SLAP tears are an injury to the soft tissues inside the shoulder joint. SLAP stands for Superior Labrum Anterior and Posterior.
SLAP Tears Anatomy
The shoulder is comprised of three bones: the upper arm bone (the humerus), the shoulder blade (scapula), and the collarbone (the clavicle).
The shoulder joint is a ball-and-socket joint, formed by the rounded head of the humerus, which sits in a socket in the shoulder blade called the glenoid. When you move your arm, the ball of the humerus rotates inside this socket.
Around the rim of the glenoid is a ring of soft tissue known as the labrum. The labrum helps to stabilize the ball of the humerus inside the glenoid socket. It also serves as an attachment point for several ligaments and tendons in the arm, including the biceps tendon. Tears to this tissue can cause looseness or instability in the shoulder joint. A SLAP tear always occurs in the tissues in the top (superior) part of the socket.
SLAP Tears Cause
Repetitive shoulder motion or acute trauma to the shoulder area can cause a SLAP tear. Injuries that could possibly tear the superior labrum include:
- A car accident
- A fall onto an outstretched arm
- Forceful pulling on the arm, such as trying to catch a heavy object
- Shoulder dislocation
- Rapid or forceful movement of the arm when it is elevated above the level of the shoulder
SLAP tears are likely to occur in athletes like weightlifters or baseball pitchers who engage in repeated overhead motions.
However, many SLAP tears are simply caused by the labrum wearing down over time. SLAP tears are more common in people over 40 and could be seen as a normal process of aging. They can occur in older adults without a history of repeated overhead shoulder movement or injury to the shoulder area.
SLAP Tears Symptoms
SLAP tear symptoms can appear superficially like symptoms of many other shoulder injuries. They include:
- Decreased range of motion
- Pain with movement or while holding the shoulder in certain positions
- A decrease in shoulder strength
- A feeling that the should is about to “pop out of joint”
- Pain with lifting objects, especially overhead
- A sensation of locking, popping, catching, or grinding
- Pitchers may notice a decrease in their throw velocity or numbness and heaviness in their arm after pitching
SLAP Tears Diagnosis
Your doctor will question you about your medical history, your symptoms, and when your symptoms began. During a physical examination, your doctor will examine your shoulder and move it into certain positions. They will also likely examine the head or neck to rule out a compressed nerve as the cause of your symptoms.
Your doctor will likely be able to determine a diagnosis through signs and symptoms, but if more confirmation is needed, X-rays and an MRI of the affected area may be ordered. An X-ray will give your doctor a clear view of your bones and potentially help them rule out other causes of your symptoms; an MRI is better able to show soft tissues like the labrum and may be able to reveal a tear in those tissues.
SLAP Tears Treatment
There are surgical and nonsurgical treatments for SLAP tears, depending on whether or not the tear occurred in conjunction with another injury, as well as the severity of the tear.
These types of treatments are able to heal the majority of SLAP tears:
- Non-steroidal anti-inflammatory medication. Drugs like ibuprofen and naproxen (Aleve) can be used to manage pain and swelling.
- Physical therapy. A physical therapist can teach you specific exercises to restore movement and strengthen the shoulder. Physical therapy may continue for 3 to 6 months while you strengthen the muscles and tissues that surround the shoulder joint. This can help relieve pain and prevent further injury.
If nonsurgical treatments aren’t effective, surgical treatment or other procedures may be necessary, such as:
- Arthroscopy. This surgical technique is most commonly used for repairing a SLAP tear. A small camera will be inserted directly above the injury. Your surgeon will use these images to guide small, pencil-like surgical instruments.
- Other repair options. There are other types of minimally invasive procedures that can be used to repair SLAP tears. The best way to repair your specific SLAP tear will be determined by your doctor after he has seen the tear arthroscopically. This may require simply removing the torn part of the labrum or replacing it with stitches. Sometimes your surgeon will be required to detach or reattach the biceps tendon.
SLAP Tears Recovery
After surgery or any other procedure, you will likely need to wear a sling for two to four weeks to keep your arm stable. Once pain and swelling have reduced to a manageable level, your doctor will start you on a physical therapy program. The results of the physical therapy program depend entirely on your dedication to it.
Though there are general guidelines, the time required for complete recovery is different for everyone. Despite it being a slow process, following your surgeon’s and physical therapist’s guidelines are key to a successful outcome.
At SPORT, we will identify the source of your pain and then utilize state-of-the-art therapeutic techniques that focus on restoring your range of motion.
Depending on the specific condition and its severity, these treatment options may include physical therapy, over-the-counter anti-inflammatory medication, slings and supports, cortisone shots, or shoulder or elbow surgery.
If you have an acute or chronic shoulder or elbow injury that needs medical attention, call SPORT at (469) 200-2832 to arrange a consultation or you can request one online. Hurt today? We can arrange a same-day urgent care visit to ensure you get fast, effective relief.