Torn labrum? Should you have surgery and what caused it?


To wrap up our week on shoulders I wanted to finish off with talking specifically about the labrum of the shoulder. The labrum is a cushion of cartilage in the shoulder and its main job is to cushion and support the shoulder.


It usually does a pretty good job at that and as long as your don’t abuse your shoulder too much the labrum stays relatively healthy.


Not abusing your shoulder is usually something most athletes can’t avoid and often they are the biggest victims of labrum injuries out there.


So why does a labrum get injured?


A lot of factors.


Trauma, too much load, poor mechanics, bad genetics and rotator cuff dysfunction.


Lets break each of them down:


Trauma: Usually from a separation, dislocation or high impact type of injury. These are where a lot of force is introduced into the shoulder in quick instance and it can rip or tear the shoulder. These usually require surgery right away to help at least stabilize the shoulder and make for a better future as far as function wise.


Poor mechanics: This is the most common cause. We spend too much time sitting, with our shoulders rolled forward and in a bad position. This puts added wear and tear on the cartilage and can lead a poor distribution of force. They tell you to always sit in good posture and roll your shoulders back, but by the end of the day you are exhausted!


Bad genetics: Blame your grandparents, blame your parents for a lousy genetic makeup that gave you cartilage that can't handle as much force. They are showing more and more with genetic testing that what you inherit from your parents can make your more susceptible to injuries in the cartilage, so you might want to think twice before engaging in high shoulder impact injuries if grandpa had a bum shoulder and so does mom.


Bad rotator cuff: This is also very common. Over time our muscles get overused from bad postures and too much sitting, this creates adhesion. Adhesion is like glue that gets inside the muscles and keeps things from being able to stretch and move like they should. This also leads to weakness and the need for more force in the shoulder. The force must go somewhere and it usually goes to the joint and cartilage, which is why you may of torn your labrum without and direct trauma.


Take home: The take home here is straightforward. Just because you may have a labrum tear on MRI doesn't mean that you should jump right into surgery. Usually these do so poorly because the labrum tear is a result of a lot of other things not moving correctly and if you don’t fix them before the surgery it will never be the same. Don't jump right into surgery, always go conservative first, but make sure that conservative is actually going to improve your function.