usually most appropriate for older people who do not engage in rigorous physical activity.

When is surgery necessary?

Surgery is typically required for athletes and other active people, such as those whose jobs involve overhead lifting. Surgery to repair torn ligaments and reattach the labrum to the bone may also be necessary if a tear worsen, physical therapy isn't helping, a person can't perform overhead motions, or if they experience recurrent shoulder dislocations.

How is a glenoid labrum repaired?

Depending on the type and severity of the tear, the labrum and ligaments may need to be reattached to the bone using sutures and anchors. This can often be performed arthroscopically, which facilitates the use of minimally invasive incisions to reduce recovery time.

Key takeaways

• The glenoid labrum is a cup-shaped cartilage rim that lines and stabilizes the shoulder's ball-and-socket joint. It also supports the rotator cuff and serves as an attachment point for shoulder ligaments.
• Many glenoid labrum tears can be treated without surgery, especially in older, less active people. Surgical treatment may be necessary for persistent symptoms, recurrent dislocated shoulder, or in athletes and other physically active people.
• When surgery is necessary, the torn labrum is often repaired arthroscopically by reattaching it to the bone with sutures and anchors, allowing for a minimally invasive approach.

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