Many people enjoy weight training at the gym to build muscle. Among them, some develop shoulder pain from overtraining and improper workout routines. Men who enjoy exercises like bench press place significant pressure on the shoulder during repetitive chest workouts, making shoulder injuries common. Exercises that most commonly cause shoulder pain include baseball, dips, bench press, and pull-ups. Do you remember the shoulder injury of Korean Monster Ryu Hyun-jin? Labral tears — the shoulder condition to watch out for in your gym routine — commonly occur in athletes who use their shoulders extensively. Beyond professional athletes, labral tears have become increasingly common among young gym enthusiasts as workout culture has expanded. While they can result from trauma or sudden shoulder impact, they can also develop from accumulated micro-damage caused by persistent stress.
Falls where you land on your arm, overhead throwing motions, and striking motions in tennis or badminton can all cause labral tears. The labrum is the cartilage tissue that surrounds the shoulder joint. It has a circular ring shape and acts as a bumper to keep the upper arm bone stable and prevent it from dislocating. The labrum is an extremely important structure for shoulder joint stability. When the upper front and back portions of this labrum are torn or damaged, it's called a labral tear. In the early stages of a labral tear, most cases don't cause significant pain. However, a torn labrum produces inflammatory substances that, over time, cause shoulder pain. Subsequently, raising or extending the arm backward may become restricted. In daily life, pain occurs during movements like putting on or removing clothes, combing hair, or washing hair. During exercise, pain is triggered by push-ups, pull-ups, throwing, and bench press. Beyond pain, symptoms can include clicking, catching, or locking sensations in the shoulder. A torn labrum may allow joint fluid to leak out, forming a cyst inside the joint. If the cyst grows large enough to compress the suprascapular nerve, tingling may occur around the arm and scapula. Prolonged nerve compression can cause muscle atrophy and weakness, which can be mistaken for cervical disc disease. Accurate examination is crucial when symptoms appear. Since labral tear symptoms are often vague and rarely cause extreme pain, most people dismiss them. Unless you're a professional athlete requiring precise shoulder movements, minor damage may go unnoticed. Damage often deepens from repetitive movement before patients seek help due to pain. When you visit a hospital for shoulder pain, the doctor will assess the condition through patient history, then conduct physical examination tests to suspect a labral tear and order an MRI. Since the labrum is located behind the humerus where ultrasound cannot penetrate, MRI is required for accurate diagnosis.
Once a labral tear is diagnosed on MRI, treatment should begin. Treatment type depends on the location and pattern of the tear. Some may think labral tear surgery is unnecessary. While there is some truth to this — for minor tears (SLAP Type I), non-surgical treatments such as appropriate injection therapy and rehabilitation exercise can help patients return to daily activities. Surgical consideration depends on the tear pattern, extent, patient's age, occupation, environment, degree of pain, instability, and sports/activity level.
As mentioned, minimal labral tears can improve with rehabilitation exercise alone. However, for SLAP Type II and above, using the arm inevitably causes continued irritation and damage, making SLAP repair surgery the better option. But does surgery complete the treatment? Our body is not like a machine that functions normally simply after being repaired. The shoulder joint needs to move freely in all 360 degrees, which requires not only anatomical restoration but also proper balance of muscles and the rotator cuff. The areas stressed by surgery and the reconstructed areas need to be trained for proper use — this is what rehabilitation exercise accomplishes. While minor labral tears can be treated without surgery, if conservative treatment has been prolonged or the tear has exceeded a certain threshold, surgical restoration of anatomy followed by rehabilitation exercise is essential for returning to normal shoulder function.
