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Physiotherapist assessing a patient's shoulder for a suspected labral tear at J&J Therapy clinic in New Malden

Labral Tear (SLAP / Bankart)

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PHYSIOTHERAPY & THERAPEUTIC MASSAGE IN NEW MALDEN

Quick Summary

A labral tear is damage to the ring of cartilage (labrum) that deepens and stabilises your shoulder socket, causing deep catching or clicking pain and a feeling that the joint might slip or give way. Research suggests many labral tears — particularly SLAP tears — improve with a structured physiotherapy programme, without surgery. Recovery is gradual and typically takes several months of staged, consistent rehabilitation.

What Is a Labral Tear?

Anatomical illustration of the shoulder glenoid labrum showing SLAP and Bankart tear locations

The glenoid labrum is a rim of firm, flexible cartilage attached around the edge of your shoulder socket (glenoid). It deepens the naturally shallow socket, anchors the long head of the biceps tendon and provides attachment for the shoulder ligaments — all of which help keep the ball of your upper arm bone securely centred in the joint.


There are two main patterns of labral tear:


SLAP tear (Superior Labrum Anterior to Posterior): a tear at the top of the labrum where the biceps tendon anchors, running from front to back. SLAP tears are typically caused by repetitive overhead sport, a fall onto an outstretched hand, or gradual age-related change, and do not usually cause the shoulder to dislocate.


Bankart lesion: a tear of the front-lower labrum caused by an anterior shoulder dislocation. It is strongly linked with recurrent instability — research shows a Bankart lesion is present in around 59% of first-time and 66% of recurrent traumatic anterior dislocations (Hurley et al., Knee Surgery Sports Traumatology Arthroscopy, 2022).


Labral tears are common findings at shoulder arthroscopy, and importantly, evidence shows that surgery is not always necessary: a landmark randomised trial found that repairing a type II SLAP tear gave no better results than a sham (placebo) operation (Schroder et al., British Journal of Sports Medicine, 2017). This is why a well-structured physiotherapy programme is the recommended first step for most people.

Do You Experience These Symptoms?

✓  Deep catching, clicking or popping sensation inside the shoulder

✓  A feeling of instability — that the shoulder may slip or give way

✓  Pain with overhead activity, throwing or reaching behind you

✓  Deep aching in the shoulder that is hard to pinpoint

✓  Loss of strength or a sense the arm goes "dead" with certain movements

✓  Apprehension in positions with the arm raised and turned out

✓  A history of dislocation, partial slip (subluxation) or a specific injury

These symptoms can be treated.
The sooner you begin, the better your chances of a smoother recovery.

What Causes a Labral Tear?

•  Traumatic shoulder dislocation

A first-time anterior dislocation, most often in sport or a fall, is the classic cause of a Bankart lesion. The ball is forced out of the socket and tears the front-lower labrum, leaving the joint prone to further instability.


•  Repetitive overhead sport

Throwing, racket sports, swimming and volleyball repeatedly load the biceps anchor and the top of the labrum. Over time this traction and "peel-back" stress can produce a SLAP tear, especially in the dominant arm.


•  Fall on an outstretched hand

Landing on an extended arm, or taking a direct blow to the shoulder, transmits a sudden compressive or traction force through the joint. This can injure the labrum acutely even without a full dislocation.


•  Age-related degenerative change

With increasing age the labrum can fray and tear as part of normal wear and tear, particularly the upper portion in people over 40. These degenerative tears sometimes occur alongside rotator cuff changes.

Not sure which condition applies to you?

How We Treat Labral Tears at J&J Therapy

Hands-On Manual Therapy

Our physiotherapists use hands-on techniques — joint mobilisation, soft-tissue work and targeted stretching of a tight posterior capsule — to help reduce pain, restore range of movement and normalise the rhythm between your shoulder blade and arm. Research suggests manual therapy works best combined with exercise, so we use it to create a comfortable window in which you can progress your strengthening programme.

Shockwave Therapy*

Swiss Storz Medical MASTERPULS shockwave therapy is not a first-line treatment for a labral tear, and current research does not show it repairs torn labral tissue. It may occasionally complement your manual therapy and exercise programme only when your physiotherapist identifies a specific additional indication during assessment — for example, calcific rotator cuff tendinopathy contributing to your symptoms. Non-invasive, and we will always explain the honest limits of the evidence first.

Targeted Exercise Programme

Progressive exercise is the cornerstone of non-surgical care for labral tears. We build you a staged, individualised programme: gentle range-of-movement and shoulder-blade control first, then rotator cuff and scapular strengthening, and finally proprioception and sport- or work-specific tasks. Evidence shows structured rehabilitation focused on scapular stabilisation and posterior capsule stretching can meaningfully improve pain and function without surgery.

When to Seek Urgent Medical Help

While most symptoms are not serious, urgent medical attention is required if you experience any of the following:

  • A visibly deformed or dislocated shoulder that has not gone back into place

  • Numbness, pins and needles, a cold or pale hand, or loss of pulse in the arm after injury

  • Sudden, complete loss of power in the arm, or an inability to move it at all

  • Severe pain with a suspected fracture after a significant fall or high-force injury

FAQs About Labral Tears

  • Do labral tears heal without surgery?

Many improve without surgery. Research suggests a large proportion of people — particularly with SLAP tears — respond well to structured rehabilitation, and one landmark trial found surgical repair of a type II SLAP tear gave no better results than a sham operation. We will assess your tear type and goals and be honest about when a surgical opinion is warranted.


  • How long does recovery take?

It varies with the tear and your goals. Non-surgical rehabilitation is usually trialled for at least three to six months, and meaningful gains often take several months of consistent work. Recovery after surgery can take up to nine to twelve months. We will give you a realistic, staged timeline based on your assessment.


  • Can I still play sport with a labral tear?

Often, yes — but it depends on the tear and the demands of your sport. Evidence shows athletes who complete a full rehabilitation programme have better return-to-sport rates than those who stop early. We build sport-specific stages into your programme so return is gradual and confidence-based.


  • I have dislocated my shoulder before — will it happen again?

It can, especially in younger, active people, where recurrence rates after a first traumatic dislocation are high. This is why early, well-structured rehabilitation matters. Where the risk of repeated dislocation is high, we will discuss whether a surgical opinion, such as a Bankart repair, is appropriate for you.


  • Can shockwave therapy fix my labral tear?

No — shockwave therapy does not repair torn labral tissue, and there is currently no reliable evidence it helps labral tears directly. We do not use it as a first-line treatment for this condition. It may occasionally have a role only if our assessment identifies a specific additional indication, such as calcific rotator cuff tendinopathy contributing to your symptoms.

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This page is for general information only and does not replace professional medical advice.

Reviewed by Lavya Arigalayan, MSc, HCPC Registered Physiotherapist.

Last reviewed

2026년 8월 20일

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