Bankart Lesion
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A Bankart lesion is an injury to the anterior part of the shoulder labrum. This cartilage ring forms part of the shoulder joint socket on the scapula. Injury to this cartilage is common with athletes who perform overhead activities, such as bowlers and pitchers, and those who play racket sports.
It is also a common injury after a shoulder dislocation, particularly with an anterior shoulder dislocation, where it moves excessively forward. This injury is often associated with a Hill-Sacks lesion, a dent in the head of the humerus, the ball of the shoulder joint.
There are two types of Bankart lesions:
- Soft Bankart lesion – this is the most common type, accounting for the majority of cases. There is only injury to the soft tissue, the cartilage labrum around the shoulder joint socket.
- Boney Bankart lesion – there is an injury to the soft tissue as well as fracture of the glenoid, the shoulder joint socket. This injury can lead to chronic instability of the shoulder.
Bankart Lesion Symptoms
The most common symptoms are pain and instability. Pain is usually a deep ache that is hard to pinpoint; often patients describe it as deep in the shoulder, and it will be worse with movement, especially overhead.
Clicking and catching in the joint can be felt, and some people describe locking, where they feel their shoulder gets stuck in a particular position. Instability can range from feeling like the shoulder is loose to feeling like it will dislocate and complete loss of trust in the joint.
This injury typically follows a traumatic event such as a fall and dislocation or repeated overload through sports, such as pitching, bowling, throwing, or overhead racket sports.
Bankart Lesion Assessment and Diagnosis
A physiotherapist or sports doctor can provide a clinical assessment, during which they will look at the range of motion, and patterns of pain, and perform clinical tests.
They will recommend confirmation with diagnostic imaging if a labral tear is suspected, such as a Bankart lesion. MRI is the gold standard. X-ray is limited and can only rule out bony pathology such as a fracture.
Bankart Lesion Treatment
Treatment will depend on the injury, symptoms, individual, and sporting involvement. Surgery may be advised if there are signs of instability, as it is for those returning to contact sports. Surgery involves repairing the tear of the labrum and fixing it back to the bone. Following surgery, rehabilitation will be needed and should be guided by an experienced physiotherapist to protect the repair site.
Bankart Lesion Rehabilitation Exercise
Rehabilitation for a Bankart lesion focuses on exercises to improve shoulder stability, proprioception and neuromuscular control.
This involves exercises for the muscles around the scapula (shoulder blade) and the rotator cuff muscles in weight-bearing and non-weight-bearing positions. Other exercises can be focused on the precision of control of the shoulder.
Related Articles:
Shoulder Pain Chart – Sleeping with a Frozen Shoulder – Rotator Cuff Tear
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We specialise in shoulder physiotherapy and post-operative care, with appointments available at our Fulham, South West London clinic.