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SLAP Lesion

Labral injury is damage to cartilage tissue deep in the shoulder joint and can be hard to identify. It is only in recent years that confirmed diagnosis of Labral injury have risen sharply. Largely due to easier access to MRI imaging technology and raised awareness of the condition. Previously pain due to Labral injury was often attributed to damage of the surrounding ligaments or tendons.


What is Labral injury?


The shoulder is a ball and socket joint where the head of the humerus, your arm, fits into the shallow cup of the Scapula and Clavicle that make up your shoulder. To deepen this socket and increase its stability, there is a band of cartilaginous tissue called the Labrum that wraps around the head of the humerus. The Labrum is held in place with ligament tissue and the rotator cuff muscles that wrap around the socket. As in other joints like the hip, the Labrum also helps reduce friction in the joint.





On going shoulder pain can occur due to a slap lesion within the shoulder capsule.Above: On going shoulder pain can occur due to a slap lesion within the shoulder capsule.



It is possible to injure the Labrum through sudden trauma, such as a car accident, but most cases are a result of repetitive strain from overuse during sports. In particular it is the repeated action of arm flexion and extension that puts you at most risk, affecting participation in sports and manual workers.


There is an acronym used for one of the most common forms of Labral tear, involving damage to the upper section of cartilage. A superior Labral tear from anterior to posterior is referred to in abbreviated form as a SLAP lesion.


What causes Labral injury?


Damage to the Labrum cartilage can occur from sudden trauma injuries, where the shoulder is subjected to high impact or overstretched into extreme positions. It can also occur as a result of overuse injury during activities that require prolonged periods of repeated flexion, especially whilst exerting force through the shoulder joint. This type of action most often applies to athletes involved in throwing or catching.


Other contributing factors that may increase the risk of Labral injury include shoulder muscle tightness or weakness, abnormal bone growths in the joint and poor technique during activity. In most cases the Labral injury results from overuse, the symptoms come on gradually and they often not connected with a specific injury event. 


What are the symptoms of Labral injury?





Slap lesion injuries require strengthening to maining stability within the joint.Above: Slap lesion injuries require strengthening to maining stability within the joint.



It can be difficult to diagnose a Labral injury as there are many layers of muscle and bone resting over the site. It is characterised as a deep shoulder pain, usually felt on one side. If you have a Labral injury you may experience.

  • Stiffness in the affected shoulder joint.
  • Sensation of clicking, catching or locking in the affected joint.
  • Limited range of movement in the joint, either from pain or blocking.
  • Instability in the joint compared to the other shoulder.
  • Weakness in the affected shoulders connecting muscles.
  • Pain or aching deep in the affected joint, as mentioned above.
  • Pain is brought on by prolonged shoulder activity, particularly if arms above head.

How is a Labral Injury Diagnosed?


A doctor or one of our specialist physiotherapists at Liverpool Physio can carry out a comprehensive assessment to diagnose a Labral Injury in the shoulder. If you have a significant tear to the Labral cartilage, an MRI scan may be required to highlight the severity of your injury.


For more information on how Physiotherapy can help treat shoulder Labral injury, or to book yourself an appointment, please email us at office@liverpoolphysio.co.uk or call 0151 558 0077 .


What would a physiotherapy assessment for Labral Injury involve?


At Liverpool Physio, we want to gain as much information as possible about your injury to ensure we give you the best treatment. In your first appointment with us, our physiotherapists will carry out an assessment which has two parts:

Subjective

A discussion between you and our physiotherapist to find out the cause of your injury and what symptoms you are experiencing, and how your injury is affecting you and your lifestyle.

Objective

An assessment of your range of pain, range of movement, and a series of special tests to identify the presence of the Labral injury.

If you have a complete tear of the Labrum you may require surgery to repair the cartilage. In this case, our physiotherapists would be happy to see you for assessment and treatment after your surgery to help you recover.


What would physiotherapy treatment for Labral injury involve?


At Liverpool Physio, Our physiotherapists will ensure you specialised treatment for your Labral injury. Depending on the extent and time elapsed since your symptoms began, your treatment may involve:

  • Advice on posture and sleeping position to avoid putting stress on the shoulder joint.
  • Joint mobility stretches for any loss of movement range.
  • Strengthening exercises of major shoulder muscles to improve joint stability.
  • Proprioception exercises to improve awareness and stability.
  • Advice on activity modification to reduce pain.
  • Biomechanical analysis for movement re-education, correcting posture and technique. Especially important for sports.

At Liverpool Physio you will experience a personalised treatment session. Each appointment will be aimed at returning to your everyday activities and what you enjoy.


How can I arrange a physiotherapy assessment for Labral injury?


If you are experiencing pain or aching deep in your shoulder joint, and feel unable to move your arm normally, one of our experienced physiotherapists will be happy to see you for an assessment.

You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 0077 .


Summary


Labral injury can affect people from all backgrounds and levels of activity. It may present as a minor discomfort or cause inhibiting pain that disrupts normal functionality of the shoulder. If you experience any of the above listed symptoms including pain, clicking or locking of the shoulder and reduced stability or mobility, you would benefit from an assessment with one of our experienced physiotherapists.

At Liverpool Physio we want to ensure you get the best treatment for your injury and we will use biomechanical analysis, strengthening exercises and activity specific treatments to help you recover.

For more information on how Physiotherapy can help treat shoulder Labral injury, or to book yourself an appointment, please email us at office@liverpoolphysio.co.uk or call 0151 558 0077 .



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