SLAP Tear Overview
The shoulder is defined as a ball-and-socket joint that is responsible for providing a smooth gliding surface when the arm is placed in motion. The labrum is an important structure within the shoulder joint and acts as an attachment site for various ligaments and tendons, including the biceps tendon. It is also responsible for deepening the shoulder socket so the joint is able to remain in the correct position. When the labrum becomes injured and involves the biceps tendon, a SLAP tear may be the outcome. Active individuals living in the Dallas, Frisco and Fort Worth, Texas communities can depend on the shoulder specialists at Texas Sports Medicine to properly diagnose and treat a SLAP tear so a full return to activities is accomplished.
What is a SLAP Tear?
A SLAP (Superior Labrum Anterior to Posterior) tear is a specific type of labral tear. This tear is located at the top (superior) of the shoulder socket and involves the biceps tendon attachment site. A SLAP tear occurs in both the front (anterior) and back (posterior) of the attachment site.
Injuries to the superior labrum are commonly caused by repetitive shoulder motions, an acute traumatic event or the natural aging process.
Common traumatic events include a fall onto an outstretched arm, a shoulder dislocation, forceful or rapid movements of the arm when it is above shoulder level and forceful pulling of the arm. Athletes who participate in overhead activities, such as throwing sports, are prone to SLAP tears because of the repeated stress placed on the shoulder joint during the throwing motion. Older adults over the age of 40 years may experience a SLAP tear from the natural degeneration of the labrum that occurs with aging.
SLAP Tear Symptoms
- Pain with certain movements and when lifting, especially overhead
- Pain when holding the shoulder in certain positions
- A locking, popping, grinding or catching sensation
- Decrease in joint strength and range of motion
- A sensation the joint may “pop out” of socket
SLAP Tear Treatment
Nonoperative
- Rest
- Stop shoulder activities that cause symptoms
- Modify activities
- Change daily and work activities that cause discomfort
- Medications
- Take non-steroidal anti-inflammatory (NSAID) medications to help reduce pain and swelling
- Physical therapy
- Flexibility, strengthening and range of motion exercises will be prescribed to help stretch the affected shoulder capsule and strengthen the muscles that support the joint
Operative
- Debridement
- Surgical technique: Typically used for minor tears, torn or frayed labrum portions are trimmed away so a smooth edge is present in order to eliminate irritation and catching.
- Labral repair
- Surgical technique: Involves the use of bio-absorbable suture anchors imbedded in the edge of the glenoid. These sutures are placed through the labrum then snugly tied, securing the torn labrum back to the glenoid rim.
- Biceps tenodesis
- Surgical technique: Recommended for patients with significant tearing or degeneration of the biceps tendon. The biceps tendon is released from its attachment site inside the shoulder joint and then reattached to the upper arm bone.
After Surgery
- Affected arm is placed in a sling for up to 6 weeks
- Physical therapy focused on flexibility and strengthening will be prescribed when pain and swelling decrease
- Sport specific exercises will begin at 3-4 months
- Return to play is usually 6 months
For additional resources on a SLAP tear, please contact the Dallas, Frisco and Fort Worth, Texas area shoulder specialists at Texas Sports Medicine.