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SLAP Tears

A SLAP (Superior Labrum Anterior and Posterior) tear is a shoulder injury that affects the top of the labrum, the cartilage that surrounds the shoulder socket, where the biceps tendon attaches. It usually results from a fall or a sports injury. Many SLAP tears improve with physical therapy, and arthroscopic surgery is available for severe cases.

What Is A SLAP Tear?

The labrum helps stabilize the shoulder joint and provides a surface for the ball of the upper arm to move against. At the top of the socket, the labrum also anchors the long head of the biceps tendon. A SLAP tear occurs when this upper portion of the labrum is damaged, from front (anterior) to back (posterior).
 
SLAP tears are common in throwing athletes and in people who fall on an outstretched arm. Because their symptoms resemble rotator cuff tears and impingement, proper diagnosis is crucial. For other labrum injuries, see shoulder labral tears.

Treatments For SLAP Tears

Treatment depends on the severity of the injury and the patient's symptoms.

Non-surgical care

  • Physical therapy. May relieve symptoms and allow a full recovery.
  • Anti-inflammatory medication. Reduces pain and inflammation.
  • Injections. Calm inflammation in the joint.
  • Rest from overhead activity. Allows symptoms to settle.

Surgical options

Surgery is typically recommended for severe cases or for patients who have not responded to other treatment.

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How a SLAP Tear is Diagnosed

Diagnosis typically involves a physical examination with tests that stress the top of the labrum and the biceps tendon, along with imaging such as MRI or an arthrogram, an image taken after dye is injected into the joint. Because SLAP tears are often difficult to diagnose, an experienced evaluation is important.
 
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Labeled diagram of a SLAP tear of the shoulder labrum at the biceps tendon attachment

What Causes A SLAP Tear?

A SLAP tear usually follows a traumatic event or repetitive overhead stress. Common causes include:

A fall on an outstretched arm

Drives the ball of the shoulder into the labrum.

Throwing sports

Repetitive overhead throwing in baseball, softball, and volleyball.

Heavy lifting

Lifting heavy objects, especially overhead.

Shoulder dislocation

The force of a dislocation can tear the labrum.

A sudden pull

A sudden jerk on the arm, such as catching a falling object.

Age-related wear

The labrum frays with age, especially after 40.

Recovery After SLAP Surgery

Recovery time after surgery varies, and physical therapy is typically necessary to regain strength and range of motion.

Weeks 0 to 4

Protect the repair

A sling and gentle, guided motion.

Weeks 4 to 12

Restore motion and strength

Physical therapy to regain range of motion and build strength.

Months 3 to 6

Return to activity

Most patients return to normal activities; throwing sports may take longer.

Timelines depend on the repair and your activity level.

Frequently Asked Questions

What does SLAP stand for?

SLAP stands for Superior Labrum Anterior and Posterior. It describes a tear at the top of the shoulder labrum that extends from front to back, where the biceps tendon attaches.

What are the symptoms of a SLAP tear?

Symptoms include dull or sharp shoulder pain, difficulty lifting and reaching overhead, a popping, clicking, or catching sensation, and reduced throwing velocity or strength.

What causes a SLAP tear?

SLAP tears usually result from a traumatic event such as a fall on an outstretched arm or a sports injury, or from repetitive overhead motion such as throwing. They can also develop with age.

Why are SLAP tears hard to diagnose?

Their symptoms overlap with other shoulder problems such as rotator cuff tears and impingement, so a careful examination and imaging are needed.

How is a SLAP tear diagnosed?

Diagnosis involves a physical examination and imaging such as MRI or an arthrogram, an X-ray or MRI taken after dye is injected into the joint.

Does a SLAP tear need surgery?

Not always. Physical therapy may be enough to relieve symptoms and allow a full recovery. Surgery is recommended for severe cases or when other treatment has not helped.

How is a SLAP tear repaired?

The most common surgery is arthroscopy, performed through small incisions. The damaged labrum is repaired or removed, and the joint is checked for other problems.

How long is recovery after SLAP surgery?

Most patients return to normal activities within a few weeks to a few months, depending on activity level. Physical therapy is necessary to regain strength and motion. Call (321) 499-4646 to schedule.

