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Shoulder Ligament Tear

Shoulder Ligament Tear Treatment in Delhi, India

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Overview

The shoulder is a ball-and-socket joint and a significant part of the skeletal system. It resembles a golf ball put on a golf tee.

A shoulder ligament tear is an injury to the soft tissues that obstruct the joint's stability and range of motion. A tear may occur in the tendons, the muscles, or the labrum, a rim of fibrous tissue that lines the glenoid. A tear may be partial or sever the tendon, muscle, or labrum entirely. With time, minor tears in the tendon can lead to a more significant tear.

Shoulder tears can happen due to repetitive use or sudden trauma. Long-term repetitive arm motions performed during sports, chores, or jobs can lead to a tear. For instance, athletes who play sports that require repetitive movements like throw ball, tennis, and baseball may experience a shoulder tear. The ligament may also tear, breaking a fall with an outstretched arm.

A shoulder gets dislocated when the humerus becomes dislodged from the glenoid, pulling muscles and tendons out of place and causing a tear.

Shoulder Ligament Tear Symptoms

Not all shoulder ligament injuries cause instant pain. Some may result from degenerative conditions, meaning the rotator cuff could be damaged for months or years, even before symptoms present themselves.

Common symptoms of rotator cuff injury are:

  1. Tenderness when reaching overhead
  2. Trouble touching behind the back
  3. Difficulty reaching out to the side
  4. Progressive weakness of the shoulder
  5. Pain in the shoulder at night
  6. Difficulty sleeping on the affected shoulder
  7. If symptoms last for over a week or the function of the arm gets affected, seek medical attention immediately.

Types of Shoulder Ligament Tear

Types of torn rotator cuffs include:

  1. Partial Tear

    The tendon is somewhat attached to the arm bone with an incomplete or partial tear.

  2. Complete Tear

    The tendon is fully separated from the bone with a complete tear. There's an entire hole or rip in the tendon.

Shoulder Ligament Tear Causes

To the shoulder or dislocation of the shoulder can tear the rotator cuff. Shoulder ligament tears occur due to the wearing of the tendon with age and use, commonly known as degenerative tears.

Some major known causes of shoulder ligament tears include:


  1. Bone Spurs

    Sometimes, bony growths form on the shoulder bone that may rub against the tendons during movement creating friction between the bone and the ligament. This causes a partial or entire tear of the ligament.

  2. Decreased Blood Flow

    The blood flow to the rotator cuff decreases with age. The muscles and tendons need a healthy blood supply to repair themselves. If blood doesn't nourish the tendons, they can tear.

  3. Overuse

    Repetitive shoulder movements during sports or work can stress muscles and tendons, causing a tear.

Diagnosis of Shoulder Ligament Tear

The doctor presses different shoulder parts during the physical exam and moves the arm into different positions. They also test muscle strength around the shoulder and in the arms. In some cases, imaging tests may be required, like:

  1. X-rays

    A rotator cuff tear cannot be seen on an X-ray. It is done to evaluate any bone spurs or other potential causes of pain - such as arthritis or bone fracture.

  2. Ultrasound

    It uses sound waves to form images of soft tissues such as muscles and tendons. It allows dynamic testing and assessment of the structures of the shoulder during function.

  3. Magnetic resonance imaging (MRI)

    This technology utilizes radio waves and a strong magnet. The images obtained display all structures of the shoulder with intricate details.

Shoulder Ligament Tear Treatment

At first, doctors may advise conservative treatments such as rest, ice, and physical therapy. These are sometimes essential to recover from a shoulder ligament tear injury. Surgery may be required in case the damage is severe.


Injections

Doctors may recommend a steroid & a mix of other medicines injection into the shoulder joint if pain interferes with routine activities such as sleep or physical therapy and when conservative treatment modalities fail. Steroids provide good relief but should be used judiciously since they can weaken the tendon and lower the success of the surgery in chronic tears.


Physical Therapy

It is the primary line of treatment. Exercises curated specifically for particular locations of the rotator cuff injury help restore flexibility and provide strength to the shoulder. Physical therapy is also integral to the recovery process after rotator cuff surgery.


Surgery

Arthroscopic rotator cuff repair

The different surgeries to repair a torn ligament are:

  1. Arthroscopic tendon repair

    Surgeons insert an arthroscope and tools through incisions to attach the torn tendon to the bone. This minimally invasive surgery can be done in daycare with excellent outcomes.

  2. Open tendon repair

    An open tendon repair requires a larger incision to reattach the tendon to the bone.

  3. Tendon transfer

    If the torn tendon is too impaired to be reattached to the arm bone, surgeons may use a close by tendon as a replacement.

  4. Shoulder replacement

    Massive ligament tear injuries with arthritis indicate shoulder replacement surgery. Reverse shoulder arthroplasty is performed to improve artificial joint stability. This installs the ball part of the artificial joint onto the shoulder blade and the socket part onto the arm bone.

Complications of Shoulder Ligament Tear

The most common complication of shoulder ligament tear is re-tearing of the rotator cuff after it has recovered. The larger the original rip, the higher the risk of a relapse.

If the injury requires surgical intervention, the risk of postoperative complications is minimal. General surgical risks include blood loss or issues with anaesthesia. Complications related to the procedure itself include:

  1. Frozen shoulder
  2. Loss of motion
  3. Reduced cuff strength

Shoulder Ligament Tear Risks Factors

Rotator cuff injuries can be of two types -

  1. Acute
  2. Degenerative

  1. Acute injuries

    Acute injuries occur from one specific incident. These can be caused by falling, lifting heavy objects, or shoulders being forced into an awkward position. Most commonly affected by shoulder ligament tears are young people.

  2. Degenerative injuries

    Degenerative injuries mainly occur due to long-term overuse of the joint. People at most risks for these injuries are:

  1. Athletes, specifically tennis players, baseball players, rowers, and wrestlers.
  2. People with jobs that require repetitive lifting, like painters and carpenters.
  3. People above 40 years of age.

Prognosis

With shoulder ligament tear, adequate rest, exercise, and other self-care measures often improve and relieve symptoms in a few weeks and months. Some people may need to alter the length of time they play specific sports to prevent pain.

Treatment often relieves the symptoms with rotator cuff tears or shoulder ligament tears. However, the treatment outcome depends on the size of the tear, how much time has passed since the injury, the person's age, and the activeness of the person before the injury.

Last Update

Reviewed by Dr. Gaurav Gupta, Associate Director, Orthopaedics & Joint Replacement on 14-Sep-2022

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