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18 m a s s a g e & b o d y wo r k s e p te m b e r/o c to b e r 2 0 2 2 Exploring Cartilage Injuries TECHNIQUE By Whitney Lowe CLINICAL EXPLORATIONS It is common for clients to present with conditions outside the usual muscle-related injuries. We can often help clients with these conditions, but sometimes these problems require referral to another health- care provider. Let's look at two cartilage injuries that fall into that category. Massage may play a benefi cial role in pain management for both conditions. Yet, understanding these pathologies helps us better determine when an appropriate referral is warranted. GLENOID LABRUM INJURY The fi rst of these cartilage injuries is called a glenoid labrum injury. As the name suggests, this problem affects the glenohumeral joint, frequently described as a ball-and-socket joint. However, the glenoid fossa (the socket) is quite shallow. The labrum helps make the socket deeper and aids in joint stability. The fossa is surrounded by a rim of cartilage called the glenoid labrum. The labrum is composed of fi brocartilage, similar to that of the meniscus in the knee. It can be torn, chipped, or cracked, and blood supply is generally poor so it often takes a long time to heal when injured. The glenoid labrum is fi brously connected to the glenoid fossa but also has other important soft-tissue attachments. Along the superior margin of the shoulder joint, the tendon from the long head of the biceps brachii attaches to the supraglenoid tubercle. However, it blends into the labrum before inserting into the bone (Image 1). As a result, very high tensile loads generated by the biceps brachii muscle are transmitted to the upper margin of the labrum. When the biceps tendon experiences an immediate, strong pull, it lifts the outer rim of the labrum and can tear it away from the central portion. Often, these forces cause a tear in the superior portion of the labrum that runs from anterior to posterior (Image 2). This injury is frequently referred to as a SLAP lesion. SLAP stands for superior labrum anterior posterior, meaning the tear is in the superior portion of the labrum and running from anterior to posterior. This injury often occurs with a sudden eccentric load on the biceps, such as catching something heavy or a sudden deceleration of the throwing arm. Because the biceps brachii works to decelerate the forceful elbow extension when you throw, it contracts suddenly to stop that motion. This injury is common in athletes like baseball players, whose sport requires a lot of throwing. Biceps tendon attaching to the scapula through the labrum. Image courtesy of Complete Anatomy. 1 KEY POINT • Massage cannot repair cartilage injuries, but it can be an excellent adjunct treatment that can ease pain, help prevent further complications, and lead to overall treatment success. Biceps tendon Glenoid labrum

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