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Health condition

Labral tear in the shoulder, from SLAP and Bankart lesions to arthroscopic repair.

A tear of the glenoid labrum can cause deep pain, clicking and instability. Diagnosis is clinical plus MRI arthrogram, and treatment is stepped from rehab to arthroscopic repair or Latarjet.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against BESS, BOA and peer-reviewed shoulder-surgery sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance on arthroscopic Bankart repair, SLAP repair and the Latarjet procedure.

Key facts

Shoulder labral tears at a glance.

The essentials, in plain English. What the labrum is, the tear patterns that matter, and how UK shoulder specialists treat them.

  • What it is

    A tear of the glenoid labrum, the fibrocartilage rim that deepens the shoulder socket and stabilises the joint.

  • Main patterns

    SLAP lesions at the top of the labrum, Bankart lesions at the anteroinferior labrum, and posterior or HAGL variants.

  • Who gets them

    Overhead athletes and throwers commonly develop SLAP tears; young patients after a first anterior dislocation often carry a Bankart lesion.

  • How it is diagnosed

    A specialist musculoskeletal clinical examination together with an MRI arthrogram, the gold-standard imaging test.

  • Foundation therapy

    Structured physiotherapy and rotator-cuff strengthening under a specialist musculoskeletal shoulder team.

  • Surgical options

    Arthroscopic labral repair, the Latarjet procedure for bone loss, and biceps tenodesis for symptomatic SLAP tears.

Why this guide matters

A stepped plan, not a hurried operation.

Labral tears sit at the crossroads of sports medicine and shoulder surgery. Getting the pattern right, and matching the operation to the pattern, is what changes outcomes.

  • The pattern dictates the plan

    SLAP, Bankart, bony Bankart, reverse Bankart and HAGL variants each behave differently and each demand a different operation.

  • Imaging is more than a scan

    An MRI arthrogram, commissioned by a specialist commissioned shoulder team, remains the gold-standard investigation.

  • Rehab does most of the work

    Even after surgery, months of structured specialist musculoskeletal shoulder physiotherapy do more for the outcome than the operation alone.

How the diagnosis is made

From first dislocation to a clear plan.

The steps a UK specialist musculoskeletal shoulder team will normally follow, so you know what to expect and why each one matters.

  1. 01

    Assessing

    History and mechanism

    The story matters. A dislocation, a throwing injury or repetitive overhead load each points to a different labral pattern.

  2. 02

    Assessing

    Red-flag screen

    Neurovascular symptoms, locking, recurrent dislocation or a first traumatic dislocation in a young patient warrant urgent specialist review.

  3. 03

    Assessing

    Targeted examination

    Apprehension and relocation tests for anterior instability, and the O’Brien active-compression test for SLAP lesions.

  4. 04

    Confirming

    Plain radiographs

    Standard shoulder views to look for a bony Bankart, Hill-Sachs impression or glenoid bone loss after dislocation.

  5. 05

    Confirming

    MRI arthrogram

    The gold-standard test for labral pathology, commissioned by a specialist commissioned shoulder team. See our guide to the MRI arthrogram.

  6. 06

    Preparing

    Diagnostic arthroscopy

    When imaging is equivocal, arthroscopy is both diagnostic and therapeutic in specialist commissioned hands.

  7. 07

    Preparing

    Shoulder MDT planning

    Complex or recurrent cases are reviewed by a specialist commissioned shoulder multidisciplinary team before surgery is planned.

Typical timeline: a first specialist visit to a settled plan in a matter of weeks.

Symptoms

What a labral tear actually feels like.

The classic mix of deep pain, clicking and instability, plus the features that mean it is time to see a specialist musculoskeletal shoulder team.

  • Deep shoulder pain

    Often felt deep inside the joint and worse with overhead activity, lifting or lying on the affected side.

  • Clicking and catching

    A mechanical click, clunk or catch during rotation is a classic labral symptom, especially with SLAP tears.

  • Instability and apprehension

    A feeling that the shoulder is about to slip out, particularly in the abducted and externally rotated position.

  • Recurrent dislocation

    Repeated anterior dislocations after a first traumatic event suggest a Bankart or bony Bankart lesion.

  • Biceps-groove pain

    Pain over the bicipital groove with resisted flexion is common in SLAP lesions involving the biceps anchor.

  • Loss of overhead power

    Throwers and swimmers often notice a drop in velocity or endurance before frank pain sets in.

  • Reduced range of movement

    Guarded external rotation, painful cross-body adduction and difficulty reaching behind the back are common.

  • Red flag – acute dislocation

    A first traumatic anterior dislocation in a young patient carries a very high risk of recurrence and a Bankart lesion.

Treatment

How labral tears are treated in the UK.

Rehabilitation and selective injections first, then arthroscopic labral repair, the Latarjet procedure or biceps tenodesis in a specialist commissioned shoulder unit when needed.

  • Structured physiotherapy

    Rotator-cuff and scapular strengthening under a specialist musculoskeletal shoulder physiotherapist. See our spinal and musculoskeletal physiotherapy guide.

  • NSAIDs and analgesia

    Short courses of anti-inflammatories and simple analgesia to control pain while rehabilitation progresses.

  • Selective steroid injection

    An image-guided steroid injection can settle a painful shoulder enough to rehabilitate. See our guide to the steroid injection.

