The socket of the shoulder joint is lined by a fibrocartilage which is known as the glenoid labrum. Chronic shoulder movements such as raising the hand above the head as done by baseball pitchers and weight lifters or a direct injury with fall on an outstretched arm can result in a glenoid labrum tear.

Patients present clinically with shoulder pain while raising the arm above the head, a sensation of shoulder joint instability, locking or popping or grinding of the joint, nocturnal shoulder pain with diminished strength. In the case of superior labral tears, patients complain of posterior shoulder pain with a sensation of popping and clicking.

A superior labral tear from anterior to posterior is called a SLAP tear and can manifest as pain in the posterior part of the shoulder during abduction and external rotation, with the patient becoming fatigued easily during throwing movements. Dead arm syndrome comprises of all these symptoms. A tear of the anteroinferior part of the glenoid labrum can cause glenolabral articular disruption (GLAD) with avulsion of the articular cartilage.

During a physical examination, several tests [1] devised to assess shoulder mobility are employed e.g. Speed's test, Jobe's test, O'Brien or active compression test [2] [3] [4], anterior slide test [5], biceps tension test I [6], and biceps tension test II [6].These are especially important in athletes as their ability to internally rotate the shoulder during abduction is affected and they are therefore at risk of developing a dead arm syndrome [7]. In an anterior type II SLAP tear, the Speed's and O'Brien test are positive while the Jobe's test is positive in posterior type II SLAP tears [8]. However, none of these tests have been found to be very reliable [9] [10]. Approximately 40% patients with SLAP lesions are also likely to suffer from rotator cuff tears and therefore, signs of rotator cuff impingement should be looked for [10] in patients with glenoid labrum tears.

• Disability

  If despite maximising non-operative treatment, pain and disability persists, surgical options can be considered. The labral tear can be repaired with small anchors and sutures. [shouldersurgery.com.au]

  Ignoring this could lead to irreversible damage in your shoulder, and ultimately lead to a disability. [leconteortho.com]

  Our physicians help patients of all ages recover from sports injuries, accidents, disabilities and even degenerative diseases. our board-certified doctors are fellowship trained Physicians marked with an asterisk (*) are fellowship trained in their field [bjc-houston.com]

  The primary outcome will be the Knee injury / Hip disability and Osteoarthritis Outcome Score - Physical Function Short Form (KOOS-PS / HOOS-PS) at 3 months follow up. [physitrack.fi]

  The substance so incorporated. la belle indifférence (lah bel an-dif-er-ahns′) A naive, inappropriate lack of emotion or concern for the perceptions by others of one's disability, typically seen in persons with conversion hysteria. [theodora.com]

• Asymptomatic

  Although standard MRI and CT and MR arthrography allow for an assessment of the labrum, the process is complicated by the considerable variation in the size and morphology of the labrum in asymptomatic individuals. [emedicine.medscape.com]

  Similar to a SLAP tear, a posterior labral tear can be ignored if asymptomatic. Diagnosis is made by history and physical exam. MRI with dye injected into the shoulder is 90% accurate to help confirm the diagnosis. [shoulderkneedoc.com]

  Black arrow in ( a ) shows a thickened coracoacromial ligament and yellow arrow shows subjacent asymptomatic subacromialsubdeltoid bursitis, ( c ) orange arrow in this axial T2 fat saturation image shows the SLAP tear at the junction of the long head [f1000research.com]

• Ecchymosis

  In patients with distal biceps, rupture, ecchymosis, swelling, and tenderness may be present in the antecubital fossa. [ncbi.nlm.nih.gov]

• Heart Disease

  If you develop shoulder pain with exercise or exertion, please contact your physician as this may be a sign of heart disease. [painspot.com]

• Shoulder Pain

  Patients present clinically with shoulder pain while raising the arm above the head, a sensation of shoulder joint instability, locking or popping or grinding of the joint, nocturnal shoulder pain with diminished strength. [symptoma.com]

  When this tissue tears, it creates general shoulder pain and weakness in the joint. This shoulder injury is often caused by repetitive movement such as overhead throwing, so resting from these activities will help to ease the pain. [sportsinjuryclinic.net]

  A program of stretching and strengthening exercises, icing, pain medications or anti-inflammatory medications may be used to help decrease pain and improve function of the shoulder. [stmarysmaine.com]

  Arthroscopy, Adhesive Capsulitis of the Shoulder, Cervicogenic Shoulder Pain, Proprioception: Testing and Treatment, and more. Details current surgical and rehabilitation information for all aspects of shoulder pathology to keep you up-to-date. [books.google.de]

• Fracture

  Other Shoulder and Elbow Conditions Adult Forearm Fractures Arthritis of the Shoulder Biceps Tendon Tear at the Elbow Clavicle Fracture (Broken Collarbone) Cubital Tunnel Syndrome Distal Biceps Rupture Distal Humerus Fractures of the Elbow Dislocated [venturaorthopedicsurgeon.com]

