By encircling the shoulder socket, your shoulder’s labrum cartilage makes movement in general, and across a wider range, possible. When you incur labral damage due to intense and recurring motion (commonly found in occupational or athletic activities) or from significant, sudden injuries (such as a blow to your shoulder or falling on your arm when it is outstretched), surgical labral surgery may be needed in order to restore the shoulder strength, agility and stability and repair other affected areas, including the biceps tendon. Your type of labral surgical repair will depend on whether you have experienced a tear above or below the area of your shoulder socket (known as a superior labrum, anterior to posterior ((SLAP)) lesion and a Bankart lesion or shoulder joint tear, respectively). Surgery will generally not be pursued until nonsurgical treatment options, including physical therapy and anti-inflammatory medications, have been utilized to reduce pain, swelling and other symptoms.
During SLAP tear repair surgery, the damaged area is evaluated via a fiber optic camera that is inserted into the incision area. This arthroscopic surgery reduces intrusion into the joint’s physical structure and allows restoration of torn tissue and smoothing over of the damaged portion of the labrum. This process will vary based upon your type of injury, age, and activity level, and can include extracting the damaged portion of the labrum, cutting the attached part of the biceps tendon, or stitching the torn sections together. Using the arthroscopic method also has the advantage of allowing for smaller incisions due to the size of the camera and equipment.
Did You Know? Due to shoulder labrum degeneration with the passage of time, many tears occur after the age of 40. Labrum tears are also common in athletes, including baseball pitchers, who repeatedly engage in overhead throwing or similar activities.
Surgery to repair a shoulder joint tear also involves using arthroscopic tools to examine the damaged area and your surgeon will conduct the procedure in accordance with the extent of the damage. Tears that are located only on the labrum can be repaired by extracting the torn area, while injuries that also include the biceps tendon require reaffixing the tendon through wires, sutures or other prosthetics. Ligament reattachment and adjustment of surrounding tissues is necessary in the case of tears near the midsection of the shoulder socket.
While regaining complete shoulder motion will be a multi-month process (generally three to four months after surgery and potentially including a year to resolve minor remaining post-surgical effects), the arthroscopic nature of the surgery limits hospital time and eases the recovery timeline for the majority of patients. You will initially be fitted with a sling to prevent arm movement for up to one month after surgery and during the initial stages of post-surgical pain and inflammation. Patients can begin mild exercises to test their level of mobility and movement within about a month after surgery, with additional time required for athletes to begin resuming activities. This process involves balancing the need to move the shoulder and avoid stiffness with the goal of protecting the repaired shoulder moving forward.
Recovery from shoulder labral surgery can be a time-consuming process and requires patience and commitment to a regular physical therapy program. During rehabilitation, you may feel uncertain about your mobility limitations and experience occasional shoulder discomfort and pressure, and even after your shoulder is fully healed, you may continue to experience lingering pain. Once recovered, you can resume overhead and other motions without limitation, however you will also need to undertake exercises moving forward to avoid having shoulder issues in the future.