Jace Amaro’s shoulder pain and range of motion has not improved since he suffered a torn labrum (cushion of cartilage) during the Jets’ pre-season opener against the Lions on August 13th. The hope was that Amaro’s pain would diminish enough to be able to play this season. Unfortunately, his pain and motion did not improve and Amaro will undergo arthroscopic shoulder surgery to repair his labrum in the near future.
The typical term for labral tears in the shoulder is SLAP tear (Superior Labrum from Anterior to Posterior tear). These tears occur as a result of direct trauma, fall on an outstretched arm, or severe traction to the arm. They also occur in repetitive overhead activities. The vulnerable point is the superior (upper) labrum attachment where the biceps tendon anchor exist on top of the glenoid (socket bone).
In throwers (which Amaro is not), the theory is that the tear is a result of a tight ligament in the back of the shoulder. This increases the sheer forces in the joint upon the superior labrum. A SLAP tear may often cause strain on the anterior (front) shoulder ligaments and, as a result, cause instability of the shoulder.
Recreational or professional athletes that suffer a SLAP tear will experience pain, weakness, clicking and, possibly, limited range of motion in the shoulder. Commonly, the symptoms present a few weeks after the inciting event if it is related to weight lifting or repetitive overhead activities. Many players experience a decrease in athletic performance.
SLAP tears are categorized in to 7 (seven) different types of tears based on their pattern of tearing, degree of involvement of the biceps tendon anchor, and extension into other stabilizing structures in the shoulder joint.
The most common type of tear that leads to arthroscopic repair is a Type 2 which is a compromise in the biceps anchor.
Initial treatment is usually physical therapy and anti-inflammatory medication. If symptoms do not improve then shoulder arthroscopic surgery is often performed. During the arthroscopic surgery, and depending upon the type of tear, degree of involvement with the biceps tendon, and extension of the tear into other structures, the orthopedic surgeon may choose to:
- repair the labrum
- debride (clean up) the labrum
- and/or stabilize the biceps tendon to another part of the bone (biceps tenodesis)
Recreational throwers and professional throwing athletes often have excellent results after such a repair. All professional throwing athletes, however, do not always have success in returning to the same level of performance as prior to the surgery. Amaro’s prognosis is, actually, excellent though, since he is not a thrower. Therefore, we should expect Jace Amaro to return ready to go next season.