Posterior Labral Repair
Posterior Labral Repair in San Antonio, TX
If you have pain deep in the back of your shoulder when you push, bench press or block, or you feel your shoulder slip backward, the cause may be a tear in the back of your labrum. Posterior labral problems are less common than front-of-shoulder instability, but they can limit your lifting, sports and work.
Travis C. Burns, MD, a board-certified orthopedic surgeon in San Antonio, TX, evaluates shoulder pain and instability at his Medical Center, Alamo Heights and Westover Hills offices. Arthroscopic treatment of labral tears and shoulder instability is a focus of his practice, and he takes a detailed look at the cause of your symptoms so that treatment fits your shoulder and your goals.
What Is Posterior Labral Repair?
Posterior labral repair, also called a reverse Bankart repair, is surgery that reattaches a torn labrum to the back of your shoulder socket with small anchors and sutures. The labrum is a rim of cartilage that deepens the socket and helps hold the ball in place. Tears at the back of the socket may occur after a single injury, such as a fall on an outstretched arm, or from repeated stress in activities like weightlifting, blocking in football and rowing.
For the more common front-of-shoulder pattern, see Anterior Labral Repair, as well as Shoulder Labrum Tear and Shoulder Instability. For a tear at the top of the socket, see SLAP Repair.
What Are the Benefits of Posterior Labral Repair?
If you are an appropriate candidate, repair may offer potential benefits:
- Pain relief: Reattaching the labrum may reduce deep, aching pain.
- Improved stability: A secure labrum may help your shoulder feel steadier.
- Better function: Pushing and loaded activities may become more comfortable.
- Minimally invasive approach: It is often performed arthroscopically through small incisions.
- Return to activity: Many patients work toward getting back to sports and training.
Your benefits depend on your injury, the extent of the tear and your rehabilitation plan.
Who Needs Posterior Labral Repair?
You may be a candidate for repair when findings support a posterior tear and your symptoms persist despite nonsurgical care. Situations may include:
- Pain at the back of your shoulder with pushing or bench pressing
- A sense of your shoulder slipping or subluxing backward
- A posterior labral tear on MRI or MR arthrography that fits your symptoms
- Limited improvement after therapy and activity changes
- Overhead or contact sports that place repeated stress on the back of the shoulder
- Associated cartilage or capsule injury
Not every posterior tear requires surgery. Therapy that strengthens your rotator cuff and shoulder blade muscles can help many patients, and Dr. Burns can discuss which option makes sense for you.
What Does Preparation for Posterior Labral Repair Involve?
Your evaluation includes an exam of shoulder motion and stability and imaging such as X-rays and MRI, often with contrast. Your surgeon may also look at the shape of your socket, since a tilted socket can contribute to posterior instability.
Before surgery, you will receive instructions as outlined in the Preoperative Instructions. Because you will wear a sling full time for about six weeks, planning for help with daily tasks is an important part of preparation.
How Is Posterior Labral Repair Performed?
Repair is typically performed arthroscopically, as described on the Shoulder Arthroscopy page. A few small incisions are made so your surgeon can look at the labrum, cartilage and rotator cuff. The torn labrum is freed and the socket edge is prepared.
Small anchors are placed in the back of the socket, and sutures are passed through the labrum to secure it back in position. The capsule may be tightened as part of the repair. The exact technique depends on your injury and is discussed with you before surgery.
What to Expect During Recovery After Posterior Labral Repair?
Dr. Burns' posterior labral repair protocol outlines each stage of your rehabilitation.
The First Six Weeks
You will wear a sling with an external rotation brace full time for six weeks, including while you sleep, to keep your shoulder in a neutral position. You can fully bend your elbow, wrist and fingers right after surgery, and early exercises include hand squeezes, supported pendulums and shoulder shrugs. Your sutures are typically removed 10 to 14 days after surgery.
Weeks 6 to 12
After the sling is discontinued at about six weeks, therapy works toward full motion and then rotator cuff and shoulder blade strengthening. Push-ups progress gradually from the wall to a table to a chair. See the Physical Therapy Protocols and Postoperative Instructions pages.
Returning to Activity
Light weight training begins around months three to four, with limits on overhead pressing and deep bench and dip positions. Between months four and six, you progress toward swimming, running and a full weight training program, with return to sports at about six months.
What Are the Risks and Complications of Posterior Labral Repair?
As with any surgery, there are potential risks. Possible risks and complications include:
- Infection
- Stiffness or loss of motion
- Recurrent instability or pain
- Nerve or blood vessel injury
- Anchor-related problems
- Persistent weakness
- Cartilage wear over time
- Complications related to anesthesia
Your surgeon can discuss these risks and how they apply to you based on your individual condition, health and activity goals.
Why Choose Dr. Burns for Posterior Labral Repair in San Antonio, TX?
Travis C. Burns, MD is a board-certified orthopedic surgeon with subspecialty fellowship training in orthopedic sports medicine through the John A. Feagin, Jr. Sports Medicine Fellowship. His practice centers on arthroscopic surgery of the shoulder, hip and knee, which is directly relevant to labral tears and shoulder instability. He performs both arthroscopic stabilization and open procedures, including revision instability operations, so your plan can be matched to your shoulder.
Dr. Burns previously served as Chief of Sports Medicine at San Antonio Military Medical Center, where his clinical focus was complex shoulder, hip and knee injuries. He has been active in research and academic medicine, including more than 35 peer-reviewed publications. You can meet with him at the Medical Center, Alamo Heights or Westover Hills office, depending on what is most convenient for you.
Posterior Labral Repair FAQs
What is posterior labral repair?
Posterior labral repair, or reverse Bankart repair, is surgery that reattaches the torn back of your labrum to the shoulder socket, usually arthroscopically with suture anchors, to relieve pain and restore stability.
How is a posterior tear different from other labral tears?
It sits at the back of the socket. It often causes pain with pushing or a feeling of slipping backward, rather than the front-of-shoulder pattern seen in many dislocations.
Can therapy treat a posterior labral tear?
Often, yes. Strengthening your rotator cuff and shoulder blade muscles may improve your symptoms, and surgery is considered if they persist.
How long will I wear a sling?
About six weeks, full time. Dr. Burns' protocol uses a sling with an external rotation brace, including while you sleep.
Will I be able to lift weights again?
Yes, for many patients. Light weight training begins around months three to four, and a progressive weight training program follows between months four and six, though heavy pressing may be changed or limited.
When can I return to sports?
Usually at about six months, once your strength and control allow.
Posterior Labral Repair in San Antonio, TX
If you have deep pain in the back of your shoulder or a feeling of slipping, an evaluation can help determine whether your labrum is involved. Request an appointment in San Antonio with Dr. Burns at the Medical Center, Alamo Heights or Westover Hills office to discuss your posterior labral repair options. You can call (210) 705-5060 to schedule a visit.