  • Arthroscopic Bankart repair

    Keyhole reattachment of the anteroinferior labrum for recurrent anterior instability. See our Bankart repair guide.

  • Arthroscopic SLAP repair

    Suture-anchor repair of a symptomatic SLAP lesion in younger overhead athletes. See our SLAP repair guide.

  • Latarjet procedure

    Coracoid transfer for anterior instability with significant glenoid bone loss. See our Latarjet procedure guide.

  • Bone-block reconstruction

    An alternative bone-graft option in a specialist commissioned shoulder unit when a Latarjet is not suitable.

  • Biceps tenodesis

    A specialist commissioned option for older patients with a symptomatic SLAP tear, moving the biceps anchor out of the joint.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist shoulder society standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or shoulder specialist knows your history and imaging and can tell you which parts apply to you. If in doubt, get seen.

  • British Elbow and Shoulder Society (BESS). Patient care pathways for shoulder instability.

  • British Orthopaedic Association (BOA) BOAST standards on shoulder trauma.

  • NICE. Clinical Knowledge Summaries on shoulder pain and instability.

  • Royal College of Radiologists. Guidance on MRI arthrography of the shoulder.

Red flags

When a shoulder needs urgent attention.

Most labral tears can be worked up in a planned way, but a handful of situations need a rapid specialist commissioned shoulder opinion.

  • First traumatic dislocation

    A first anterior dislocation in a young patient has a high recurrence rate and should trigger early specialist commissioned review.

  • Recurrent instability

    Repeated dislocations or subluxations, especially in daily activities, warrant early surgical assessment.

  • Locked or irreducible shoulder

    A shoulder that will not relocate, or that locks, needs urgent emergency-department review.

  • Neurovascular symptoms

    Numbness, weakness or vascular change after dislocation raises concern for axillary nerve or vessel injury and needs urgent care.

  • Significant bone loss

    Glenoid or humeral bone loss on imaging changes the operation and needs a specialist commissioned shoulder opinion.

  • HAGL and RHAGL lesions

    Humeral avulsion of the glenohumeral ligament, including the Bill variant, is often missed on standard imaging and needs specialist input.

  • Posterior instability

    Reverse Bankart lesions from posterior dislocation, seizures or electric shock are easily missed and benefit from specialist assessment.

  • Persistent pain despite rehab

    Symptoms that fail to settle after a properly delivered specialist musculoskeletal shoulder programme deserve re-imaging.

  • Overhead athlete with dropping velocity

    A thrower losing speed or endurance before pain fully develops is a soft red flag for a SLAP lesion.

Living with it

A treatable injury, with a clear ladder.

Four things make the biggest difference day to day. Trusting the rehabilitation, returning to sport in stages, knowing when to escalate, and being patient with your shoulder.

A quiet reminder

Consistency beats intensity, every time.

Small, steady sessions kept up for months do more than a heroic week that leaves the shoulder swollen and sore.

  1. 01 Rehab

    Trust the programme

    Labral rehabilitation is a months-long process, not weeks. Consistent, progressive loading is what rebuilds a stable shoulder.

  2. 02 Sport

    Return to play gradually

    Contact sports and overhead throwing come back last, and only after strength, range and control have been formally re-tested.

  3. 03 Surgery

    Know when to escalate

    Recurrent instability, bone loss or a symptomatic SLAP tear in a thrower are the classic triggers for a surgical conversation.

  4. 04 Mindset

    Patience beats bravado

    The shoulders that do best are the ones whose owners stick to the plan, even when it feels slow.

Frequently asked

Everything we get asked about labral tears.

Quick answers on SLAP and Bankart lesions, MRI arthrogram, arthroscopic repair, Latarjet and recovery timelines.

  • What is a labral tear in the shoulder?

    A tear of the glenoid labrum, the fibrocartilage rim around the shoulder socket. It can affect the top of the labrum (a SLAP lesion), the front (a Bankart lesion), the back (a reverse Bankart) or involve the glenohumeral ligaments (HAGL and RHAGL, including the Bill variant).

  • How is a shoulder labral tear diagnosed?

    By combining a careful history, a targeted specialist musculoskeletal examination using the apprehension, relocation and O’Brien tests, and imaging. An MRI arthrogram is the gold-standard test, and diagnostic arthroscopy is used in a specialist commissioned unit when the picture remains unclear.

  • Do all labral tears need surgery?

    No. Many tears settle with a structured programme of physiotherapy, rotator-cuff and scapular strengthening, activity modification and, when appropriate, a selective steroid injection. Surgery is reserved for recurrent instability, significant bone loss or a symptomatic SLAP tear in an overhead athlete.

  • What operation is used for a Bankart lesion?

    Most Bankart tears are repaired arthroscopically using suture anchors to reattach the labrum to the front of the glenoid. When there is significant glenoid bone loss, a Latarjet procedure or a bone-block reconstruction is preferred in a specialist commissioned shoulder unit.

  • How is a SLAP tear managed?

    Younger overhead athletes with a symptomatic SLAP lesion usually undergo arthroscopic SLAP repair. In older patients, or when the biceps anchor is degenerate, a biceps tenodesis is a specialist commissioned alternative that gives reliable pain relief.

  • How long is recovery after arthroscopic labral repair?

    A typical timeline is a sling for around four to six weeks, progressive physiotherapy from the outset, return to non-contact activity by three to four months and a return to contact sport or full overhead throwing between six and nine months, guided by objective strength and range testing.

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