What is a SLAP tear?
The labrum is a ring of strong, fibrous tissue or cartilage, that lines and supports the ball and socket of the shoulder joint. The humeral head, or ball, of the shoulder joint is much larger than the glenoid socket, which creates instability. The surrounding labrum serves as a bumper to provide additional stability, and is the attachment site to important ligaments. The biceps tendon also attaches to the top of the labrum.
A SLAP tear occurs in the top (superior), the front (anterior) and back (posterior) of the point where the biceps tendon attaches to the labrum. The term SLAP is an acronym for Superior Labrum Anterior and Posterior.
What causes a SLAP tear?
A SLAP tear can occur from trauma or from overuse. Athletes involved in sports that require repetitive overhead activities are particularly vulnerable to develop this condition. Motor vehicle accidents, falling on an outstretched arm, or forceful pulling on the arm can also cause a labral tear. Shoulder dislocations can also cause a tear, often to the front (anterior) or back (posterior) of this structure. Chronic degenerative fraying of the labrum is commonly seen in patients over the age of 40 years and is often seen in association with other problems including rotator cuff tears.
What are the symptoms of a SLAP tear?
Some of the most common symptoms of a SLAP tear include:
- A feeling of catching, locking, popping, or grinding in the shoulder.
- Pain associated with overhead activities.
- Loss of strength, pain with lifting heavy objects.
- Loss of velocity or control in throwers, “dead arm” feeling.
- Feeling of instability, or true dislocation of the joint
Surgical and non-surgical treatments for a SLAP tear
For most SLAP tears, conservative management is often effective in alleviating symptoms and improving function. Anti-inflammatory medication and periodic icing may be used to help alleviate some of the symptoms. Following diagnosis, rehabilitation exercises may also be administered to help strengthen the rotator cuff and correct shoulder blade mechanics.
If patients continue to experience symptoms despite conservative management, surgery may be recommended. A SLAP repair is a minimally invasive arthroscopic procedure which uses a tiny camera and miniature surgical instruments to repair the damaged area. During the procedure the surgeon will remove damaged tissue and the torn labrum will be sutured to a tiny anchor set into the bone. In some cases, a biceps tenodesis procedure is performed to release the biceps tendon from the torn laburm. It will be reattached lower down on the humerus bone.