Labral tears of the Shoulder

Labral tears of the Shoulder Blog  Treatment Methods Shoulder

The shoulder, consists of thick cartilage that surrounds the rim of the shoulder socket. The shoulder is similar to a ball inserted into a socket joint. Stability is improved by the use of the labrum by increasing depth of the shoulder socket. There is an area where the tendons located on the bicep and are attached to the top, this is called the labrum. At this site, also located in this spot are secure attachments of the shoulder joint capsule and ligaments.

Labral tears of the Shoulder Blog  Treatment Methods Shoulder

The Injuries Of The Labrum

The Superior Labrum Anterior to Posterior, or SLAP, lesion injury is the most common one affecting the labrum. These injuries involve the movements of the biceps tendon attached to the labrum, as well.
SLAP lesions are caused by various activities, such as stretching the arm out too far, carrying a heavy load on the shoulders or falling on top of an arm. These actions may cause a severe tear forms in the labrum and biceps tendon area.

Non-SLAP lesions form when the shoulder gets fully or partially dislocated. People may feel grinding whenever they move their arms or hear clicks and pops. It takes an MRI scan and a series of clinical tests to make a diagnosis.

Treatments for Labral Injuries

A common treatment for this injury is arthroscopic surgery, which involves removing the tear and damaged tissue. After surgery, patients are expected to follow a regimen that allows them to regain their joint strength and balance. The average exercise routine consists of simple to elaborate exercises. Over time, they take on tasks that are more challenging in the gym room and regular life.

Getting Back to Sports

After a while, injured people decide if they can return to playing sports. This decision is determined by the number of weeks or months that it takes for the shoulder to heal.

There are certain signs when it is safe to go back to doing sports:

  • Full mobility in the shoulder without pain
  • Full strength in the shoulder

In their exercises, patients should gradually increase the loads placed on their shoulders. That way, they can handle the pressures that come with playing intensive sports again.

Physiotherapy Treatment

After surgery, patients are expected to undergo physiotherapy consisting of different exercises and massages that soothe and strengthen the shoulder. The point is to expand control of the muscles around the shoulder blade and rotator cuff. Also, they improve the strength and balance of the humerus found within the glenoid. Overall, they improve the entire use of the shoulder as they take on everyday activities.

Everyone has a different way of regaining strength, balance and mobility after a serious injury. Fortunately, there are surgeons, physical therapists and nutritionists with the right plans to get people back on their feet. After days of vital research and weeks of careful therapy, it is possible to regain strength in an injured shoulder and return to important physical activities.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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