Updated: Oct 20, 2019
The two most common types of labral injuries are SLAP (Superior Labrum from Anterior to Posterior) tears and Bankart tears. SLAP tears occur at the front of the upper arm where the biceps tendon connects to the shoulder. Bankart tears typically occur on the lower portion of the labrum. In either case, the labral support of the humerus becomes weakened and the head of the humerus shifts toward the front of the body, leading to anterior instability of the shoulder.
Dylan is a weightlifter and trainer at The C.N.E. Gym in Boulder, Colorado. He has a right-sided labral tear. He focuses on power lifting which consists of three main lifts: bench press, squat, and deadlift. It is not surprising that Dylan has a labral tear (Bankart tear). The risk with heavy bench press is that when your elbows break the plane of your chest, you're putting significant strain on the stabilizing structures of the shoulder, specifically the labrum and capsule. Add heavy weight and it's a labral tear waiting to happen. Dylan is still able to lift his goal weight. However, he feels he is weaker on the affected side of his chest during a lift because his right pectoral and latissimus dorsi muscles feel under active.
Visual inspection of the anterior chest shows an anteriorly rotated shoulder. This anterior rotation has caused a loss of surface area on the front of the chest, causing his clavicle and pectoral muscle to lift upwards. This constant anterior rotation due to instability of the shoulder joint is causing a strain on the back muscles of the latissimus dorsi, and trapezius.
Structurally imbalanced muscles impede free flow and develop a build-up of Qi and blood causing the muscles to be tight, painful, weak, and to have less contraction. Severe stagnation is present on Dylan’s back, as evidenced by the dark purple discoloration (sha) produced by the fire cup over the latissimus dorsi and trapezius muscles. Which, are constantly strained due to the forward rotation of his shoulder joint created by the labral tear.
Recommendations would include continued weekly cupping sessions x4 to move Qi and blood through the affected muscles to increase muscle strength and performance and decrease pain; Weekly acupuncture sessions x4 with needle E-stim to focus on strengthening the labrum to prevent further tearing by nourishing yin, blood, muscles, tendons and ligaments; and a Chinese herbal formula prescription. Meanwhile, Dylan would work on rehabilitating his shoulder by focusing on volume instead of weight in the gym, practicing daily shoulder stretches, and foam rolling to prevent internal rotation of the shoulder joint and further tearing of the labrum that would require surgical repair.