  For this reason, some insist that the term "Bankart lesion" be reserved for soft tissue injury. eponymous fractures [radiopaedia.org]

  Non-displaced fractures require immobilization in a sling for about six weeks. Your doctor usually prescribes medication to relieve pain and inflammation. [carrellclinic.com]

  Anterior dislocation with Bankart fracture The images show a subtle Bankart fracture (arrows). Scroll through images. Bankart fracture This is a post-reduction view. Notice the very large fracture of the glenoid rim with displacement. [radiologyassistant.nl]

  Plain X-rays of the shoulder may reveal associated fractures while ultrasonography is very sensitive in detecting labral tears and is useful for the preoperative evaluation of patients with an anterior instability of the shoulder joint. [symptoma.com]

• Stiffness of the Shoulder

  The visible symptoms are: A numbing and diffused pain in the posterior portion of the shoulder Varied shoulder movements cause some popping or clicking sounds Stiffness of the shoulder joints Shoulder strength weakening Feelings of a shoulder dislocation [injuredshoulder.com]

  Glenoid Labrum Tear Signs and Symptoms Symptoms of glenoid labrum tear can include: Pain with overhead movement Catching, locking, popping or grinding sensation Decreased range of motion Shoulder stiffness Shoulder instability Shoulder weakness, often [baptisthealth.com]

• Frozen Shoulder

  Shoulder Elbow Dislocation Elbow Injuries in the Throwing Athlete Elbow (Olecranon) Bursitis Elbow Fractures in Children Forearm Fractures in Children Fracture of the Shoulder Blade (Scapula) Frozen Shoulder Golfer’s Elbow Lateral Epicondylitis Osteoarthritis [venturaorthopedicsurgeon.com]

  While it is important to move the shoulder to prevent scar tissue, or a frozen shoulder, from developing, there should only be passive motion of the shoulder. [miamisportsmedicine.com]

• Neck Pain

  The patient reported an immediate onset of deep pain distributed around the shoulder region more so posteriorly with an associated ‘click’. There was no pain or discomfort described below the deltoid or associated neck pain or headaches. [f1000research.com]

A glenoid labrum tear can be diagnosed after obtaining a detailed patient history, performing a clinical examination of the shoulder joint and neck followed by imaging studies. Specific inquiry about the activities should be made as the patient may be using the shoulder for repeated overhead shoulder movements such as pitching or weightlifting.

Imaging studies such as plain X-rays of the shoulder, ultrasonography, computed tomography (CT) scan, magnetic resonance imaging (MRI) and CT arthrography can help in the diagnosis [11] [12], although contrast- enhanced MRI is the gold standard test used for confirmation. Plain X-rays of the shoulder may reveal associated fractures while ultrasonography is very sensitive in detecting labral tears and is useful for the preoperative evaluation of patients with an anterior instability of the shoulder joint.

Based on findings of arthrotomography, labral tears have been classified as [13]:

Grade I: simple tears within the labrum or at the labrum-glenoid cartilage junction
Grade II: complete segmental tear
Grade III: labral tear associated with a fracture of the bony rim of the glenoid.

Other imaging findings in glenoid labral tears include paralabral cysts (in SLAP tears), and fluid in the suprascapular notch with nerve compression.

Some of the types of treatments are: Non-surgical treatments: One of the most important non-surgical treatments that are suggested are physical therapy and exercises. [injuredshoulder.com]

(eds.), "24 - Shoulder Instability Treatment and Rehabilitation", Clinical Orthopaedic Rehabilitation: a Team Approach (Fourth Edition), Philadelphia: Content Repository Only! [en.wikipedia.org]

Glenoid Labrum Tear Treatment at Baptist Health: Our Approach Baptist Health is known for advanced, superior care for patients with orthopedic conditions and the diagnosis, treatment and management of a glenoid labrum tear. [baptisthealth.com]

Conservative treatment of labral tears involves: Pain management Activity modification Physiotherapy to restore range of motion, strength and endurance. [shouldersurgery.com.au]

Conservative treatment methods may prove to be effective if the condition is not severe. These treatments include physical therapy, rest, and medication to reduce inflammation. [parkviewortho.com]

Prognosis The prognosis for people with a glenoid labrum tear depends upon where the tear is located and how severe it is. [baptisthealth.com]

[…] linear high T2/PD intensity through the non-displaced anteroinferior labrum, indicating tear abnormally small or absent anterior labrum 3 double axillary pouch sign (coronal MR arthrogram) - specific sign for an anteroinferior labral tear Treatment and prognosis [radiopaedia.org]

