Shoulder Labrum Injury
1. Introduction
The shoulder is a ball and socket joint. It is made up of the humeral head (ball) and the glenoid fossa (socket). Unlike the hip which has a ball and a deep socket that wraps tightly around it, the shoulder has a shallow socket which allows more movement. The labrum is made up of fibro cartilage, this lines the rim of the glenoid fossa which makes the socket deeper and has a ‘suction effect’ on the humeral head (1).
The labrum is a site where stabilising structures are attached. These structural components make the shoulder more stable whilst still allowing a large degree of movement. Injuries to different parts of the labrum are referred to as specific types of tears. It can be useful to look at the labrum as a ‘clock’ when identifying what type of tear has taken place.
A SLAP (superior labrum anterior posterior) tear occurs at the top of the shoulder (between 11 and 1 o’clock). These injuries commonly occur following an initial forceful movement of the labrum that’s attached to the biceps tendon, causing it to be torn away from the bone (glenoid). This may be associated with a dislocation of the joint but commonly occurs in sportsmen and women with a pull on the arm, with weightlifting, throwing, or tackling (2).
A tear occurring at the front (anterior) and bottom (inferior) between 3 and 6 o’clock is referred to as a Bankart tear. These are common in younger people who dislocate their shoulder. This type of torn labrum occurs in the lower portion of the glenoid socket. A person who has sustained a Bankart tear may feel as though their shoulder could fall out of place if they move their arm in a certain way (1).
A Reverse Bankart tear occurs at the back (posterior) of the shoulder and is between 6 and 11 o’clock. These are commonly seen because of trauma leading to dislocation. It’s possible for a tear to be a combination of all of these, and this is referred to as a 270-degree tear (5).
Also, degenerative shoulder labrum tears can occur due to age related changes within the joint and other structures in the shoulder complex (5).
Frequently Asked Questions
The Labrum is a piece of fibrocartilage (rubbery tissue), attached to the rim of the shoulder socket that helps keep the ball of the joint in place. When this cartilage is torn, it is called a labral tear. Tears may result from injury, or sometimes as part of the aging process.Â
- The true incidence for shoulder labrum injury is unknown.
- They make up 5-10% of shoulder instability injuries, which means the incidence in the general population is rare.
- Labral tears are reportedly found in between 6% and 26% in people undergoing keyhole surgery (1). However, this does not mean they are always the source of pain.
- No
- Most people with a shoulder labral tear will not require surgery (6) and will recover well.
- Due to the long recovery after surgery, non-operative treatment is usually preferred.
- In appropriate cases if surgery is required, the outcome is good and will result in less pain with more strength (2).
- If you are experiencing constant numbness, altered sensation or a loss of power in the hand or arm – seek medical advice quickly, as this could mean there is nerve involvement.
- The most common cause of this injury is overuse through repetitive motion of the shoulder or direct trauma.
- Sports that involve repetitive ‘quick snapping’ movements of the arm above the head such as baseball (4), tennis or cricket.
- Types of trauma that can lead to this injury include a fall onto and outstretched hand, direct trauma to the shoulder or a hard downward pull on the arm.
- They are less commonly seen in the elderly population (3).
- Pain when moving the shoulder
- A ‘popping’ sound or feeling when moving the shoulder.
- A grinding, catching or locking sensation.
- Decreased range of motion.
- A feeling of instability in the shoulder.
- Loss of strength and function.
- Modify and reduce shoulder movement whilst healing is taking place.
- Take a break from sports that may aggravate the injury.
- Over-the-counter pain medication and/or anti-inflammatories which may be prescribed by your GP.
- Physiotherapy to help regain strength, stability and movement of the shoulder.
Healing times can vary depending on several variables such as:
- Location of the tear
- Severity of the tear
- Age
- Other medical conditions
- Whether surgery is necessary
- Type of surgery
Overall recovery is expected with 2-6 months (5).
We recommend consulting a musculoskeletal physiotherapist to ensure exercises are best suited to your recovery. If you are carrying out an exercise regime without consulting a healthcare professional, you do so at your own risk. Book online with us today to get a programme tailored to your specific needs.
2. Signs and Symptoms
The most common symptom of shoulder labral tears is pain. Other symptoms may include:
- A ‘popping’ sound or feeling when moving the shoulder.
- A grinding sensation when moving the arm.
- A sensation that the shoulder is ‘catching’ or ‘locking’.
- Decreased range of motion.
- A feeling of instability in the shoulder.
- Loss of strength and function (2).
3. Causes
Shoulder labrum injuries commonly occur due to chronic overuse or acute injury. They often happen at the same time as other shoulder injuries. These can include torn biceps tendons, rotator cuff injuries, and dislocation.
