In the above picture, it is the thin blue ring around the glenoid. The labrum is a cartilage ring that surrounds the shoulder socket (called the glenoid) and makes it deeper.
Since the socket is deepened by the labrum, the ball of the arm bone (called the head of the humerus) has a better fit into it.
Labrum or labral tears are usually associated with trauma (caused by a direct injury to the shoulder, such as falling on an outstretched hand), or instability of the shoulder.
The biceps tendon attaches to the front part of the labrum. The biceps is the large muscle on the front of your upper arm.
Sports can cause injuries to the labrum when the biceps tendon pulls sharply against the front of the labrum.
Baseball pitchers are prone to labral tears because the action of throwing causes the biceps tendon to pull strongly against the top part of the labrum.
Weightlifters can have similar problems when pressing weights overhead.
Golfers may tear their labrum if their club strikes the ground during the golf swing.
The soft labral tissue can be caught between the glenoid and the humerus. When this happens, the labrum may start to tear.
If the tear gets worse, it may become a flap of tissue that can move in and out of the joint, getting caught between the head of the humerus and the glenoid. The flap can cause pain and catching when you move your shoulder.
Several tendons and ligaments attach to the labrum that help maintain the stability of the shoulder. So when the labrum tears, the shoulder often becomes much less stable.
Signs and Symptoms of a labral tear are painful clicking, locking, or popping during certain shoulder movements.
This may be followed by a vague aching for several hours.
At other times, the tear may not cause any pain.
Shoulder instability from a damaged labrum may cause the shoulder to feel loose, as though it slips with certain movements.
Instability may be present because the labrum is not doing its job of holding the ball in the socket.
Medical intervention for a labral tear typically involves an MRI for diagnosis and arthroscopic repair but labral tears are often hard to diagnose.
A special kind of labral tear, a superior labral anterior to posterior (SLAP) tear, often involves the biceps tendon as well.
What treatment options are available?
Your doctor's first goal will be to control your pain and inflammation.
Initial treatment for pain control is usually rest and anti-inflammatory medication, such as aspirin or ibuprofen.
Your doctor may suggest a cortisone injection if you have trouble getting your pain under control. Cortisone is a strong anti-inflammatory medication. It can provide good relief, although its effects are temporary.
Your doctor will probably have a physical or occupational therapist direct your rehabilitation program.
Your first therapy treatments will try to ease pain and inflammation by using such treatments as heat or ice.
Hands-on treatment and various types of exercises are used to improve the range of motion in your shoulder and the nearby joints and muscles.
Later, you will do strengthening exercises to improve the strength and control of the rotator cuff and shoulder blade muscles.
Your therapist will help you retrain these muscles to keep the ball of the humerus in the glenoid. This will improve the stability of your shoulder and help it move smoothly during all your activities.
You may need therapy treatments for four to six weeks. Most patients are able to get back to their activities with full use of their arm within this amount of time.
What should I expect after treatment?
Even nonsurgical treatment requires a rehabilitation program.
Some evidence suggests that shoulder instability may eventually make labral tears worse.
The goal of therapy will be to strengthen the rotator cuff muscles to make the shoulder more stable.
At first you will do exercises with the therapist.
Eventually you will be put on a home program of exercise to keep the muscles strong and flexible.
This should help you avoid future problems.