Shoulder Joint labrum tear physiotherapy in Delhi.
The shoulder or glenoid is a rim of thick cartilage tissue around the edge of the shoulder socket (the shoulder is a ball and socket joint). The labrum helps to make the shoulder socket deeper and in this way helps to make the shoulder more stable. The labrum is the site of attachment to one of the tendons of the bicep muscle (it attaches to the top part of the labrum) as well as the shoulder joint ligaments and the shoulder joint capsule.
The glenoid labrum usually tears as a result of a specific trauma, such as a fall onto an outstretched arm. Tears can also result from chronic overhead movement, as occurs in pitching. A glenoid labral tear causes pain during motion. Treatment is with physical therapy and sometimes surgery.
The shoulder (unlike the hip or elbow) is an inherently unstable joint; it has been likened to a golf ball sitting on a tee. To enhance structural stability, the glenoid (anatomically, a very shallow socket) is deepened by the labrum, which is a rubbery, fibrocartilaginous material attached around the lip of the glenoid. This structure can tear during athletics, especially during throwing sports, or as a result of blunt trauma when falling and landing on an outstretched upper extremity.
Symptoms and Signs
A glenoid labral tear results in deep shoulder pain during motion, especially when pitching a baseball. This discomfort may be accompanied by a painful clicking or clunking sensation and a feeling of catching in the shoulder.
Symptoms of a labral tear depend on where the tear is located, but may include:
An aching vague pain in the front or top of the shoulder.
Clicking or catching sensation in the shoulder during certain movements.
Ex: catching/clicking during the “cocked” position of throwing.
Pain with specific overhead activities.
Diagnosis
Usually contrast-enhanced MRI
A thorough shoulder and neck physical examination should be done initially, but referral to a specialist is frequently needed because more sophisticated diagnostic tests (eg, contrast-enhanced MRI) are often the only way to definitively identify the pathology.
Treatment
Physiotherapy
Physical therapy is the initial treatment. If symptoms do not subside with physical therapy, and the diagnosis has been confirmed by MRI, surgical debridement or repair is the treatment of choice. Surgery is usually done arthroscopically.
Those patients with a minor labral tear of the shoulder that responds well to conservative management can usually return to sport or activity in approximately 2 - 8 weeks.
For minor tears that are managed surgically, patients can sometimes return to sport or activity within 4 – 12 weeks, although most patients (especially when the tear is moderate to severe) will require a significantly longer rehabilitation period (usually between 3-12 months).
It is important that patients with a labral tear of the shoulder are managed appropriately, as inappropriate treatment may lead to the development of early shoulder osteoarthritis.
