The shoulder is a ball and socket joint but, unlike the hip joint, the socket in the shoulder is very shallow. The advantage of this is that you can get a lot of movement from the joint enabling you to do things like reaching overhead. The disadvantage is that the joint is inherently unstable. There are therefore a few additional stabilising structures to prevent it dislocating all the time. One of these is called the glenoid labrum, which is like an octopus sucker between the ball and socket. A good picture of this can be seen here where you are looking into the socket from the side.
This labrum can be injured in several ways, such as when falling onto the top of the shoulder directly or falling onto an outstretched hand.
A conservative approach is the best way to go in most cases, at least initially, although part of the decision making on this will depend on how bad the tear is. Whilst the labrum doesn’t repair particularly well on its own due its poor blood supply, good treatment will ensure muscles are adequately trained so they’re not just strong enough but also work at the right time throughout shoulder movements to ensure good control. For more information and to get a good visual demonstration, watch the following short video. It will also explain the different grades of tear.
Surgery is another option if the aim is to repair the damaged labrum. The decision of whether to operate or not will be based on a number of factors including include the extent of the tear and also the aims of recovery e.g. are you just trying to get rid of pain and get back to normal daily shoulder function or are you returning to rugby, for example?
For more information on this injury, here’s a blog we did on this previously.