Sports that involve repetitive ‘quick snapping’ movements of the arm over the head such as tennis or baseball (4). Trauma such as a fall onto an outstretched hand which leads to the head of the humerus to be forced upwards leading to a compressive force being placed on the labrum. Direct trauma and heavy lifting can lead to injuries. Also, damage can occur with a hard downward pull on the arm.
Degenerative labral tears are caused due to age related changes. These tears are distinctly different from the others as they don’t typically reduce function and, therefore, doesn’t usually require repair. Degenerative tears are often addressed at the time when surgery is required such as shoulder replacement. This is usually due to severe arthritis being present.
4. Risk Factors
Shoulder strength can be helpful in avoiding this type of injury. However, shoulder labrum injuries can occur at any time due to trauma. Types of activities that increase your risk include:
- Sports involving repetitive overhead arm activities such as cricket bowlers, baseball pitchers and tennis players (4).
- Manual labourers that use tools above their head.
- Contact sports such as rugby or American football.
- Extreme sports including windsurfing, surfing, snowboarding, skiing and kayaking.
- Degenerative changes in the structures of the shoulder.
5. Prevalence
The true prevalence is unknown. They are more common in the active younger population. It has been estimated that approximately 5-10% of all shoulder injuries involve the labrum. In a study examining the prevalence of labral injuries in patients undergoing arthroscopic (keyhole) surgery, it was found that 6-26% had SLAP tears (1).  Â
6. Assessment & Diagnosis
Diagnosing a labral tear is most often done by taking a thorough case history. If it is known that a heavy trauma has occurred, this makes it more likely that a labral tear is present. Also, if the patient is younger and played a competitive overhead sport, this could also be suggestive of tear. A comprehensive physical examination will help to produce an accurate diagnosis and assist in collaboratively deciding on the best treatment and management options, with your best interests at the forefront of those decisions. Having a timely diagnosis will ensure the best possible outcomes are achieved. It might be recommended that you have an MRI (magnetic resonance imaging) scan which can identify and confirm more severe labral tears.
7. Self-Management
Upon obtaining your diagnosis, a musculoskeletal physiotherapist or other appropriately qualified specialist will teach you about your injury and will discuss effective strategies to help manage your symptoms and support recovery. Your clinician may offer recommendations on anti-inflammatory medications to help relieve symptoms, consulting your GP where appropriate. In the early stages following injury, you will be advised to rest the shoulder so that healing can commence. Ice will commonly be recommended as a useful way to further reduce pain.
Your treating clinician will give you advice on how you may be able to perform certain activities in ways that avoid symptom aggravation and help you to maintain function. Regular re-assessment will help keep your treatment and management optimal and can ensure that you are making progress towards your goals. As you move forward through recovery, you will be given ongoing advice and support.
8. Rehabilitation
Exercise rehabilitation is a crucial element of your recovery. Your musculoskeletal physiotherapist will create a specialised exercise plan for you that will be adapted in line with your progress. Initial exercises will focus on restoring range of motion and maintaining strength in the surrounding soft tissues. The exercises will evolve becoming more strength focused and then eventually for a return to sporting activity where applicable.
In severe cases where there is significant loss of function and joint stability, surgical intervention may be required. Generally, non-surgical management is preferred by surgeons and the rate they are performing these is decreasing (6).
Below are three rehabilitation programmes created by our specialist musculoskeletal physiotherapists targeted at addressing shoulder labrum injuries. In some instances, a one-to-one assessment is appropriate to tailor individual targeted rehabilitation. However, these programmes provide an excellent starting point as well as clearly highlighting exercise progression.
9. Shoulder Labrum Injury
Rehabilitation Plans
Our team of expert musculoskeletal physiotherapist have created rehabilitation plans to enable people to manage their condition. If you have any questions or concerns about a condition, we recommend you book an consultation with one of our clinicians.
What Is the Pain Scale?
The pain scale or what some physios would call the Visual Analogue Scale (VAS), is a scale that is used to try and understand the level of pain that someone is in. The scale is intended as something that you would rate yourself on a scale of 0-10 with 0 = no pain, 10 = worst pain imaginable. You can learn more about what is pain and the pain scale here.
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10. Return to Sport / Normal life
When treating shoulder labral injuries through non-operative rehabilitation, most patients can resume pre-injury activity levels following participation in a well-designed physical therapy programme. Approximately, 40% of athletes with labral tears can return to sports without surgery (8).
For people undergoing shoulder surgery, athletes are often able to begin partaking in sport-specific exercises 12 weeks after the surgery, but it normally takes four to six months for the shoulder to heal fully (7).
