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Shoulder Pain.......Is it the Mysterious Torn Labrum?



torn labrum treated by physical therapyShoulder 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.

Physical Therapy

Diana welcomes your comments


Very Interesting
Posted @ Sunday, October 23, 2011 12:37 PM by MR. L. Dork
Diana i was just diagnosed with a torn labrum in my left shoulder after a shoulder mri. I have had chronic shoulder blade and back pain for months now and my left shoulder rolls forward now and i am experiencing shoulder scalp winging. I am a football player and used to lift weights and bodybuild almost every day. I got this injury back in october 2011 i believe from a very hard hit i took in a football game and landed very hard on my left side, and in the months after kept lifting heavy weights in the gym. So my question is can this torn labrum cause my back/ and neck pain, my shoulder instability and rolling forward, and the scalp winging? I am going to New England orthopedics next week and just wanted some more insight on this before my visit. 
Thank You, 
Murphy Serafino  
Posted @ Thursday, July 05, 2012 1:41 PM by murphy
Hi Murphy, 
Did you ever get a response or follow up on this? I have near identical symptoms for almost 4 years. Would be curious to hear your update. 
Jeff O.
Posted @ Friday, October 19, 2012 4:55 PM by Jeff O.
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Posted @ Monday, May 12, 2014 3:57 AM by moon
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Diana Echert

Jumping for PT DocTools

Diana is a licensed physical therapist whose experience spans inpatient and outpatient work in rehab, geriatrics, orthopedics and sports medicine. An avid hker and tennis player, she you must practice what you preach.  Stay active and informed any way you can

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