The Top Doctor Is In by Castle Connolly Top DoctorsÂŽ Q: I have a labral tear in my shoulder. Do I need surgery?
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A: A labral tear is a tear of the labrum in the shoulder, a band of connective tissue that surrounds the socket and is torn usually from overhead trauma such as weightlifting or degenerative wear and tear. The need for surgery depends on the patient. When one suffers a labral tear, the problem is micro-instability. Younger patients who are active, especially with overhead activity, will do much better with an arthroscopic repair. Older patients who do not use their arms for overhead activity should try physical therapy first to see how they do. In some cases, those patients do well temporarily, but then fail after they go back to overhead activity. I have found that older patients that enjoy weightlifting have difficulty living with most labral tears. The best approach is to see a board certified orthopedic surgeon that sub-specializes in sports medicine and arthroscopic surgery of the shoulder. Spending enough time with the patient to determine the proper diagnosis prior to an imaging test is critical. The surgeon's clinical judgement is by far the most important factor in the final decision for surgery.
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