Everything You Need to Know [Diagnosis and Treatment] - The El Paso Physical Therapy Handbook (2023)

Having a torn labrum in your shoulder can be very scary as you will hear many people say they need surgery because of it. But it is possible to heal naturally without surgery as long as you understand how a torn shoulder labrum works and what to do about it.

In this video, I'll explain everything you need to know about a torn shoulder labrum, including the diagnosis, treatment, and cause of a torn shoulder labrum. First let me explain what a shoulder lip is.

So you can understand that there is a ball joint in the shoulder. And the lace is on the shoulder blade. It is a small cup compared to the hip joint down, the cup is much larger and covers the ball much better.

But it is quite small on the shoulder. Yeah, it's more like thinking about the tee, and the golf ball, the way the golf ball sits on the tee, is much smaller than the hip. So what the labrum does is it goes around the edge of the socket to make it deeper so you have better contact with the ball.

Now there's a tear in the labrum which just means the edge of the edge of the cartilage, that's what labor means in Latin, because it means labrum, it means that the edge of the cartilage has sort of separated, there are different types of tears. I won't go into that in this video. But if it comes out, it means that the plug is now not normal.

So the ball will move normally in the bearing, it has bad mechanics or abnormal mechanics, it will receive abnormal forces on the joint, it can shift, it can move in a way it shouldn't. And this is what causes the excruciating pain that people feel. I will tell you more about the symptoms that appear.

Now, to diagnose a torn labrum in your shoulder, you're probably going to end up going to the doctor and he's probably going to order an MRI, the MRI is going to look at the soft tissue. In other words, everything but the bone and you can see the bone there. But you can also see cartilage and tendons.

They will also tell you if you have a torn rotator cuff because that can happen. Sometimes in the case of a torn lip they may also order an x-ray to get a good look at the bony edge of the socket because sometimes when the lip is torn it can pull out a piece of bone. And they have to take that into account.

And if they're having trouble seeing the tear properly on a regular MRI, they might order an MRI where they inject you with dye, they inject something into your shoulder that they can see better on the MRI so they can better detect the tear, they'll take the findings from your images, x-rays, magnetic resonance and relate them to the symptoms you report.

And the usual symptoms that accompany a shoulder labral tear will be cracking and may or may not be painful, but there is an increased feeling of cracking or shifting in the joint.

In more extreme cases it can get stuck which means the shoulder joint gets stuck as if it is moving to do something and then looks like it is stuck, usually people end up lifting their arm like that and have to move it. released and then starts moving normally again. And that's usually painful. When this happens as the day progresses.

And someone with a labrum tear in the shoulder gets more and more painful and can become very painful when you're lying in bed. This is why many people with shoulder labral tears have trouble sleeping at night because of shoulder pain.

And it doesn't always matter if they lie on the side that hurts, even if they lie on the other side they can be painful because the cartilage tissue inside the labrum and other parts of the body inside the shoulder can be irritated. And that night can seem more intense. Now I will tell you what causes a tear in the oral cavity.

Of course, there are accidents that happen that can immediately cause a cracked labrum, such as a car accident, motorcycle accident, bicycle accident, or even a nasty fall where you land on your hand, elbow, or directly under your shoulder, which can jar your shoulder and tear it. labrum.

But more often we see a labral tear labeled as non-traumatic, meaning it wasn't an accident, it just started hurting over time while doing normal everyday things. And then at night it started to be really painful, all those symptoms that I was just talking about when you have a non-traumatic labrum tear in your shoulder.

This is usually due to a muscle imbalance that develops within the shoulder, placing excessive stress on the labrum. In a moment I will talk more about the upcoming muscle imbalance. If you have this muscle imbalance, before the cleft palate, you may have experienced shoulder pain that occurs when performing exercises that involve the shoulders. Or if you do some heavy work around the house like gardening.

You may have shoulder pain or discomfort that doesn't last long, but lasts long enough to be noticed. And this could go on for months or even years without interruption. But now it has developed to where it is more consistent and hurts at night and is more painful than ever.

This type of bit presentation is consistent with a non-traumatic shoulder error. Now I'm going to tell you about the common treatments that are done for labral tears in the shoulder, you go to the doctor, they will first tell you to rest, not to do anything strenuous, they may even tell you to put ice or heat, and they will tell you may recommend over-the-counter pain relievers.

If that doesn't work, they'll recommend strong medications to relieve your shoulder pain. They may even recommend injections like cortisone shots to help ease your shoulder pain a little more. Now all those treatments are for short term pain relief, even the injection is short term because it doesn't really address the root of the problem. It's a simple pain reliever, but it's injected directly into the joint.

So it will last a little longer. Sometimes surgery may be recommended, and surgery is very good for shoulder repairs these days. Now there's rehabilitation that happens after that, which means you have to do physiotherapy and slowly, it's a recovery and healing process of fixing the birth.

But in some cases, they might even tell you to go to physical therapy before surgery to see if you can get better. Now, be careful when going to physical therapy for a labrum tear that hasn't been operated on, because most physical therapists are trained to rehabilitate people after they've had surgery and repair a shoulder labrum tear without surgery.

That is, you will not operate, you will try to fix it without going to a surgeon. If you are getting help from a physical therapist, he may not be an expert in preoperative care. So be sure to do your research to find the right person to help you.

One thing that's particularly stressful for the labrum is stretching the shoulder, like when you push your arm all the way through, or some people like to climb a wall and twist like that. There are other exercises that are not well understood by general physical therapists that love and are great for treating people after surgery.

And so, doing the same exercises that you would do if you had surgery can actually be harmful to you if you're trying to avoid labral repair surgery. Now let's talk about the root cause of a non-traumatic oral cavity injury, the muscle imbalance that is present in people who have these injuries is what causes the ball to roll forward in the socket.

So on someone's shoulder it may look like your shoulders are more rounded towards the front, you can check this yourself, look sideways in the mirror or ask someone to take a picture of you like that, don't turn your head and throw away the reading But it's usually pretty obvious that your shoulders are a little rounded forward.

And one telltale sign that I like to see is that you can see it a mile away, once you notice it, it's if you look at people's hands from behind. If they are walking upside down, their arms should be at their sides. Then the palms should be facing the body.

But if your palms are facing backwards, when your arms are hanging down, that means your whole arm and shoulder are facing this way, and that's causing your arms to go backwards. So if you're walking with your hands and your palms are swaying behind you, that's a sign that everything down there and your shoulder may be internally rotated, or inward, which means the ball is going forward. bed and this will stress the labrum.

If you've been like this for years, there's a good chance you have a root muscle imbalance that needs to be addressed. Even if you have labor repair surgery, it won't correct the muscle imbalances that must be addressed separately so you don't end up injuring the labrum, which often requires strengthening of certain rotator cuff muscles, such as the subscapularis.

In addition to the contraction of the muscles in the neck, those who raise the shoulders also need to do this in the process to get the right mechanics in the ball joint so that the ball moves properly in the socket and does not overwhelm the labrum, allowing it to heal and behave naturally.

If you would like more information on labral tears, please see the link in the description below for a playlist of all of our labral tear videos. impingement syndrome.

If you found this video helpful, please give it a thumbs up and don't forget to subscribe and turn on the notification bell so you don't miss any of our upcoming videos. Thank you very much for watching and until the next video. Good bye

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