Jace Amaro: Recovering from a Labral Tear

Jace Amaro was recently placed on the IR with a torn shoulder labrum. This primer looks into what a labrum is and his road to recovery.

What is the labrum?

The shoulder labrum is cartilage that surrounds the glenoid fossa (aka the arm socket). It functions to stabilize the glenohumeral joint (aka the shoulder joint) and deepen the socket so the humerus (the arm bone) fits better in the socket to move smoothly. Several ligaments attach at the labrum thus making the labrum crucial for stability in the shoulder. The stability of the shoulder is very important for a tight end especially when he is trying to fend off a safety with a stiff arm or making sure the force from the tackle does not injure the ligaments or muscles around the shoulder complex.

The two most common labral tears are SLAP tears and Bankart Lesions. SLAP stands for superior labrum anterior to posterior, meaning that tear extends from the front part (anterior) of the shoulder capsule towards the back part (posterior) of the capsule. Common ways to get a SLAP tear is through repetitive throwing motions and trying to brace your fall by extending your hand out (PSA: never do this! Tuck your arms in and try to roll). On the other hand, Bankart lesions indicate that only the anterior portion of the labrum has torn; these lesions are usually associated with dislocated shoulders. Traumatic force can result in either of these types of labral tears or other less common labral tears. I am not sure the type of tear Amaro has suffered but it will not affect his status for this season or whether he will be ready for next season.

Why is Amaro out for the season?

The typical recovery time for a labral tear is about 6 months before the shoulder is back to 100%.  After the surgery, the shoulder is immobilized via a sling for the first few weeks as the injured tissue begins healing. The initial phase of the recovery process is to minimize the muscle atrophy/weakening as a result from disuse. Exercises will be prescribed to move the shoulder in a pain-free range so the joint does not stiffen up; adhesive capsulitis (aka frozen shoulder) may occur as result from increased stiffness and that could extend the recovery process by several months. You must make sure the elbow does not stiffen up as well since the sling holds the elbow in a certain position for a prolonged period of time.

The first month of recovery primarily revolves around reducing the swelling and preserving as much strength and range of motion as possible until you can start using your arm again. At about the 6 week mark, the patient can begin strengthening the muscle and stretching the shoulder capsule. In addition, the patient can try to use the operated arm for normal daily activities. Throughout the whole recovery process, the doctor will place restrictions on the patient to assure the injured tissues are healing properly; these precautions slowly reduce as the rehab process progresses and the patient is beginning to resuming their normal activities before the surgery.

The recovery protocols begin to differ a little between SLAP tear vs. Bankart lesions after the initial first few weeks. After a SLAP repair, full range of motion should be regained around the 12 week mark. Exercises are focused on maintaining this full range of motion and strengthening the muscles of the shoulder and elbow. Return to sport will not happen until 4-5 months after the surgery and a brace may be worn initially to protect the newly healed labrum. Bankart repairs take a little more time for full recovery. Full range of motion will not be regained until about 5 months after the surgery and the player will not return to sport until the 7th month mark (also initially wearing the shoulder brace). Regardless of the procedure, being 100% back on the field may take up to 9-12 months as the conditioning and endurance level of the athlete has dramatically decreased from the inactivity.