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The
glenoid labrum usually tears as a result of a specific trauma such
as a fall onto an outstretched arm. Tears can also result from chronic
overhead movement, such as in pitching. A glenoid labral tear causes
pain during motion. Treatment is with physical therapy and sometimes
surgery.
The shoulder (unlike the hip or elbow) is an inherently unstable joint; it has been likened to a golf ball sitting on a tee. To enhance structural stability, the glenoid (anatomically, a very shallow socket) is deepened by the labrum, which is a rubbery, fibrocartilaginous material attached around the lip of the glenoid. This structure can tear during athletics, especially during throwing sports, or as a result of blunt trauma when falling and landing on an outstretched upper extremity.
Symptoms and Signs
A glenoid labral tear results in deep shoulder pain during motion, especially when pitching a baseball. This discomfort may be accompanied by a painful clicking or clunking sensation and a feeling of catching in the shoulder.
Diagnosis
A thorough shoulder and neck physical examination should be done initially, but referral to a specialist is frequently needed because more sophisticated diagnostic tests (eg, contrast-enhanced MRI) are often the only way to definitively identify the pathology.
Treatment
Physical therapy is the initial treatment. If symptoms do not subside with physical therapy, and the diagnosis has been confirmed by MRI, surgical debridement or repair is the treatment of choice. Surgery is usually done arthroscopically.
Last full review/revision April 2009 by Brian D. Johnston; Paul L. Liebert, MD
Content last modified April 2009
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