Symptoms Of A SLAP Tear

Symptoms of a SLAP tear include:

  • Dull or sharp pain deep in the shoulder.
  • Difficulty with certain movements, such as lifting and reaching overhead.
  • A popping or clicking sensation in the joint.
  • Reduced strength or throwing speed in athletes.
  • A feeling of instability in the shoulder.
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Related Conditions

Shoulder Labral Tears

Shoulder labral tears are a common injury that can cause pain and limited mobility in the shoulder joint. The labrum is a ring of cartilage around the socket of the shoulder blade (scapula), which helps to deepen the socket and stabilize the shoulder joint. A tear in this cartilage can occur due to injury, degeneration, or overuse, causing pain, weakness, and instability in the shoulder.

Rotator Cuff Tears

A rotator cuff tear is a very common condition in the shoulder that can cause recurring pain, weakness, and a variety of other symptoms. When the tissues connecting muscles in the shoulder to bone, commonly known as tendons, become damaged or "torn", it can create a sensation of pain or weakness. The severity and symptoms of the tear can vary depending on what caused the tear to form and other factors.

Sports Injuries

Sports injuries are a common occurrence, especially among athletes and active individuals. Whether it's a sprained ankle, a torn ligament, or a broken bone, sports injuries can sideline even the most seasoned athlete and impact their ability to perform at their best. Orthopedic treatments are often the go-to solution for these types of injuries, helping individuals get back on their feet and back to the sport they love.

Knee Pain

Knee Pain is a common symptom that can be caused by a wide variety of conditions ranging from sports injuries to tendonitis or certain medical conditions such as arthritis. The best way to determine the exact cause and available treatment methods for your specific situation is to have a diagnosis done by an expert physician such as our team of doctors here at Total Spine.

Hip Pain

The hips are one of the most critical joints in the body, allowing you to do many of your normal daily activities such as walking, standing, and more. This makes it all the more debilitating if pain, numbness, or weakness begins to affect your hips. Symptoms such as difficulty walking, trouble sleeping, and general uncomfortableness when lying on one side or the other are all common indicators of a hip issue that may need to be addressed.

Shoulder Pain

Shoulder pain can come from rotator cuff injuries, arthritis, frozen shoulder, or a pinched nerve in the neck, and it can limit sleep and daily tasks.

Joint Pain

Pain in the joints is a very common symptom often experienced in the feet, hips, spine, knees, or hands. In addition to pain, joint stiffness, as well as a burning or throbbing sensation in or near the joints, are also commonly associated with joint-related issues. It is important to note that in many cases the pain or burning sensation may not be constant but can increase or decrease depending on activity.

Osteoarthritis

Osteoarthritis (OA) is a common degenerative joint disease that affects millions of people worldwide. It is characterized by the wear and tear of the cartilage that cushions the joints, leading to pain, stiffness, and loss of mobility. Osteoarthritis can affect any joint in the body, but it most commonly occurs in the hips, knees, and hands.

Meniscus Tears

Meniscus tears are a common injury to the knee, often caused by twisting or bending the knee forcefully. The meniscus is a crescent-shaped piece of cartilage that acts as a cushion between the thigh bone and the shin bone. It helps to distribute weight evenly across the knee joint and provides stability.

Runner’s Knee

Runner's knee is a common injury among runners and athletes. It occurs when the knee joint experiences excessive stress or wear and tear, leading to pain, inflammation, and discomfort. In this article, we will discuss the causes, symptoms, and treatments for runner's knee.

Hip Labral Tears

A labral tear is an injury to the tissue between the socket and ball portions of the hip joint. This tear can cause a variety of symptoms including intense pain, difficulty moving your hip, and reduced mobility of the hip.

When A SLAP Tear Needs Surgery

The Arthroscopic Advantage

How arthroscopic (keyhole) surgery of the shoulder compares with traditional open surgery.

Open surgeryArthroscopicMinimally invasive
IncisionOne larger incision to open the joint.A few small incisions for a camera and slim instruments.
Soft tissueMore disruption of muscle and tissue.Less disruption of the surrounding tissue.
VisualizationDirect view through the open incision.A magnified camera view inside the joint.
Hospital stayMay require a hospital stay.Usually outpatient; most patients go home the same day.
Recovery and scarringA longer recovery and a larger scar.Typically less pain, smaller scars, and a quicker start to rehabilitation.

Arthroscopic SLAP repair is performed through small incisions, and the joint is checked for any other issues during the same procedure.

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