May 19, 2010
Turf toe? What in the world is turf toe? University of Wisconsin graduate assistant athletic trainer Ryan Dean answers questions many fans have about common sports injuries in a new series on UWBadgers.com, The Sports Medicine Corner. In part two of the series, Dean examines the shoulder labrum.
MADISON, Wis. -- In the world of sports medicine there are dozens of confusing terms and injuries that, to the average fan, can make little to no sense. One injury that falls into this confusing category is known as a torn labrum.
What and where is a labrum? What does it do? Today we take a closer look and shed some light on another confusing sports injury.
What is it? A torn shoulder labrum is a simplified term usually used for a number of injuries involving the shoulder joint. Other (more technical) terms associated with this injury include: SLAP lesion, Bankart lesion, and Hill-Sachs lesion.
Where is it? The human body actually has two pairs of labrums. One pair sits in the hip joint while the other sits in the shoulder joint. While both labrums can be injured, today we will talk about the shoulder joint. The glenoid (shoulder) labrum rests on the side of the shoulder blade in between the blade and the arm.
Why is it important? The labrum is an important structure for shoulder movement. The labrum is actually a cartilage structure. The human body contains several of these cartilage structures including the meniscus in the knee joint. The importance of these structures lies in their ability to act as a shock absorber for the joint as well as to add joint depth to increase stability. Similar to a gel shoe insert, these structures absorb shock. Without a labrum, an action as simple as throwing a ball could be very painful.
Who's at risk? Just like any injury, everyone is susceptible to suffer a torn labrum. However, individuals involved with overhead arm sports such as volleyball, swimming and baseball are at a higher risk to suffer from this injury. This is attributed to their repeated overhead arm movements as well as the likelihood to have an outstretched arm hit in an awkward way. Also, athletes in high contact sports are at a higher risk because of the chance to have the arm and shoulder hit or twisted during collisions.
How is it injured? There are a few ways that the labrum can be injured. In one way, chronic arm motions can slowly lead to a tear occurring due to overuse. These injuries take a while to develop and initially will present minor pain. Another way to injure the labrum is by causing a collision or twisting motion to the arm. When this occurs, the head of the humerus (top of the arm) is driven into the labrum and the twisting motion grabs and tears the labrum. In these injuries, the athlete may feel a popping or tearing sensation accompanied with pain. It is also possible for a labrum to be injured in the event of a shoulder dislocation.
Then what? An MRI is the best imaging method to diagnose a torn labrum. Sometimes a dye is injected into the joint to better identify a tear. Once identified, a torn labrum can be treated in one of two ways. For minor tears, the patient may forgo surgery and participate in physical therapy to strengthen the shoulder. In the case of a more significant tear, surgery is typically encouraged. During this procedure, the labrum is anchored onto the shoulder blade using anywhere from two to six strong stitches.
How long? After surgery to repair a torn labrum, a rehabilitation program can take several months to return the athlete to 100 percent. Depending on the sport and the severity of the injury, it may take anywhere from three to six months to bring the athlete back to full participation.
Rehab? Recovery from this surgery requires a lot of patience. The athlete will take as much as eight weeks to regain their full range of motion. Return of full strength may take another four to eight weeks after that. During the rehab, it is important to limit several motions of the arm in order to prevent the labrum from being re-torn. During the early stages of rehab, it is important to keep the muscles of the shoulder in shape without actually moving the arm.
Who Had It? Professional baseball players Robb Nen and Troy Glaus are among the many baseball players to have suffered from a torn labrum. Likewise, numerous professional football players have suffered the injury, including NFL quarterbacks Rich Gannon and Matt Hasselbeck.
UW Sports Medicine