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February 29, 2012

Shoulder labrum tears, what is the deal with these?

The shoulder is an amazing joint with an remarkable range of motion.  

We pay a price for that range of motion.  The shoulder is inherently unstable.  The ball and socket joint is comprised of a large ball resting on a flat and shallow joint or a dish.  The dish itself has a rim around it called a labrum. The labrum itself acts to deepen the socket and make it inherently more stable. 

Tears can occur in the labrum can cause a variety of symptoms.  The shoulder can have painful clicks and feel unstable.  The shoulder can have quite a bit of pain when reaching overhead. 

Labral tears are tough to diagnose.  We do get some clues from the physical exam. Many MRIs do not show the labral tears.  Many times special dye needs to be injected into the joint to help define the tear.  Many times it is not truly diagnosed until surgery.

The crazy thing is that WE DO NOT KNOW THE NATURAL HISTORY OF LABRAL TEARS.  Yes we have no idea which ones will get better and which will not.  SO THE UNDERLYING MESSAGE IS LABRAL TEARS DO NOT EQUAL SURGERY.  What you need is a good therapy regimen.  

Good luck.  These are a bit of a bugger and take some time to get better.

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