11. Other Treatment Options
The different types of treatment for SL injuries include:Â
- Shoulder braces – can be useful in preventing re-injury of reverse Bankart tears (5).Â
- Corticosteroid injections – can provide pain relief in athletes for various pathologies affecting the shoulder and help with rehab. These are avoided if possible due to the potential side effects (9). Â
- Various surgical options – all of which should only be reserved for injuries that require invasive treatment or have not responded to appropriate conservative management. (7)Â
12. Links for Further Reading
https://www.shoulderdoc.co.uk/section/896
25 locations and counting across the UK
References
- Datta, N., Ghodadra, N. S., & Mologne, T. S. (2023). SLAP tear. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441870/
- American Academy of Orthopaedic Surgeons. (2024). SLAP tears. OrthoInfo. Retrieved June 26, 2025, from https://orthoinfo.aaos.org/en/diseases–conditions/slap-tears/
- Ireland ML, Andrews, JR, Fleisig GS (2017) Preventing baseball injuries. https://www.stopsportsinjuries.org/STOP/Prevent_Injuries/Baseball_Injury_Prevention.aspx. Accessed
- Baker, H. P., Tjong, V. K., Dunne, K. F., Lindley, T. R., & Terry, M. A. (2016). Evaluation of shoulder-stabilizing braces: can we prevent shoulder labrum injury in collegiate offensive linemen?. Orthopaedic journal of sports medicine, 4(12), 2325967116673356.
- Lack, B. T., Childers, J. T., Mowers, C. C., Berreta, R. S., Jackson, G. R., DeFroda, S. F., Knapik, D. M., & Verma, N. N. (2025). Biceps tenodesis and SLAP repair show similar outcomes in overhead throwing athletes with baseball pitchers exhibiting worse rates of return to sport: A systematic review. Arthroscopy: The Journal of Arthroscopic and Related Surgery. https://doi.org/10.1016/j.arthro.2025.01.061 0363546512447785
- Rowe, D. G., Hurley, E. T., Bethell, M. A., Lorentz, S. G., Meyer, A. M., Klifto, C. S., Lau, B. C., Taylor, D. C., & Dickens, J. F. (2025). Return to play after arthroscopic superior labral repair: A systematic review. The American Journal of Sports Medicine, 53(3), 727–733. https://doi.org/10.1177/03635465241246122
- Smith, R., Lombardo, D. J., Petersen‑Fitts, G. R., Whaley, J., & Sabesan, V. J. (2025). Return to play and prior performance in Major League Baseball pitchers after repair of superior labral anterior‑posterior tears. Orthopaedic Journal of Sports Medicine, 13(4). https://doi.org/10.1177/23259671231234567 96
- Haskel, J. D., Kaplan, D. J., Kirby, D. J., Bloom, D. A., & Youm, T. (2021). Revisiting Intraarticular Corticosteroid Injections and Sports Medicine: Outcomes and Perioperative Considerations. SN Comprehensive Clinical Medicine, 1-9.
Other Conditions in
Shoulders, Orthopaedics
Whiplash Disorders
An injury which typically occurs following a road traffic collision, often affecting the soft tissues of the neck.
Thoracic Outlet Syndrome
A condition presenting with pain in the arm as a result of compression of structures around the neck/shoulder.
Shoulder Osteoarthritis (OA)
Age and activity related changes to the joints of the shoulder which can lead to pain and stiffness.
Shoulder Impingement
Shoulder impingement is an umbrella term used to describe a variety of conditions that can cause pain in the shoulder.
Shoulder Dislocation
An injury in which your upper arm bone ‘pops out’ of the cup-shaped socket of your shoulder blade.
Rotator Cuff Tendinopathy
Pain and weakness affecting the shoulder and limiting function.
Frozen Shoulder
An insidious (no clear cause), painful/stiff condition of the shoulder persisting for more than 3 months.
Degenerative Rotator Cuff Tear
A common cause of shoulder issues as we age, one of the tendons that insert into the shoulder joint can be damaged.
Clavicle Fracture
A clavicle fracture is a break in the collarbone, one of the bones that helps co-ordinate shoulder movement.
Calcific Tendinopathy
A rare condition causing pain and loss of free movement in tendons and joints.
Biceps Tendinopathy
A tendon-related issue affecting the long bicep tenon at the front of the shoulder.
Benign Joint Hypermobility Syndrome
Common age related changes to the structure of the knee joint which may be associated with pain, stiffness and loss of function.
Acute Torticollis
Sometimes referred to as “wry neck”, this is a condition causing muscle spasms and associated neck pain.
Acromioclavicular Joint Injury
Injury to a small joint at the end of the collar bone (clavicle)/top of your shoulder.