Q: I recently fell and wrenched my shoulder. The shoulder is now quite painful. Should I rest it and take pain medication or do stretches?
A: An unstable shoulder joint could be the cause or the result of a labral tear. "Labral" refers to the glenoid labrum-a ring of cartilage that surrounds the base of the shoulder joint. Injuries to the labrum are common, can cause a great deal of pain and may make it hard to move your arm. A labral tear can occur from a fall or from repetitive activities or sports that require you to use your arms raised above your head. Some labral tears can be managed with physical therapy; in severe cases, surgery may be required to repair the torn labrum.
Q: Who should I see to determine what could be causing this pain in my shoulder?
A: An examination by an orthopedic surgeon, physical or occupational therapist will reveal if it is a labral tear. With a labral tear, you might have:
"Popping," "clunking" or "catching" with shoulder movement, because the torn labrum has "loose ends" that are flipped or rolled within the shoulder joint during arm movement and that may even become trapped between the upper arm and shoulder blade
Shoulder weakness, often on one side
A feeling that your shoulder joint will pop out
Pain over the top of your shoulder
Q: If I do have a labral tear, how can a therapist help?
A: When labral tears cause minor symptoms but don't cause shoulder instability, they usually are treated with therapy. Your therapist will:
Educate you about positions or activities to avoid
Tailor a treatment plan for you recovery
Design specific shoulder strengthening exercises, such as external rotation and internal rotation exercises, to help support the joint and decrease strain on the glenoid labrum
Design stretching exercises, such as the cross-body stretch or the doorway stretch, to help improve the function of the muscles surrounding the shoulder
Perform a special technique called "manual therapy" to decrease pain and improve movement
In more severe cases, when conservative treatments are unable to completely relieve the symptoms of a labral tear, surgery may be required to re-attach the torn labrum. Following surgery, your physical therapist will show you how to slowly and safely return to your daily activities.
A surgically repaired labrum takes nine to 12 months to completely heal. Immediately following the repair, you should avoid putting excessive stress or strain on the repaired labrum and should increase stress to your shoulder slowly over time. Your physical therapist is trained to gradually introduce activity in a safe manner to allow you to return to your usual activities without re-injuring the repaired tissues.
If you have shoulder pain, call Chautauqua Physical & Occupational Therapy at 488-2322 to schedule a free consultation. We are located in the Riverwalk Center in Brooklyn Square and are therapist owned for 17 years. Visit www.chautauquapt.com for more information.