Posterior GLAD; Posterior labrocapsular periosteal sleeve avulsion lesion (POLPSA); Kim lesion (superficial tears between the posterior glenoid labrum and glenoid articular cartilage without labral detachment) Circumferential labral lesion Treatment and prognosis [physio-pedia.com]

The recovery time for a labral tear will depend greatly on the severity of the tear and its prognosis. If your injury is one that responds well to conservative treatment in the form of Physiotherapy or Chiropractic Care then estimate 6-12 weeks. [rebalancetoronto.com]

Objectives: Identify the etiology of biceps tendon rupture. Review the presentation of biceps tendon rupture. Outline the management options available for biceps tendon rupture. [ncbi.nlm.nih.gov]

Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]

Epidemiology The incidence of distal biceps tendon rupture is around 2.55 per 100,000 patient-years. [ncbi.nlm.nih.gov]

[…] associated with internal impingement rotator cuff tears (usually articular sided) instability (may be subtle) Mechanisms repetitive overhead activities (often seen in throwing athletes) fall on outstretched arm with tensed biceps traction on the arm Pathophysiology [orthobullets.com]

Gulotta Chapter 2 Pathophysiology and Biomechanics of Glenohumeral Instability Xinning Li, Paul Yannopoulos, Jon J. P. Warner Chapter 3 Workup of the Patient Presenting with Instability Ryan T. Cassilly, Jon-Michael E. Caldwell, William N. [euro-libris.ro]

Pathophysiology Age, overuse, smoking, and corticosteroid use contribute to tendon degeneration and, later, tendinopathy. [ncbi.nlm.nih.gov]

Prevention While many risk factors cannot be controlled, you can help prevent a glenoid labrum tear in these ways: Avoid certain athletics: Sports that involve repetitive overhead motion or heavy overhead lifting are a primary cause of glenoid labrum [baptisthealth.com]

Request an Appointment: 443-997-2663 (BONE) SLAP Tear Prevention Tips for Baseball and Softball Players Sports medicine specialist John Wilckens, M.D. explains the origin of SLAP tears and what players, parents and coaches can do to prevent this injury [hopkinsmedicine.org]

Demonstrates which exercises your patients should perform in order to decrease their chance of injury or increase strength following an injury through illustrated exercises for rehabilitation and injury prevention. [books.google.de]

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2. O'Brien SJ, Pagnani MJ, Fealy S, McGlynn SR, Wilson JB. The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J Sports Med. 1998 Sep-Oct; 26(5):610-3.
3. Green RA, Taylor NF, Mirkovic M, Perrott M. An evaluation of the anatomic basis of the O'Brien active compression test for superior labral anterior and posterior (SLAP) lesions. J Shoulder Elbow Surg. 2008 Jan-Feb; 17(1):165-71.
4. Stetson WB, Templin K. The crank test, the O'Brien test, and routine magnetic resonance imaging scans in the diagnosis of labral tears. Am J Sports Med. 2002 Nov-Dec; 30(6):806-9.
5. Kibler WB. Specificity and sensitivity of the anterior slide test in throwing athletes with superior glenoid labral tears. Arthroscopy. 1995 Jun; 11(3):296-300.
6. Kim SH, Ha KI, Han KY. Biceps load test: a clinical test for superior labrum anterior and posterior lesions in shoulders with recurrent anterior dislocations. Am J Sports Med. 1999 May-Jun; 27(3):300-3.
7. Burkhart SS, Morgan C. SLAP lesions in the overhead athlete. Orthop Clin North Am. 2001 Jul; 32(3):431-41, viii.
8. Jobe CM. Posterior superior glenoid impingement: expanded spectrum. Arthroscopy. 1995 Oct; 11(5):530-6.
9. Dessaur WA, Magarey ME. Diagnostic accuracy of clinical tests for superior labral anterior posterior lesions: a systematic review. J Orthop Sports Phys Ther. 2008 Jun; 38(6):341-52.
10. Tibone JE, Jobe FW, Kerlan RK, et al. Shoulder impingement syndrome in athletes treated by an anterior acromioplasty. Clin Orthop Relat Res. 1985 Sep; 134-40.
11. Zlatkin MB, Sanders TG. Magnetic resonance imaging of the glenoid labrum. Radiol Clin North Am. 2013 Mar; 51 (2):279-97.
12. Fallahi F, Green N, Gadde S, Jeavons L, Armstrong P, Jonker L. Indirect magnetic resonance arthrography of the shoulder; a reliable diagnostic tool for investigation of suspected labral pathology. Skeletal Radiol. 2013 Sep; 42 (9):1225-33.
13. el-Khoury GY, Kathol MH, Chandler JB, Albright JP. Shoulder instability: impact of glenohumeral arthrotomography on treatment. Radiology. 1986 Sep; 160(3):669-73.