The labrum supports the ball-and-socket joint as well as tendons and muscles in the shoulder. When it's torn, partial or complete shoulder dislocation is the result.
In 2019, swimmer Shane Ryan began to notice some wear and tear on the shoulder, in spite of keeping up with all the rehab. Tokyo 2020 was around the corner and Ryan was determined to compete at a second Olympics.
And then Covid came. For the American-turned-Irish competitor, the delay did not lessen his determination to be on the starting blocks come July 2021. And through the pain barrier, Ryan, while unable to compete in his signature event - the 100m backstroke - still set an Irish record in the 100m fly. He was also part of the 800m freestyle team in Tokyo
In December of last year came the "big surgery".
Speaking to RTÉ Sport ahead at the Olympic Federation of Ireland's inaugural Make A Difference Athletes’ Fund Golf Tournament at The K Club, the 28-year-explained the procedure: "I got my labrum all patched up, so I got seven suture anchors around my whole shoulder. Then they ended up cutting my bicep and sowing it to the bone. It takes about four years to fully recover from that type of surgery, so as things stand now we're ahead of schedule."
In August, Ryan competed at the European Championships. He was glad to be back in the pool, but thankful for the backing from key stakeholders in ensuring that he still has one key goal to aim at.
"I have had great support from Sport Ireland and the Irish Olympic Council; they've been very good throughout everything. Once we get this shoulder sorted we'll be absolutely fine.
"I got to compete in the Europeans only eight months after the surgery. I did okay there; a lot of positives to come out of that meet. I'm back training now but you have to look at it as a long-term gain. What we're looking at now is Paris - and competing at my third Olympics.
Ryan did make the semi-finals of the 50m backstroke at the recent Europeans, but he had to pull out of the 100m backstroke - the reasons were obvious
"Because of how aggressive the stroke is on the backstroke in that you have to come all the way up, turn your whole shoulder and then press down, there was a lot of grinding and popping of the shoulder. You have to protect the integrity of it.
"I was okay in sprint events but that back end of the 100, that last 15, I just didn't have the fitness, the shoulder just couldn't handle it. The 100 back is my bread and butter but there is a long-term gain and we had to protect the shoulder."
Rehab has gone well for Ryan - a period where he was able to return to the States and see his family. Back on these shores he would spend four hours a day rehabbing at the Sport Institute over the course of five months.
"Things are progressing well with Paris in mind," he added.
The points in the calendar are already marked out for the 28-year-old.
"We're gearing up for Irish short course in December, then we got the worlds next summer, as well as meets all the year round. We have worlds again in January 2024. April (2024) are the Olympic trials, so we have three major events to get the qualifying times. For me it's about being consistent in my approach - showing up in the water every day, doing my rehab, sleeping well, eating well, all those little things."
For Ryan, a third Olympic appearance is all about going that extra step - and maybe prioritising a different event.
"I'm definitely capable of reaching a final," he predicted.
"In Tokyo I was able to make semi-finals even with a bum shoulder. I have put myself through a lot of pain and pressure to get the shoulder fixed. Now have that good shoulder again. So, how fast can I really be now? I wake up every morning now and I say 'Wow, let's see how far we can push this'.
"I've beaten some of the best in the world in short course events. It's now about showing up and doing my job at the Olympics. I can swim in multiple events - I currently hold 17 Irish senior records - that's in freestyle and butterfly. Coming up to Tokyo I was only .1 [of a second] off the A standard in the 100 free.
"If I focus more on the free, that could be my main event. In Tokyo I swam the 100 fly, not my normal event, and was .8, .9 off the A standard.
"If I work on that there could be a lot of potential there. The 100 backstroke is my main event, but I think we could be looking at the 100 fly - think there is untapped potential there.
Looking further down the road, there is Los Angeles 2028 - and Ryan would like to have some involvement at a Games in the land of his birth.
"I would love to go but my mindset is I want to be there regardless, because I genuinely care about the sport. If I don't go as an athlete I could potentially go as a coach. I have so much knowledge, I love teaching kids, I genuinely care about the future of the sport.
"To see the Olympics from another side and to work with decent group of younger swimmers coming through would be great."
