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SLAP Tear

SLAP is an acronym that stands for Superior Labral Tear from Anterior to Posterior. A SLAP tear is also referred to as a labral Tear or SLAP Lesion. It is an injury to the labrum of the shoulder. As we know, the shoulder is a ball and socket joint. The labrum is a cartilage lining around the socket of the shoulder. The labrum helps to deepen the socket and stabilize the shoulder joint. SLAP lesion is a damage to the top of the labrum, or where the biceps tendon connects to the labrum. A SLAP tear occurs both in front (anterior) and back (posterior) of this attachment. Depending on the type of injury, the SLAP tears are classified into several types:

Front view of shoulder joint showing SLAP lesion

Types of SLAP Tear

There are several types of Slap Tears:

Type 1 SLAP Tear

Involves isolated fraying of the labrum, but it is still attached to the Glenoid. Generally, does not show any symptoms. It is said that most of the people have a Type 1 SLAP tear that they would not know of.

Type 2 SLAP Tear

This is the most common type of SLAP Tear. Involves detachment of labrum from the Glenoid causing instability of the biceps-labral anchor. They can be further classified as anterior, posterior or a blend of the two.

Type 3 SLAP Tear

Involves bucket-handle tear of the labrum. Biceps anchor are attached. Labrum droops into the shoulder joint. Often treated with Arthroscopy

Type 4 SLAP Tear

This is again a bucket-handle tear of the labrum however it extends upto the biceps tendon in varying degrees. It also involves instability of the biceps-labrum anchor. Depending on the extent of biceps tendon involved, treatment options are selected.

Causes of SLAP Tear

SLAP tears are generally caused by repeated motions or acute trauma. Athletes have high chances of getting a SLAP tear. The main causes are:

Due to an injury – fall or sudden force
Wear and tear due to age
Repeated overhead motions like in volleyball, swimming
Lifting heavy objects too often or suddenly

 

Symptoms of SLAP Lesion

Pain with specific movements of shoulder.
Decreased strength in the shoulder
Limited range of motion
Popping, clicking or catching sensation in the shoulder
Inflammation in the shoulder

 

Diagnosing a shoulder labral tear

A Shoulder Specialist will evaluate the patient’s medical history which includes discussing the symptoms, current occupation, previous treatments, medications etc. Evaluating medical history of the patient along with physical examination plays a very important and intricate part of diagnosing the problem. In many cases, doctor diagnoses the problem based on medical history and physical examination which is then validated using x-rays or imaging technologies.

Treatment of SLAP Tear

Like other shoulder conditions, treatment starts with the following standard non-surgical methods:

Non-steroidal anti-inflammatory medications
Physical Therapy
If the symptoms persist even after taking standard non-surgical treatment for a considerable period of time, based on the case a surgery will be recommended.

Surgical Treatment

Arthroscopy

The technique commonly used to correct a SLAP tear is shoulder arthroscopy where very small incisions are made in the shoulder. Best repair option through arthroscopy is determined depending on the type of SLAP tear a patient has.

Rehabilitation

Depending on the severity of the SLAP injury, a sling will be recommended for a particular duration. Once the pain and swelling subsides, doctor will recommend customized physical therapy sessions. The aim is to regain the strength of the shoulder and resume normal shoulder functions.

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