A shoulder labrum tear is an injury to the labrum, the ring of cartilage that encircles and helps stabilize the shoulder joint. Common symptoms include pain in the shoulder (often worse with overhead use), a feeling that the shoulder is loose or unstable, clicking, popping, and reduced range of motion and strength. Some people may notice catching or grinding, and at times, the shoulder may dislocate.

Labrum tears can occur in people of all ages. They may occur in people who participate in sports or activities that require frequent overhead motion, such as throwing athletes and weightlifters. They can also happen when people fall on an outstretched arm or receive a blow to the shoulder. In people over age 40, shoulder labrum tears may develop due to normal wear over time.

Most people improve with nonsurgical care, such as physical therapy, activity modification, injections, and anti-inflammatory medications. If symptoms persist, surgery can help, and with rehabilitation, most people regain shoulder strength, experience less pain, and return to their usual activities.

The shoulder is a ball-and-socket joint formed by three bones: the upper arm (humerus), shoulder blade (scapula), and collarbone (clavicle). The ball at the top of the humerus sits in a shallow socket in the scapula called the glenoid. The labrum, a tough ring of cartilage, surrounds this socket, deepening it to improve stability and serving as an anchor for shoulder ligaments and the biceps tendon. The biceps tendon comes from the biceps muscle and attaches to the top of the shoulder socket. It has two attachment sites, connecting to both the bone (coracoid) and the top of the labrum.

In a healthy shoulder, the labrum helps keep the joint stable and allows for a wide range of motion while preventing the ball of the humerus from slipping out of the socket. When the labrum is torn, the shoulder joint can become less stable. This may lead to a number of symptoms including pain and a feeling of instability of the shoulder, among others.

There are several types of shoulder labrum tears, which are classified by which part of the labrum is affected and by their specific features:

• SLAP tear (superior labrum anterior to posterior): This is the most common type and involves a tear at the top of the labrum, where the biceps tendon attaches. SLAP tears can vary in severity and may involve the biceps tendon itself.
• Bankart lesion: This is a tear of the front part of the labrum at the bottom of the socket, often associated with shoulder dislocations and instability.
• Posterior labral tear: This involves the back part of the labrum and can result from trauma or wear and tear over time. This can be common in weightlifters or athletes.
• Other types: Tears can also occur in other regions of the labrum, and some injuries may involve multiple parts of the labrum or extend to nearby ligaments.

Shoulder labrum tears can develop from both sudden injuries and ongoing stress to the shoulder joint. Trauma and injuries are frequent causes and may happen during events such as falling on an outstretched arm, receiving a direct blow to the shoulder, a sudden pull (for example, when lifting a heavy object), or a forceful overhead reach, such as when trying to stop a fall. Motor vehicle accidents and shoulder dislocations can also result in labrum tears.

Repetitive shoulder motion can also cause shoulder labrum tears, especially in people who participate in sports or activities that involve frequent overhead movements, such as throwing athletes and weightlifters. Over time, repeated stress can cause the labrum to wear down or fray, leading to a tear. In people over the age of 30 to 40, labral tears may also develop as a normal part of the aging process due to gradual degeneration of the tissue.

Certain anatomical differences, such as variations in the shape or attachment of the labrum, may also increase the risk of developing a tear.

Risk factors for shoulder labrum tears include:

• Participation in sports or activities involving repetitive overhead motion
• Shoulder trauma and injuries
• Sudden pulling or forceful overhead reaching
• Shoulder dislocation
• Older age
• Anatomical variations in the labrum or shoulder ligaments

Symptoms of shoulder labrum tears may include:

• Shoulder pain, especially during movement or overhead activities
• A feeling of instability in the shoulder
• Shoulder dislocations
• Clicking, popping, catching, or grinding sensations in the shoulder
• Locking of the shoulder
• Decreased range of motion
• Loss of shoulder strength or weakness
• Pain with lifting objects, especially overhead
• Night pain or pain with daily activities
• A feeling that the shoulder may slip out of the joint
• Decreased throwing speed or power

In some cases, people with shoulder labrum tears do not have any symptoms.

To diagnose a shoulder labrum tear, your doctor will review your medical history, conduct a physical exam, and order one or more diagnostic tests.

