Labral Tear (SLAP & Bankart Lesions)

Labral Tear (SLAP & Bankart Lesions)

Diagnosis Explanation:

A labral tear is an injury to the glenoid labrum, the cartilage that helps stabilize the shoulder joint.

  • SLAP Tear (Superior Labrum Anterior to Posterior) – Affects the top part of the labrum, often caused by repetitive overhead motions (throwing, lifting, swimming) or trauma.
  • Bankart Lesion – Affects the front and lower part of the labrum, commonly due to shoulder dislocation or instability.

Symptoms:

  • Deep shoulder pain (especially with overhead activities).
  • Clicking, popping, or grinding in the shoulder.
  • Weakness or instability, difficulty lifting objects.
  • Decreased range of motion, pain with certain movements.

Specific Work Modifications:

  • If your job requires standing or walking: Avoid carrying weight on the injured side, take frequent breaks, and maintain good posture.
  • If your job involves lifting: Avoid lifting objects above shoulder height, pushing, pulling, or repetitive overhead movements.
  • If your job is desk-based: Use proper arm support, avoid hunching forward, and take breaks every 30 minutes to prevent stiffness.
  • Avoid: Heavy lifting, repetitive shoulder use, and prolonged reaching overhead.

Specific Activity Modifications:

  • If you play sports: Avoid throwing, swimming strokes, and overhead activities until cleared for return.
  • If you do weightlifting: Avoid bench presses, pull-ups, dips, and overhead presses; instead, focus on controlled, pain-free movements.
  • If you do yoga or Pilates: Modify poses to avoid excessive shoulder stretching, deep rotation, or weight-bearing on the arms.
  • Avoid: Contact sports, repetitive overhead motions, and exercises that cause shoulder discomfort.

Recommended Supplements:

  • Collagen Peptides – 10g daily for cartilage and joint repair.
  • Vitamin C – 500mg daily to support collagen synthesis.
  • Glucosamine & Chondroitin – 1500mg/1200mg daily for joint health.
  • Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
  • Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

  • Increase Lean Protein (chicken, fish, tofu, eggs) to support cartilage repair.
  • Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce pain and stiffness.
  • Consume Hydrating Foods (cucumber, watermelon, citrus) to keep tissues lubricated.
  • Limit Processed Foods & Sugars to prevent inflammation.
  • Hydration: Drink 8-10 cups of water daily to support joint function.

Home Exercise Prescription (Rehabilitation for Labral Tear)

Early Phase (0-2 Weeks, Reducing Pain & Protecting the Joint):

  • RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
  • Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
  • Scapular Retractions – Squeeze shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.
  • Isometric Shoulder Holds – Press palm against a wall without moving the shoulder, hold 5 seconds, repeat 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Stability & Mobility):

  • External Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm outward, 10 reps, 2x/day.
  • Wall Slides (Forward & Lateral) – Stand facing a wall, slide affected arm up and down, 10 reps, 2x/day.
  • Bicep Curls (Light Resistance) – Controlled motion, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Restoring Strength & Preventing Recurrence):

  • Lateral Arm Raises (Light Resistance) – Raise arms to shoulder height, 10 reps, 2x/day.
  • Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
  • Modified Push-Ups (Wall or Knees) – Maintain control, 10 reps, 2x/day.

Helpful Books:

  1. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.
  2. Overcoming Shoulder Pain: A Guide to Rehabilitation and Recovery – Peter T. J. Barrett.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.