A SLAP tear is a specific type of injury that affects the shoulder joint. SLAP stands for Superior Labrum Anterior to Posterior, and refers to a tear in the top part of the labrum that surrounds the shoulder socket. The labrum is a fibrous ring of cartilage that helps to keep the ball of the upper arm bone (humerus) in place within the socket. The long head of the biceps tendon attaches to the top of the labrum and can be involved in a SLAP tear.
Causes and Symptoms
SLAP tears are commonly seen in athletes who engage in activities that require repetitive overhead motions, such as baseball, tennis, and swimming. They can also be caused by traumatic injuries, such as a fall onto an outstretched arm or forceful pulling of the arm. Degenerative changes in the labrum and biceps tendon attachment can also lead to a SLAP tear, particularly in older adults.
The symptoms of a SLAP tear can include shoulder pain, especially with overhead activities or when the biceps muscle is used, a sense of instability or catching in the shoulder joint, and limited range of motion. However, it is important to note that not all SLAP tears cause symptoms, and many people with SLAP tears may not even be aware they have an injury.
Treatment Options
Treatment for a SLAP tear depends on the severity of the tear and the individual’s activity level and goals. Conservative treatment options include rest, activity modification, pain management, and physical therapy to improve shoulder strength and range of motion. In some cases, corticosteroid injections may be used to reduce inflammation and pain. Surgery may be considered for more severe or symptomatic tears, particularly in athletes or those with high shoulder demand lifestyles.
Surgical options for SLAP tears include arthroscopic repair, biceps tenotomy (cutting of the biceps tendon), or biceps tenodesis (moving the biceps tendon to a new location outside of the shoulder). Arthroscopic repair involves using small instruments and a camera to visualize and repair the torn labrum. Biceps tenotomy or tenodesis can be performed alone or in conjunction with labral repair, depending on the extent of the injury and the patient’s goals.
Postoperative Care and Recovery
Following surgery for a SLAP tear, patients typically wear a sling for 4-6 weeks to protect the repair and allow for healing. Active range of motion exercises are typically started after 4-6 weeks, with a focus on gradually increasing shoulder mobility without putting stress on the repaired labrum. Strengthening exercises can be started after 12 weeks, with a gradual return to activities over the next few months. It can take up to 6 months for a full recovery after SLAP repair surgery.
It is important for patients to follow their surgeon’s postoperative instructions carefully, including avoiding certain activities and adhering to any physical therapy recommendations. While SLAP repair surgery can be effective in reducing symptoms and improving shoulder function, it is not a guarantee of a completely pain-free or invulnerable shoulder. Patients may need to make lifestyle modifications and continue with shoulder strengthening exercises to prevent future shoulder injuries.
