Shoulder Labral Tear / SLAP Tear
SLAP tears are a type of shoulder injury. The shoulder labrum is a ring of cartilage that surrounds the shoulder socket and helps to keep the ball (the head of the upper arm bone) in its socket on the shoulder blade. A SLAP tear is a tear of the labral cartilage on the top front area where the biceps tendon attaches to the labrum. Consequently, a labrum tear may also involve a tear of the biceps tendon.
What causes a SLAP tear?
An acute SLAP tear can be sustained from a single traumatic event such as a fall on an outstretched arm or a shoulder dislocation and can injure other shoulder tissues like the rotator cuff. Chronic SLAP tears commonly affect athletes who perform repetitive overhead motions, such as those often seen in tennis, volleyball, baseball, and weightlifting.
What are the symptoms of a SLAP tear?
Patients with SLAP tears often complain of vague, deep shoulder pain during overhead motions and may have a sensation of popping, clicking, or catching. Other symptoms include decreased shoulder strength and range of motion. SLAP lesions can result in “dead arm syndrome” which is paralyzing pain experienced during throwing activities, such that the patient is unable to perform a throwing motion with control and speed.
How is a SLAP tear diagnosed?
Dr. Harrison will review your medical history, ask about the symptoms you are experiencing, and when they began. He will perform an orthopedic examination testing strength, range of motion, and checking for signs of instability or weakness. He will use special tests to help diagnose a SLAP tear and rule out other causes of your pain. Additionally he may order imaging studies to aid in diagnosis including x-rays to check the bones, and an MRI to evaluate soft tissues including the labrum.
What are the treatment options for a SLAP tear?
A course of nonoperative management is often the initial approach to treating a SLAP tear. This will include rest, activity modification, NSAIDs anti-inflammatory medication, and steroid injections for physical therapy or for diagnosis. Overall, nonoperative management can be successful in athletes with SLAP tears, especially when the athlete completes their rehabilitation program before attempting to return to play.
When conservative management fails to relieve pain, surgery may be recommended. SLAP surgery may be performed arthroscopically or as open surgery. Arthroscopic surgery involves insertion of an arthroscope, a small thin lighted tube with a camera attached, into the shoulder through tiny incisions, to view the inside of the shoulder joint.
Images are displayed on a video screen and Dr. Harrison can guide tiny surgical instruments to repair the labrum. Arthroscopic surgery is minimally invasive which means there is less damage to surrounding tissues, less pain and bleeding, and quicker recovery.
There are several surgical procedures to treat SLAP tears. Dr. Harrison will determine the best procedure for you based on what he finds inside the shoulder joint. It may involve simply removing torn labral tissues (debridement) or reattaching the torn labrum with sutures (repair). Sometimes it can involve releasing the biceps tendon attachment to relieve pain (biceps tenodesis).
After surgery you will wear a sling for up to six weeks to protect the shoulder and prevent movement while you heal. Rehabilitation to restore range of movement and strength will begin when pain and swelling have resolved. Return to play can take 3-4 months.
Dr. Harrison is a board-certified fellowship trained orthopedic and sports medicine surgeon who specializes in arthroscopic knee and shoulder surgery. He is the Head Team Physician for the United States Alpine Ski Team and the Head Team Physician for Weber State University for over 20 years. Dr. Harrison completed his undergraduate degree at Baylor University and received his medical degree from the University of Arizona College of Medicine. He completed his orthopedic residency at the University of Utah followed by a fellowship in sports medicine at the Cincinnati Sports Medicine and Orthopedic Center. He finished his formal training with an additional AO Trauma Fellowship in Bern, Switzerland.
At a Glance
Dr. Jeffrey Harrison
- Board-Certified, Fellowship-Trained Orthopedic Surgeon
- Head Team Physician US Women's Alpine Team and Weber State University
- Performs over 800 surgeries per year
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