Hi, I’m Dr. Molly with your Goals Physical Therapy. Just the other day I answered the phone and I got a fabulous question and that is what sparked today’s video. So the question that I got was, “how is moving my shoulder going to help my labrum tear?”
I personally agree that if I just think about that, it makes no sense. Why would moving something that’s torn help it? But I have seen it happen many, many times over the years. I have witnessed the miracle that if you work on your shoulder, improve its strength, the labrum tear no longer is a problem. So that’s what I’m going to talk about today. I’m gonna talk about what a labrum tear is and how physical therapy can help that labrum tear. So let’s get started.
As I mentioned, I have worked with many people that have had labrum tears. I have worked with cyclists, runners, powerlifters, and just health enthusiasts. Some people who don’t even like to work out. I’ve helped lots of people with labrum tears. There are a few similarities.
Generally speaking, there are people in their forties, maybe a little bit older, they enjoy working out, they stay pretty active, and they spend long hours in front of a computer. So all of those things are gonna play into what I talk about next. So what is a labrum tear? Most of us have heard about a rotator cuff, but the labrum, not everybody’s heard of.
So let’s talk about the shoulder joint. Really, you have an arm bone, which is rather large. The head of the arm bone is pretty big, and then the cave in which it sits, or the joint in which it sits is relatively small. The reason that is, is so that you get all of that range of motion that we need.
Our shoulders do a whole lot of movement forwards backwards. They rotate, they do amazing things in part because of the larger ball on the end of your humerus and the smaller joint in which it sits. But to keep it stable and to keep it where it’s able to do all the tasks that we want it to, it has a few things that help it with that.
Your labrum is one of those things, if you think about a water balloon that’s not full, it’s not so big, you can’t smush it. That’s actually only halfway full. So it’s actually thin and if you put your hand into it, it would still roll, right? You’d be able to move your hand up and down and it would squish kind of around your hand.
That’s similar to what your labrum looks like and how it functions. It helps with that gliding. It helps keep everything, like your arm bone sucked up into the joint and it gives it a lot of stability to that joint. Your rotator cuff are muscles – there’s four muscles that help overall what they do is they pull down and they help your arm bone rotate. Your deltoids, the big shoulder muscles, they’re like the powerhouse that help move your shoulder after a certain point when your rotator cuff has done its job of rotating the deltoids take over with the big muscle muscle movements.
They’re really your strength. Your rotator cuffs are more endurance and fine motor for lack of a better description. Another thing around your shoulder, which we tend to forget about is that there are ligaments. There are ligaments in the front of your shoulder. There are ligaments in the front and the back of your shoulder that also help give it stability.
Depending on how we sit and how we move, some ligaments are stretched outside of the norm for what anatomical position would be, or the ideal bone structure position should be. Some get shortened because of the way that we sit. When we sit for long hours, we tend to be a little bit more rounded, which then stretches out those back ligaments, tightens up those front ligaments.
We’re just sort of stuck in this position anytime we come out of the normal anatomical position. There’s some variation with this, but it is putting the rotator cuff muscles at a functional disadvantage. It puts your deltoids at a functional disadvantage.
One more little thing, little tidbit is that your biceps, the fibers for the biceps go into that shoulder joint and connect with the labrum. So if you have a sudden sharp movement with your biceps, sometimes you can tear your labrum from that.
Depending on how rounded we are, we can wear down certain aspects of our shoulder, which can add stress to the labrum and eventually tear it. Now what is a tear? Most of us, when we think of a tear, we’re thinking of a piece of paper and somebody just ripped it all the way down and it’s no longer connected.
Whether you’re talking about a rotator cuff or a labrum tear, it’s not so much as a sheet of paper being ripped as much as a hole being bore through something. Think more button hole and it’s just a little spot that got rubbed or maybe one section where the fibers got pulled beyond their capacity.
Again, with a labrum tear, you’re typically looking at fibers. So you see on the MRI you’ll see things that look like they’re little fibers or little fingers you see little shreds of things. What the surgeon’s gonna do is go in and try to stitch those back together to help give you back some of the stability that the labrum helps you have in your shoulder.
So that is what a labrum tear is. A little bit about the overall health of your shoulder. How does moving your shoulder help and/or how does physical therapy help you recover from our labrum tear? Well, I’m not here to tell you that we actually heal the tear, but what we do is help you improve the overall health of your shoulder, allowing that labrum tear not to be a problem.
Really what we want when we have a labrum tear that we’re going to seek help for is we want the pain to stop. I want to be able to use my arm again. I want to get back to cycling., to running, to sleep and not have my arm hurt, to walk with my arm hanging and not be in agony at the end of the walk. These are what we’re looking for. If the tear is there or the tear is not, I’m not sure many people care.
You just wanna get back to your life, to stop worrying about this thing. So let’s get on with it. That is what physical therapy helps with. As I talked about before, a lot of these passive structures can be like the capsule or the ligaments around your shoulder can be getting tight just over years. It has nothing to do with your workout schedule.
It could have something to do with the eight hour schedule that you have during the week where we get stuck in this position. Then when you go work out, you might be blaming that and maybe there was. You might have done something while you were working out or doing something that caused the injury. Normally these things happen slowly over time. It’s more of a ‘wearing down of tissue’ versus an immediate, ‘this event did it’.
Because of that, working with somebody to help you improve the overall health of your shoulder, getting your posture to be in a more anatomical position, helping you stretch things, strengthen things, work on a range of motion, learning how to move your arm inside that joint is invaluable. That is where the magic happens. Learning how to do all of those things allows your rotator cuff to work better. Taking off that pulling sensation inside your arm.
If your rotator cuff is stronger, it’s gonna hold your arm bone up and not need as much help from the labrum. So if your shoulder is just hanging and you have pain, then your rotator cuff is not able to overcome the strain basically. The stronger your rotator cuff is, the less strain there is just by hanging again, there’s less work on your labrum, it is less pulling on your labrum, then there’s less pain.
The other way to get that to work is improving your posture and getting your shoulder blades to come back. Most of us sit and our shoulder blades are very far apart from each other. The closer they are, the more room there is for everything in your shoulder to function properly. The more room there is for your shoulder to have range of motion and space so that your arm bone is not hitting the top of its joint. Again, reducing pain on that labrum.
That is really the huge benefit behind going into physical therapy and learning how to get all those muscles to work together in the right order at the right time with the right amount of strength to stabilize your shoulder, to take over for the amount of stability lost from that labrum.
If this is the type of service that you’re looking for, there’s a button below that says, “ask about cost and availability”. You’ll fill out a quick form and my office will get back to you to set up that for you.
Then if you have specific questions, maybe you want to know a little bit more about how therapy can help you with your specific labrum tear to get you back to your sport, then I’m gonna leave a button down below that says “talk to a therapist”. You’ll fill out a quick form.
My office will get with you to schedule a time for us to have maybe 20 minutes to chat. So until we have the opportunity to speak, I hope you’re having a great day. Bye.
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