IC 02-2026-The Dark Side of the Glenoid: A Case-Based Approach to Biceps, Labral and Shoulder Dysfunction in the Overhead Athlete-IC 02-2026-The Dark Side of the Glenoid: A Case-Based Approach to Biceps, Labral and Shoulder Dysfunction in the Overhead Athlete

IC 02-2026-The Dark Side of the Glenoid: A Case-Based Approach to Biceps, Labral and Shoulder Dysfunction in the Overhead Athlete

Back to course

Video Transcription

Video Summary

The discussion centered on shoulder dysfunction with a focus on the posterior glenoid labrum, especially in overhead and military athletes. Presenters emphasized that the labrum is not just a passive structure: the superior labrum and biceps form a mobile “organ of tension,” while the anterior and posterior labrum act as static bumpers that stabilize the humeral head. The “ripstop” region around the 10 o’clock position was highlighted as a critical transition zone that must be preserved to maintain biceps function and shoulder stability.<br /><br />A recurring theme was that many injuries labeled as SLAP tears are actually posterior or combined posterior-superior labral injuries, often related to internal impingement, scapular dyskinesis, and repetitive overhead motion. Clinically, these can present as anterior shoulder pain despite posterior pathology, leading to frequent misdiagnosis and inappropriate treatment such as over-tight SLAP repair or premature biceps tenodesis.<br /><br />Case examples illustrated that in overhead athletes, the goal is usually to restore posterior labral anatomy without over-constraining the biceps or capsule. Speakers stressed that repairs should respect anatomy, avoid excessive capsular imbrication, and preserve motion. Several panelists argued that traditional SLAP repair often alters shoulder kinematics unfavorably, while biceps tenodesis can also change stability and is not always the best solution in throwers.<br /><br />The final talk shifted to military athletes, who face unavoidable overhead and load-bearing demands and often cannot fully rest. Because “return to duty” is not the same as “return to function,” the speaker advocated more aggressive treatment when appropriate and a milestone-based functional testing approach rather than time alone for clearance.

Keywords

posterior glenoid labrum

shoulder dysfunction

overhead athletes

military athletes

SLAP tears

biceps tenodesis

internal impingement

scapular dyskinesis

labral repair

return to duty