Labral Tears: Hip and Shoulder
The labrum refers to pieces of protective cartilage found in your hips and shoulders. In these ball-and-socket joints, the labrum surrounds the socket to provide stability. Both the hip and shoulder joints are critical to any physical activity, often making them a target for injuries like labral tears.
Labral Tear Causes
Labral tears typically occur in conjunction with a traumatic shoulder dislocation. This could be as a result of forceful contact, like a linebacker in football, or a severe fall, like a worker who falls down on a slippery floor. In young people, specifically young women, the labrum may also tear as a result of instability in the shoulder or hip. This is common in both swimmers and volleyball players.
Labral Tear Symptoms
In the case of a shoulder labral tear, the patient will likely experience pain around the joint, especially during movement. Even when stationary, the joint may feel unstable. The shoulder joint may also suffer from recurrent dislocation, meaning the pain comes and goes.
In the case of a labral tear in the hip, the patient may experience pain around the hip during normal activities, such as walking. The patient may also hear mechanical sounds during movement, such as a clicking or popping sound.
Labral Tear Treatment
For all labral tears, Dr. Melander begins diagnosis with a full physical exam. From there, Dr. Melander may use x-ray imaging to get a clearer picture of the tear and prescribe an MRI, if necessary.
For shoulder labral tears, Dr. Melander may use the Apprehension Relocation test to gauge the joint’s integrity during diagnosis. Treatment for shoulder labral tears varies depending on the injury’s severity. For most tears, Dr. Melander typically recommends a shoulder arthroscopy with a labral repair. Watch the video below to see how Dr. Melander performs a trimming of a torn shoulder labrum.
For hip labral tears, Dr. Melander may diagnose the injury by applying the FADIR test, which tests for flexion, adduction and internal rotation. Much like shoulder labral tears, he may treat the hip injury with a minimally invasive arthroscopic procedure. For tears caused by impingement, treatment may involve an osteoplasty in which Dr. Melander shaves down the femoral neck of the joint in order to alleviate pain.
Labral Tear Recovery
Both shoulder and hip labral tear treatments require 3-4 weeks in a sling or brace, during which the patient should avoid physical activity. For shoulder labral tears, athletes may expect to return to their sports within 3-4 months. Athletes suffering from a labral tear in the hip require a slightly longer recovery time, and may require 3-6 months before returning to their sports.
Labral Tear Prevention
Aside from wearing protective gear and completing stretching regimens, the best way to prevent labral tears is to keep the joint’s surrounding muscles in good shape. For shoulders, patients should follow workout routines that keep the rotator cuff engaged. Exercises involving the hips and gluteus muscles will help prevent labral tears in the hip. However, some labral tears are due to variances in human anatomy, meaning they aren’t entirely preventable.
Schedule a Consultation
If you’re feeling a recurring pain in your hip or shoulders, schedule an appointment with Dr. Melander’s sports medicine team for an exam. If your injury is due to a labral tear, our team will develop a treatment plan that repairs the torn labrum and returns you to your normal activity levels as quickly as possible.
Orthobiologics
One of the fastest-growing areas of orthopaedic treatment is orthobiologics. For certain, minor injuries, orthobiologics have proven to be a safe, effective solution that accelerate the body’s natural healing process. Let’s take a closer look.
Orthobiologics Definition
Orthobiologics refers to the application of biologic treatment for musculoskeletal injuries. The orthobiologic substances are derived from the body’s own cells, proteins and growth factors. When injected into the site of an injury, orthobiologics have a good chance of reducing inflammation and creating an environment more conducive to healing.
When Are Orthobiologics Used?
Dr. Melander typically recommends orthobiologic treatment for tendon, ligament and cartilage injuries. It is considered a hybrid between conservative and surgical treatment. Dr. Melander may recommend it as an intermediate step before surgery, or as a temporary relief for chronic conditions, such as arthritis. In some cases, orthobiologics may delay major treatments, such as a joint replacement.
Where Do Orthobiologics Come From?
Orthobiologics are usually created from two sources: platelet-rich plasma (PRP) and pluripotent stem cells, and occasionally stromal fat cells. PRP cells are drawn from your own blood and contain the critical growth factors necessary to enhance healing. Stem cells, on the other hand, are usually harvested from the bone marrow or pelvis or from a donor. In theory, these cells assist with the rebuilding of the damaged tissue.
Outlook on Orthobiologics
Although orthobiologics have provided relief for several patients experiencing joint pain, science has yet to completely validate them as a reliable treatment option, however, there is growing evidence that orthobiologics can work exactly as intended. That said, the treatment is quite promising and may be right for some patients experiencing specific types of pain. Dr. Melander will be able to evaluate your injury and recommend the best course of action.
Schedule a Consultation
If you are experiencing joint pain and are interested in orthobiologic treatment, schedule an appointment with Dr. Melander and the sports medicine team. If he determines you are a good candidate for orthobiologics, he will develop a treatment plan that restores you to full health as quickly as possible.