Your doctor may ask you about your symptoms, when they began, and whether a specific injury or activity caused your shoulder pain. They may also ask about your participation in sports or work activities that involve repetitive shoulder motion, as well as any previous treatments you have tried.

During the physical exam, your doctor will check the range of motion, strength, and stability of your shoulder. They may perform specific tests by placing your arm in different positions to reproduce symptoms and may also examine your neck and head to rule out other causes of pain.

Additional tests are necessary to make a diagnosis. These may include:

• X-rays: Used to rule out other problems in the shoulder, such as arthritis or fractures. The labrum does not show up on X-rays.
• Magnetic resonance imaging (MRI): Provides detailed images of soft tissues, including the labrum. Sometimes, a special type of MRI called an MRI arthrogram is used, which involves injecting dye into the shoulder to better visualize a tear.
• Computed tomography (CT) scan: An imaging test that may be used, sometimes with a dye to improve the image, to help detect labral tears and assess associated bone injuries.
• Arthroscopy: A minimally invasive surgical procedure in which a small camera is inserted into the shoulder joint to directly visualize the labrum and confirm the diagnosis. This is often considered the most definitive way to diagnose a labrum tear.

Shoulder labrum tears can often be managed with nonsurgical treatments. If they aren’t effective after three to six months, your doctor may recommend surgical treatment. Treatments may include:

• Physical therapy: A program of specific exercises to restore movement, improve flexibility, and strengthen the muscles that support the shoulder. This can help relieve pain and prevent further injury.
• Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can reduce pain and swelling.
• Corticosteroid injections: These may be used to reduce inflammation and help diagnose the source of pain if it is unclear.
• Activity modification and rest: Avoiding activities that worsen symptoms and allowing time for the shoulder to heal.
• Surgical treatment: If nonsurgical treatments do not relieve symptoms, surgery may be recommended. The most common procedure is a minimally invasive surgery in which a small camera and instruments are used to remove or repair the torn part of the labrum, or address injuries to the biceps tendon if needed.
• Sling immobilization: After surgery, the shoulder is often placed in a sling for 2 to 6 weeks to protect the repaired structures while they heal.
• Postsurgical rehabilitation: A tailored physical therapy program is started after surgery to restore flexibility, range of motion, and strength, and to help patients gradually return to their usual activities and sports.

People with shoulder labrum tears may be at increased risk for certain complications, including:

• Recurrent shoulder instability, where the shoulder feels loose or the ball of the humerus may repeatedly move partly out of the socket (a subluxation) or completely out (a dislocation). Full dislocations are more likely with certain types of tears such as Bankart lesions
• Decreased range of motion, making it difficult to move the shoulder fully
• Persistent pain, which may interfere with daily activities or sports
• Weakness or loss of strength in the shoulder
• Symptoms such as ongoing clicking, popping, catching, or grinding sensations
• Development of associated injuries, such as rotator cuff tears or injuries to the biceps tendon
• Shoulder stiffness, which can occur after injury or surgery
• Complications from surgery, including infection, excessive bleeding, blood clots, or damage to blood vessels or nerves

The outlook for people with a shoulder labrum tear is favorable but varies depending on factors such as the type and severity of the tear, the presence of other injuries, the individual’s age, activity level, and how well they follow their treatment and rehabilitation plan. Some people recover fully with nonsurgical treatments, while others may need surgery to restore shoulder stability and function.

Most people experience improved shoulder strength, less pain, and a return to their usual activities after appropriate treatment and rehabilitation. Recovery time can differ from person to person, and in cases of more complex injuries or repairs, full recovery may take several months. Following your doctor’s recommendations and participating in a tailored rehabilitation program are important steps toward achieving the best possible outcome.

“At Yale Medicine, we take a comprehensive, patient-centered approach to shoulder labrum tears,” says Yale Medicine orthopaedic surgeon Andrew Jimenez, MD. “Our program integrates advanced imaging, minimally invasive arthroscopic repair techniques, and individualized rehabilitation plans to help patients safely return to their sports and daily activities. Collaboration between our sports medicine specialists, physical therapists, and athletic trainers ensures each patient receives coordinated, state-of-the-art care tailored to their specific goals.”