Neck & Shoulder

What It Is

Doctors can now use a tiny camera, inserted through a small cut (keyhole surgery, called arthroscopy), to see inside the shoulder joint. This helps them to identify and treat injuries known as shoulder labral tears (AAOS, n.d.a).

Shoulder Labral Tear Anatomy

The shoulder is a ball and socket joint. Around the edge of the socket is a labrum, a rim of tough, cartilage-like tissue. The purpose of the labrum is to make the socket deeper (by up to 50%), which helps to hold the ball in the joint and makes the shoulder more stable. It is also an attachment point for ligaments that help keep the shoulder stable and for one of the tendons of the biceps muscle (AAOS, n.d.a).

Causes of Labral Tear

Labral tears can be caused by a sudden injury or by repeated shoulder movements (AAOS, n.d.a). Examples of injuries include falling on an outstretched arm, a direct blow to the shoulder, a sudden pull such as when trying to lift a heavy object or having your arm wrenched, and a violent overhead reach, such as when trying to stop a fall (AAOS, n.d.a). Impact sports like rugby, football and hockey can involve these kinds of injuries. Repeated overhead movements are a common cause in throwing athletes and weightlifters (AAOS, n.d.a), so throwing sports, tennis, cricket and other overhead sports can also lead to labral tears.

A common cause of labral tears is shoulder dislocation. As the shoulder dislocates, the labrum can be pulled off the rim of the socket (The Dudley Group NHS Foundation Trust, 2025; AAOS, n.d.a).

Labral tears can also develop through normal wear and tear of the joint, along with arthritis (AAOS, n.d.a).

How do I Know if I have a Labral Tear?

Some people remember a specific injury, but many labral tears come on gradually from repeated overhead use or wear and tear (AAOS, n.d.a). The symptoms can be similar to other shoulder problems and may include (AAOS, n.d.a):

A feeling that the shoulder is unstable, or the shoulder dislocating
Deep shoulder pain, usually with overhead or reaching activities
Catching, locking, popping or grinding in the shoulder
Occasional pain at night or with daily activities
Reduced movement and loss of strength

Some people find their movement comes back after an injury, but months later they still have a low-grade shoulder pain on certain movements, or repeated clicking. This could be a sign of a labral tear.

How is a Shoulder Labral Tear Diagnosed?

A shoulder labral tear is usually diagnosed from the case history and a physical examination (The Dudley Group NHS Foundation Trust, 2025; AAOS, n.d.a). There are some special shoulder tests which can point towards a possible labral tear, but these are not foolproof.

If a labral tear is suspected, the doctor might request an MRI scan, which is the best type of scan for showing soft tissues like the labrum (AAOS, n.d.a). Sometimes a special MRI scan called an MRI arthrogram (MRA) is needed, where dye is injected into the joint before the scan to help show the labrum and any tear (AAOS, n.d.b; The Dudley Group NHS Foundation Trust, 2025).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat a Shoulder Labral Tear

Rehabilitation exercises to strengthen the rotator cuff muscles and improve the range of movement can improve the stability of your shoulder (AAOS, n.d.a). I can guide you through these, alongside hands-on work, within the plan your medical team sets. See the My Approach tab for how I work.

1. Anti-Inflammatory Medication

While a diagnosis is being made, a doctor may recommend anti-inflammatory medicine along with rest to relieve symptoms (AAOS, n.d.a). (This medicine information comes from the American Academy of Orthopaedic Surgeons (AAOS), not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Rest

Take some time to rest and allow the shoulder the time it needs to heal by avoiding activities that aggravate it (AAOS, n.d.a). However, do not completely stop using your shoulder, as this can stop it getting better (NHS, 2023).

3. Ice

A pack of frozen peas wrapped in a tea towel can be held on the shoulder for up to 20 minutes, 3 times a day (NHS, 2023). Wrapping the ice helps prevent an ice burn on the skin.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Arthroscopic (keyhole) surgery: a surgeon uses a small camera and thin instruments to look inside the shoulder and remove or repair the torn part of the labrum; if the biceps tendon is involved, it may be repaired, released or moved to a new position, and studies show these options give similar results (AAOS, n.d.a). Not all labral tears are helped by surgery, especially those caused by wear and tear or arthritis (AAOS, n.d.a).

