Hey DocJean, what's the difference between a torn labrum and a rotator cuff injury? If need be, and not to derail this conversation maybe you could start a thread further down the dial (if you know what I mean)... Thanks, my brother.
Lay terms... please!
I'm not the Doc but as a lifter who couldn't touch the top of his head for a year because he blew out his shoulder in competition, I know a thing or four about rotator cuff injuries.
There are 4 muscles that make up the rotator cuff: supraspinatus, infraspinatus, subscapularis, and teres minor. They basically attach your arm to your shoulder blade in a bizarre and confusing tangle.
The LABRUM is actually the tissue on the inside of the shoulder joint that the ball that forms the head of the upper arm bone (the humerus) fits into. There are also bursa sacks up in there that get inflamed (I had one of those and it hurt. Bad.)
So the Labrum and the Rotator Cuff are kinda separate things but they're very closely inter-related in the way they work with each other. There are strength tests that can usually determine which one of the RC muscles is damaged.
You forgot to mention that the cure is damn near as bad as the ailment. I spent almost 3 months sleeping sitting up and over 6 months rehabbing. My torn rotator cuff was severe and had a torn labrum to boot. It was absolute hell getting over the surgery.
Bill, The Pencil Neck and DocBar both share good information.
To summarize an answer to your question:
Labral tears are not uncommonly misdiagnosed as as rotator cuff tears by many lay persons and even some physicians. It is importance to distinguish the difference since the former is much more serious and much more potentially debilitative.
A labrum tear is a tear in the cartilage that lines the inside of the shoulder joint. That cartilage is there to help secure the arm in the socket, as the joint is somewhat unstable by nature. If the socket rim is disrupted, the ball can pop out (shoulder subluxation or dislocation).
Many are quick to ascribe shoulder pain to rotator cuff strains but that may be a dangerous self-diagnosis. Rotator cuff injuries affect the smaller, secondary, stabilizing muscles that surround the shoulder joint. These muscles include the teres minor, infraspinatus, supraspinatus and subscapularis. These injuries are usually small strains (muscle or musculotendinous tears) and will usually heal on their own with rest, ice and proper rehab, many times even in the case of severe tears. Those that don't will require surgery.
Why is a labrum tear more serious? Tears in the labrum will not heal on their own. They can become less symptomatic or even asymptomatic if treated properly. The tear remains but by strengthening and retraining the surrounding (rotator cuff )musculature, you may be able to continue activity symptom free. But this isnt always the case. Many of these tears will require surgery. This depends on the type and level of activity/competition you are involved in. A competitive athlete would need to seriously consider surgery to remain at peak performer.
How can you tell the difference? Its very difficult. If the injury doesnt improve with treatment, thats a good indicator youre probably dealing with your labrum. After an initial diagnosis, a doctor will usually use an MRI to confirm the finding. Bottom line, if you have shoulder pain or instability that isnt improving with therapy and rest, you need to see a doctor well-versed in shoulder injuries.
