Shoulder Labral Sprain

Shoulder Labral Sprain

According to my Injury classification system, Shoulder labral tear is considered Level 3 Injury, as per the three structures compromised, the alignment, muscles/tendon, and the ligaments. The overall alignment of the spine and shoulder complex are key structures involved and responsible for maintaining the health and resilient of the ligamentous support. When the shoulder misaligned or a visible deformity is presence, certain ligaments becomes overstretched, and in an attempt to maintain the joint apposition leads to further deformation and injury.

Shoulder labral tear tends to cause significant pain and inflammation as per the number of tissues being damage and compromised from the trauma. There is a crepitus (clicking) sound that develops once the labral structure is compromised. Morning stiffness and reduced joint overall movement are common symptoms reported by patients.

Shoulder labral tears and the associated corresponding misalignment

Bankart Tear is an injury at the inferior portion of the labrum and is predisposed by a chronic Anterior inferior (AI) shoulder misalignment resulting a direct irritation on the inferior portion of the labrum.

SLAP tear is an injury at the superior portion of the labrum  where the long head of the biceps attached and is predisposed by a chronic externally rotated (AEX) inferior (AI)  shoulder misalignments causing a traction injury of long head of the biceps to the superior portion of the labrum.

Is important to note that for the labrum to become injured, the previous defence mechanism have to have failed to allow the biomechanical stress to damage the ligamentous and labrum, therefore, the treatment care must aim to restore the health of the entire shoulder complex protective structures.

 

Assessment Protocol

The entire upper extremity biomechanical chain must be evaluated as per the neurological and mechanical influences of the spine, elbow, and hand.

Clinical assessment to identify the key dysfunctions of the shoulder complex that have contributed to this condition. Soft tissue analysis to pinpoint the level of irritation in the ligaments.

X-ray

Anterior – Posterior (AP) shoulder view is essential to analyse the level and direction of the different patterns of shoulder misalignments

MRI

Shoulder MRI is essential for visualizing the extent of injury on the muscle/tendon and ligamentous and labrum layers.

Locate the exact injury point; Allows the treatment to be more specific during the application of the treatment modalities

Identify the extent of tissue damage and the presence of scar tissue; Provides valuable information regarding prognosis and the application of friction soft tissue modalities to aid on scar tissue removal.

 

Treatment protocol

Specific shoulder adjustments followed by a rehabilitation regime to strengthen the entire soft tissue support of the shoulder .

Application of Low-level Laser and PEMF to aid on the cellular level of heling as well as improving the microcirculation for the area.

Friction soft tissue therapy helps to reduce dysfunctional scar tissue

Specific selected essential oil application to enhance healing

Depending on level of misalignment and chronicity a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.

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