Expert Sports Injury
Care in San Diego

Maybe your shoulder clicks every time you reach for a high shelf. Or maybe it slipped out of place during a big serve and never felt right again. Both are common signs of a shoulder labral tear, an injury that can make throwing, lifting, paddling, and even sleeping uncomfortable.

Labral tears are treatable, and surgery has a strong track record when you need it. In fact, studies of patients who had arthroscopic repair of a tear at the top of the labrum show that 91% of patients regained their pre-injury shoulder function. Yet not every tear needs surgery, and the right plan depends on your symptoms, activity level, and goals.

Read on to learn how labral tears happen, when surgery is right for you, and what to look for when searching for the best orthopedic surgeon in San Diego.

What Does the Shoulder Labrum Do? 

Your shoulder is a ball-and-socket joint with a shallow socket, a lot like a golf ball sitting on a tee. The labrum is a firm ring of cartilage around the rim of that socket. It deepens the socket and helps hold the ball in place. Doctors usually describe labral tears by location:

• SLAP tears affect the top of the labrum, where the biceps tendon attaches
• Bankart tears affect the lower front of the labrum and usually happen when the shoulder dislocates
• Posterior tears affect the back of the labrum and can develop from repeated pushing or blocking

Common Shoulder Labral Tear Symptoms

Symptoms of a torn shoulder labrum can mimic a rotator cuff injury. Common signs include:

• Deep, aching pain inside the shoulder
• Clicking, catching, or popping when you move your arm
• Shoulder instability or feeling like your shoulder can’t bear the weight of a throw
• A feeling that your shoulder might slip or pop out of place
• Pain when you reach overhead or throw
• Lost speed or power in your throwing arm

That loose, shifting feeling, called instability, is an important clue. Each time the shoulder slips, it can damage more cartilage and bone.

Why Overhead Athletes Face a Higher Risk

Pitchers, volleyball players, tennis players, and swimmers raise their arms overhead thousands of times each season, and surfers and pickleball players put similar stress on the joint. When you reach your arm back to throw, the biceps tendon twists and tugs on the top of the labrum. Over time, that repeated pull can peel the labrum away from the bone. Overhead athletes also face a tougher road to recovery because of the shoulder's intricate anatomy. 

How Doctors Make a Labral Tear Diagnosis

The best orthopedic surgeons in San Diego start by asking how your pain began and whether your shoulder has ever dislocated. During the exam, a surgeon will move your arm through specific positions to test stability, strength, and range of motion. Imaging helps confirm what the exam suggests:

• X-rays check for fractures, bone loss, or arthritis
• Magnetic resonance imaging (MRI), which shows the labrum, cartilage, and rotator cuff
• An MR arthrogram adds a contrast dye to the joint, which makes small tears easier to see

Is it Possible to Treat a Labral Tear Without Surgery?

Many patients start with conservative care, especially when the tear is small and the shoulder still feels stable. Your plan may include:

• Rest from throwing, lifting, or other movements that trigger pain
• Physical therapy to strengthen the rotator cuff and shoulder blade muscles
• Anti-inflammatory medication to ease pain and swelling
• Orthobiologic injections, including platelet-rich plasma (PRP) injections, which use concentrated platelets from your own blood to support soft tissue healing

Signs Your Labral Tear May Need Surgery

Surgery becomes a necessary treatment option when conservative care stalls or when you have:

• Repeated dislocations or a shoulder that keeps sliding partway out of place
• Pain, clicking, or catching that continues after several months of physical therapy
• A first-time dislocation as a young athlete, since this group has a higher chance of dislocating again
• Trouble throwing, serving, or lifting at your usual level
• Bone damage or other injuries found on imaging

What Happens During Arthroscopic Labral Repair

Surgeons usually perform labral repairs arthroscopically and under general anesthesia. Surgery starts when the surgeon makes a few small incisions and inserts a tiny camera, called an arthroscope, to see inside the joint. Small anchors go into the rim of the socket, and attached sutures pull the torn labrum back against the bone. The small incisions needed for an arthroscopic procedure usually mean less pain and scarring than open surgery, and most patients go home the same day. During recovery, you can expect: 

• To wear a sling for several weeks to protect the repair
• Begin physical therapy that will start with gentle motion and build toward strength
• Return to full activity in four to six months; sometimes longer for throwing athletes or those in sport-specific programs

Looking for the Best Orthopedic Surgeon in San Diego for a Labral Tear?

Dr. Sanjum Samagh leads our team at San Diego Performance Orthopedics & Regenerative Therapy. He completed his fellowship in orthopedic sports surgery and sports medicine at Northwestern University, where he served as an assistant team physician for Major League Baseball’s Chicago Cubs. He also completed a research fellowship at the University of California, San Francisco, and has authored more than a dozen peer-reviewed publications.

Today, Dr. Samagh serves as vice chair of orthopedic surgery at Scripps Memorial Hospital Encinitas. He performs minimally invasive arthroscopic labral repair with suture anchors and can pair surgery with regenerative therapies, including Arthrex ACP platelet-rich plasma, to support recovery.

Our Encinitas clinic is trusted by patients across Leucadia, Del Mar, Solana Beach, Cardiff, Carlsbad, Oceanside, Torrey Pines, and throughout North County San Diego and Southern California. 

If you're looking for the best shoulder surgeon in San Diego, we'll give you an honest answer about whether your tear needs surgery. Ready to get a clear diagnosis and a return-to-sport recovery plan built around your needs?