What is a labral tear?

The labrum is a rim of cartilage that lines the rim of the shoulder socket (glenoid), deepening it like a gasket so the ball of the arm bone stays seated. A labral tear is a split or fraying of this cartilage. A SLAP tear refers specifically to a tear at the top of the labrum, front to back, where the biceps tendon anchors (Superior Labrum Anterior to Posterior). Labral injuries happen from falling onto an outstretched arm, a sudden pull or jerk on the arm, repetitive overhead throwing, or a shoulder that has partly slipped out of place. Because the labrum sits deep in the joint, the pain is often felt inside the shoulder rather than on the surface.

Labral tear symptoms

Labral symptoms tend to involve mechanical sensations inside the joint, not just ache. Patients often describe the shoulder catching during specific motions, especially overhead.

• Deep, hard-to-pinpoint pain inside the shoulder
• Catching, locking, popping, or grinding with certain movements
• A feeling that the shoulder is loose, slipping, or unstable
• Pain and loss of power with overhead motions, throwing, or pushing
• Weakness and reduced range of motion, sometimes with night discomfort

How a labral tear is diagnosed

A clinician reviews the mechanism of injury and performs provocative tests that load the labrum and biceps anchor, such as the O’Brien (active compression), crank, and apprehension tests. Plain X-rays are usually normal because cartilage does not show on them, but they rule out fracture and bone injury. Because standard MRI can miss labral tears, an MR arthrogram, where contrast dye is injected into the joint first, is often used to outline the torn cartilage. The findings, combined with how unstable the shoulder feels, guide treatment.

Labral tear treatment

Many labral tears are managed without surgery at first, particularly when the shoulder remains stable and the main issue is pain. Treatment focuses on calming the joint and rebuilding the muscles that keep the ball centered in the socket so the labrum is protected. Surgical evaluation is considered when the shoulder is unstable or repeatedly slips, when mechanical catching and locking persist, or when symptoms continue to limit work, sport, or daily activity after a fair trial of rehab.

• Physical therapy emphasizing rotator cuff and scapular stabilization to control the joint
• Activity modification away from painful overhead and throwing motions
• Anti-inflammatory measures and image-guided injections from pain-management specialists when appropriate
• Manual and chiropractic care for associated upper-back and neck tightness
• Orthopedic surgical evaluation for instability, persistent catching, or rehab that does not relieve symptoms

Recovery & when to see a doctor

Recovery depends on the type and location of the tear, whether the shoulder is unstable, and the demands you place on it; progress is individual and no fixed timeline can be promised. See a doctor if your shoulder catches, locks, or feels like it is slipping out, if overhead activity is painful and weak, or if symptoms persist after an injury. Early evaluation helps distinguish a labral tear from other shoulder injuries. Our Long Island team coordinates orthopedic, physical therapy, chiropractic, and pain-management care so the diagnosis and plan stay connected.

Related care at Injury Recovery MD

• shoulder pain
• sports injury care

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Shoulder labral (SLAP) tear FAQ

What is a SLAP tear?

A SLAP tear is a labral tear at the top of the shoulder socket where the biceps tendon attaches, running from front to back. It is a specific type of labral injury common after falls on an outstretched arm and in throwing athletes.

Why didn’t my MRI show the tear clearly?

Standard MRI can miss labral tears because the cartilage is thin and deep in the joint. An MR arthrogram, which injects contrast dye into the shoulder first, outlines the labrum more clearly and is often used when a tear is suspected.

Is this covered under No-Fault or Workers’ Comp?

If the injury came from a car accident it is generally billed to New York No-Fault auto coverage, and a work-related injury is billed to Workers’ Comp. Eligible patients typically pay $0 out of pocket for covered visits, and we verify coverage before care begins.

Can I keep working out with a labral tear?

Often yes, with modification. Overhead pressing, throwing, and heavy pushing load the labrum and biceps anchor directly, while controlled rotator cuff and shoulder-blade work is usually encouraged because it helps keep the ball centered in the socket. The aim is to change what you do, not to stop moving the shoulder.

Why does my shoulder click and catch?

A torn flap of labral cartilage can move within the joint during specific motions, producing catching, popping, or grinding felt deep inside the shoulder. Painless clicking on its own is common and not always a problem. Clicking accompanied by pain, weakness, or a sense that the shoulder is slipping is what warrants evaluation.