Labral Tear (Shoulder)
Deep shoulder pain, clicking, and lost throwing power — the labrum is often the answer.
Overview
Understanding labral tear (shoulder)
The labrum is the fibrocartilage rim that deepens your shoulder socket and anchors the biceps tendon. Tears come in families: SLAP tears at the top where the biceps attaches (classic in throwers), and instability-related tears at the front or back.
Labral treatment is one of the most individualized areas in shoulder care — the same MRI finding can mean different things in a 19-year-old pitcher and a 48-year-old lifter, and the right procedure differs accordingly.
Symptoms
What it feels like
- Deep, hard-to-localize shoulder ache
- Clicking, popping, or catching with rotation
- Loss of throwing velocity or a "dead arm"
- Pain with overhead and cross-body positions
Common causes
Why it happens
- Repetitive overhead throwing or swimming
- Traction injuries — a sudden pull on the arm
- Dislocation and instability events
- Falls onto an outstretched arm
Diagnosis
How it's diagnosed
MRI arthrogram is the imaging of choice, but context rules: labral signal changes are common in pain-free overhead athletes, so the diagnosis is made by matching imaging to a careful exam and your symptom pattern — not by treating the picture.
Treatment
The full range of options
Non-surgical
Thrower's rehabilitation
Restoring rotation balance, scapular mechanics, and kinetic-chain strength resolves many labral symptoms without surgery — first-line for most SLAP-type tears.
Injection therapy
Targeted injections can both treat and help confirm the pain source.
Surgical
Arthroscopic labral repair
Anchoring torn labrum back to the socket rim — favored for instability-pattern tears and younger patients.
Biceps tenodesis
For many SLAP tears — especially beyond the early 30s — relocating the biceps attachment outperforms repairing worn labral tissue, with more predictable pain relief.
Recovery
The road back
Repair and tenodesis both involve staged rehabilitation over three to six months, with throwers following an interval throwing program before full competition. The specific timeline follows the procedure and your sport's demands.
Dr. Johnson's approach
Dr. Johnson's labral care starts with a question most patients haven't been asked: what does your shoulder need to do? The pitcher, the tradesperson, and the weekend swimmer with the same MRI get different plans — and the operation, when needed, is chosen for your tissue and your demands.
Straight answers
Frequently Asked Questions
The information on this site is for education only and is not a medical diagnosis or a substitute for professional medical advice. Every patient is different — please consult Dr. Johnson or a qualified provider about your specific condition.
Ready when you are
Take the first step past labral tear (shoulder)
A focused evaluation, an honest conversation, and a plan built for your goals.