Shoulder Pain.......Is it the Mysterious Torn Labrum?
Shoulder discomfort occurs in many forms....sharp, burning, aching, pinching.....all spell p-a-i-n. It is estimated that more than one-quarter of all visits to a physical therapist is due to shoulder pain. How does this happen?
Our shoulder joint is an engineering marvel. Not only is it a ball and socket joint, it also contains some of the most vital blood vessels and nerves in our body. When working right, we can move mountains or at least reach the top. The ball-shaped top of our arm bone (humerus) fits into a socket formed by an extension of our shoulder blade. As our arm reaches, pushes and pulls, the shoulder blade provides the stabilizing force to give us power.....to lift, climb, and carry heavy objects.
Rotator cuff injuries get the most attention. True....they occur fairly frequently and have a long healing period - with and without surgery. Sometimes overlooked, a torn labrum is also a common injury. Both conditions are very painful and limit activity.
Labrum - an interesting word - describes a group of soft tissues which hold the ball or head of the humerus inside the socket, preventing dislocations when moving your arm in different directions. The labrum protects the shoulder joint. When a tear occurs in a portion of this group of soft tissues, it is not likely to heal with time. Instead, it usually worsens by getting larger or fraying - both cause increased pain. Tears can occur with sudden trauma or with highly repetitive, intense shoulder movements as in manual labor or high speed pitching. We often hear of a famous baseball pitcher or tennis player whose career is in jeopardy due to a torn shoulder labrum.....but this can affect other professionals whose jobs require strenous, repetitive overhead work as electricians, plumbers, and drywall hangers.
A common symptom is a feeling "your arm is falling out of its socket." A torn labrum will cause the ball or head of the humerus to slip out of place. If you find yourself supporting your arm or putting your hand in your pocket to protect your arm, make an appointment to see an orthopedist. Heaviness, arm fatigue, muscle weakness are also symptoms of a torn labrum. These symptoms occur as the head of the arm bone slips out of place, the surrounding muscles including those of the rotator cuff have to do more physical work - overtaxing them - leading to fatigue and more pain. Shoulder and arm movements also change to compensate to avoid pain and make up for the loss of muscle power. Other symptoms as popping, catching, or a "locked" sensation may indicate a labral tear. These occur when the ball drops out of position, causing tendons to rub or soft tissues to "snag."
Physical therapy comes into play both to help determine the exact problem via specific movement tests and postions....and for treatment. In today's digital world of EHR's, therapists can quickly document their test results and send these electronic medical records to an orthopedist ensuring the patient receive treatment in a timely manner.
Surgery is usually the best course of action for all labral tears - the sooner the better. Long-term inflammation and fraying limit the effectiveness of surgical intervention. These tears can occur at any age - and treatment results are positive for all age groups. For those who are not good candidates for surgery... or choose a more conservative approach...exensive modified strengthening programs help to restore function.
Take good care of your shoulders, you never know when the Yankees or Red Sox may call.
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