Overview
A shoulder labral tear is an injury to the labrum, a ring of tough cartilage around the rim of the shoulder socket (the glenoid). The labrum helps deepen the socket and stabilize the ball of the upper arm bone, while also anchoring the biceps tendon and other stabilizing structures. When the labrum is torn, it can cause pain, a sense of catching or instability, and reduced strength because the shoulder joint mechanics become less smooth. Symptoms can be especially noticeable with overhead movement, reaching behind your back, or sports and work activities that place stress on the shoulder.
Symptoms
People with a shoulder labral tear often feel pain in the front or deep inside the shoulder, which may worsen with overhead activity, throwing, pushing, or reaching behind the back. Many notice clicking, catching, or a "clunk" sensation, along with stiffness or reduced range of motion. Some patients describe a feeling that the shoulder is unstable or may slip, particularly during certain arm positions. Weakness can develop because painful or unstable movement patterns lead to reduced use of the shoulder.
Causes
A labral tear usually develops after a traumatic injury, such as a fall on an outstretched arm or a shoulder impact, or after a sudden pulling or twisting event. It can also occur gradually from repetitive stress, including throwing, overhead work, heavy lifting, or sports that require frequent arm motion. In some cases, degenerative change or abnormal shoulder mechanics can weaken the labrum over time.
Risk Factors
Risk is higher in people who participate in overhead sports (such as baseball, swimming, volleyball, or tennis) or have physically demanding jobs involving repeated reaching or lifting. Prior shoulder instability episodes, previous injuries, and abnormal movement patterns can increase stress on the labrum. Age-related wear and tear, as well as limited shoulder mobility or weakness in the rotator cuff and shoulder blade muscles, can contribute as well.
Prevention
You can lower your risk by strengthening the rotator cuff and shoulder blade muscles and using proper mechanics for throwing, lifting, and overhead tasks. Gradually build intensity and volume for sports or repetitive work so the shoulder can adapt, and avoid "playing through" sharp pain. Regular mobility work and stretching of the chest and back muscles can help maintain balanced shoulder movement. If you have a history of shoulder instability, a structured stability and control program is especially important to reduce reinjury risk.
How the Diagnosis Is Evaluated
Clinicians typically start with a detailed history about how symptoms began, including whether there was an injury, a throwing episode, or a gradual onset. A physical exam checks shoulder range of motion, strength, stability, and specific provocative maneuvers that may reproduce labral symptoms. Imaging may begin with an X-ray to rule out other problems, and ultrasound or MRI may be used depending on suspected associated injuries. MRI arthrogram is sometimes recommended when the goal is to better define labral tears and related instability, but not every patient needs every test.
Nonsurgical Treatment Options
Non-surgical care usually begins with activity modification to reduce positions that provoke pain or catching, along with short-term pain control using anti-inflammatory medications when appropriate. Physical therapy is a key treatment and focuses on restoring shoulder range of motion, improving scapular (shoulder blade) mechanics, and strengthening the rotator cuff and deep stabilizers to improve joint control. If pain limits participation in rehab, an image-guided corticosteroid injection may help calm inflammation and improve comfort temporarily. Platelet rich plasma (PRP) injections may be considered in select patients as an adjunct, especially when symptoms persist despite good rehabilitation, though results vary. For patients with significant muscle guarding around the shoulder, trigger point-focused treatment may help reduce pain and improve tolerance of exercises.
When to Seek Medical Attention
Seek prompt medical evaluation if your shoulder feels unstable, repeatedly "slips," or you cannot use the arm normally after an injury. Get urgent care if there is a sudden deformity suggesting dislocation, severe weakness that prevents lifting the arm, or numbness/tingling that is worsening or persistent. You should also be seen quickly if there is major swelling, fever, redness, or pain that rapidly escalates without a clear explanation. If symptoms such as catching and pain do not improve after several weeks of appropriate conservative care, arrange follow-up with an orthopedist or sports medicine clinician.
Frequently Asked Questions
It often causes deep, front or side shoulder pain along with clicking, catching, or a feeling that the shoulder is unstable during certain arm positions.
It can happen after a traumatic shoulder injury or gradually from repetitive overhead stress and abnormal joint mechanics.
Next Steps
Start by limiting provocative activities and scheduling an evaluation with a clinician who can assess shoulder stability and function through an appropriate exam. If pain and mechanical symptoms persist, a structured physical therapy plan tailored to your shoulder can help guide next steps. Seek follow-up if you notice worsening instability, increasing weakness, or failure to improve with conservative care.