Anatomy of the Shoulder
The shoulder is a ball-and-socket joint, where the humeral head (ball) fits into the glenoid (socket) of the shoulder blade (scapula). The joint capsule, a fibrous tissue surrounding the shoulder joint, plays a crucial role in stability and movement. It is reinforced by ligaments and works alongside the labrum, rotator cuff, and other soft tissues to keep the shoulder properly aligned. Capsular tears occur when this structure is stretched, weakened, or torn, often leading to instability and pain.
Causes for Shoulder Capsular Tear
A shoulder capsular tear can result from:
- Traumatic injury (e.g., shoulder dislocation or subluxation)
- Repetitive overhead motions (e.g., throwing, swimming, weightlifting)
- Excessive stretching or sudden force applied to the shoulder joint
- Underlying shoulder instability from ligamentous laxity or previous injuries
Capsular tears can lead to shoulder instability, making the joint prone to further dislocations or subluxations, particularly in athletes and individuals with hypermobility.
Symptoms of Shoulder Capsular Tears
- Pain deep in the shoulder joint
- A sensation of looseness or instability
- Clicking, popping, or grinding with movement
- Decreased range of motion
- Weakness, especially in overhead or pushing motions
Treatments for Shoulder Capsular Tears
Non-Surgical Treatment:
- Rest and activity modification to prevent further strain
- Anti-inflammatory medications for pain relief
- Physical therapy focused on strengthening the rotator cuff and scapular stabilizers to improve joint stability
- Bracing in cases of mild instability
Surgical Treatment:
If conservative treatment fails, arthroscopic capsular repair may be required. This procedure involves tightening and reinforcing the capsule with sutures or anchors and addressing any associated labral tears or ligament damage.
Postoperative Care for Shoulder Capsular Tears
Following surgery, a shoulder sling is typically worn for 3-6 weeks to allow healing. Physical therapy is gradually introduced to restore range of motion, strengthen the shoulder, and prevent stiffness. Full recovery can take several months, with a gradual return to sports or strenuous activities.