How I can help (see the My Approach tab)

Strengthening for the rotator cuff and shoulder blade muscles
Hands-on work for the shoulder, neck and upper back
Support after surgery, within your surgeon's limits

Tips

If possible, try to avoid falling on an outstretched arm.
Try to refrain from any activity where your shoulder is going to take a direct blow.
Suddenly pulling when trying to lift heavy objects can tear the labrum.
Violently reaching overhead, such as when trying to stop yourself sliding or falling, can tear the labrum.
Repetitive overhead shoulder motions can cause a labral tear (AAOS, n.d.a).

Treatment

My Approach

With a labral tear, your medical team leads the care: a doctor confirms the tear, often with a scan, and decides with you whether surgery is needed. I work within their plan either way. After surgery, your surgeon's protocol sets the timeline (how long the sling stays on, which movements are allowed and when strengthening starts), and I need their okay before any hands-on treatment.

I start by assessing how your shoulder, neck and upper back move, testing strength within what you've been cleared for, and asking which movements bring on pain, clicking or slipping.

If You're Not Having Surgery

Hands-on work for the shoulder, neck and upper back muscles that tighten up or work overtime to protect the joint
Strength before range: rotator cuff and shoulder blade strengthening, from gentle holds to bands, dumbbells and gym-based work
Avoiding the positions that make it feel unstable; I don't mobilise a loose shoulder, but a stiff upper back can get gentle mobilisation
A home programme, and changes to how you reach, lift and train

After Surgery

Early on, easing the neck, upper back and other arm, and keeping the elbow, wrist and hand moving
Gentle lymphatic drainage for swelling, and scar work once the incisions have healed
Assisted movement, then gentle strengthening; firm stretching and heavier biceps work wait until your surgeon says the repair is ready
Later, gym-based strength work and a graded return to throwing, lifting or sport

What to Expect

Typical Course

Typical course: Early on, most people come once or twice a week, then weekly, with a reassessment at about 4 to 6 weeks, then less often. Without surgery, improvement usually builds over about 3 months of regular strengthening; after a repair, recovery takes several months and follows your surgeon's protocol.

What I Focus On

Working Within Your Medical Team's Plan

Compensation Relief

Shoulder Blade Control

Progressive Cuff Strength

Scar & Shoulder Mobility

Please read

When to See a Doctor First

When to Get Help

Call 911 or go to the emergency room at your nearest hospital if you have injured your shoulder and it looks out of place or has changed shape, you cannot move your arm, there is no feeling in your arm or shoulder, or your arm feels hot or cold to touch (NHS, 2026; NHS, 2023). Do not try to put a dislocated shoulder back in yourself (NHS, 2026).
See your family doctor or nurse practitioner if your shoulder pain is getting worse or does not improve after 2 weeks, or if it is very difficult to move your arm or shoulder (NHS, 2023).

Sources

References

American Academy of Orthopaedic Surgeons (n.d.a) Shoulder joint labral tear. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/shoulder-joint-tear-glenoid-labrum-tear/ (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (n.d.b) SLAP tears. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/slap-tears/ (Accessed: 7 October 2026).
The Dudley Group NHS Foundation Trust (2025) Instability of the shoulder. Patient information leaflet. Available at: https://www.dgft.nhs.uk/pil/instability-of-the-shoulder/ (Accessed: 7 October 2026).
NHS (2023) Shoulder pain. Available at: https://www.nhs.uk/conditions/shoulder-pain/ (Accessed: 7 October 2026).
NHS (2026) Dislocated shoulder. Available at: https://www.nhs.uk/conditions/dislocated-shoulder/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooShoulder Labral Tear

What It Is

Shoulder Labral Tear Anatomy

Causes of Labral Tear

How do I Know if I have a Labral Tear?

How is a Shoulder Labral Tear Diagnosed?

Self-Care & Treatment

How to Treat a Shoulder Labral Tear

1. Anti-Inflammatory Medication

2. Rest

3. Ice

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

If You're Not Having Surgery

After Surgery

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooShoulder Labral Tear

What It Is

Shoulder Labral Tear Anatomy

Causes of Labral Tear

How do I Know if I have a Labral Tear?

How is a Shoulder Labral Tear Diagnosed?

Self-Care & Treatment

How to Treat a Shoulder Labral Tear

1. Anti-Inflammatory Medication

2. Rest

3. Ice

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

If You're Not Having Surgery

After Surgery

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Biceps Tendon Tear at the Elbow

Biceps Tendon Tear at the Shoulder

Glenoid Labrum Tear

SLAP Tear (Superior Labrum Anterior to Posterior)

Book a session