Shoulder Labral Tear

The Role of the Labrum

The glenoid labrum is a ring of fibrocartilaginous tissue that lines the rim of the glenoid — the shallow socket of the shoulder joint. Despite its modest size, the labrum performs three critical functions:

1. Deepens the socket — the labrum increases the depth of the glenoid by approximately 50%, expanding the effective articular contact area and making the joint more resistant to dislocation
2. Anchors the glenohumeral ligaments — the inferior, middle, and superior glenohumeral ligaments, which are the primary static stabilizers of the shoulder, all attach to the labrum; a torn labrum compromises these restraints
3. Provides the biceps anchor — the long head of the biceps tendon originates at the superior labrum and is the site of SLAP tear pathology

Without an intact labrum, the humeral head (ball) can slip too easily within the glenoid (socket), producing instability, pain, and mechanical symptoms.

Types of Labral Tears

Labral tears are classified by their location on the glenoid clock face and their clinical significance:

Anteroinferior labral tear (Bankart lesion) The most common labral tear, occurring at the 3–6 o'clock position of the anteroinferior glenoid. A Bankart lesion results from traumatic anterior shoulder dislocation, when the humeral head forcefully displaces forward and avulses the labrum and inferior glenohumeral ligament from the glenoid rim. When the avulsion involves a bony fragment of the glenoid, it is called a bony Bankart lesion — a more complex injury requiring different surgical planning. Bankart lesions are the anatomic lesion of traumatic anterior shoulder instability.

SLAP tear (Superior Labrum Anterior to Posterior) SLAP tears involve the superior labrum at the 10–2 o'clock position, at and around the biceps anchor. There are four Snyder types, but Type II — a true avulsion of the superior labrum and biceps anchor from the glenoid — is the most clinically significant and the most common type requiring surgical intervention. SLAP tears occur in overhead throwing athletes from repetitive traction and peel-back forces on the biceps anchor, or acutely from a fall on an outstretched arm or a traction injury. They produce deep shoulder pain, particularly in the late-cocking phase of throwing.

Posterior labral tear (Reverse Bankart) Posterior labral tears occur at the 6–9 o'clock position and result from posterior shoulder instability — typically from a direct blow to the anterior shoulder, a fall on a flexed, adducted arm, or repetitive posterior loading (bench-press, offensive line blocking, swimming). These tears are less common than anterior labral tears but are frequently missed or misdiagnosed.

Pan-labral and 270° tears In patients with severe or recurrent instability, tears can involve the entire anteroinferior, inferior, and posterior labrum in a continuous arc. These complex tears — sometimes called 270° labral tears — require comprehensive arthroscopic repair addressing all affected quadrants.

Who Gets Labral Tears?

Labral tears are most common in:

• Young athletes in contact and overhead sports — football, wrestling, hockey, gymnastics, baseball, softball, volleyball, swimming
• Adults aged 15–45 — the primary demographic for traumatic and overhead-related labral pathology
• Older adults — degenerative labral fraying becomes increasingly common after age 50, often in association with rotator cuff pathology

Treatment options

Treatment is individualized based on tear type, degree of instability, associated injuries, your age, sport, and functional goals.

Frequently Asked Questions