A SLAP (Superior Labrum Anteroposterior) tear occurs in the shoulder joint. The labrum is a small piece of cartilage which is circular shaped. The Superior anteroposterior part of SLAP refers to the position of the tear which is usually the top front or back of the circle. There are two main methods in which one can get a SLAP tear. The first is by falling on a straight arm. This pinches the labrum between the two shoulder bones causing a tear. The second method is a forceful contraction of the biceps muscle causing the biceps muscle to pull away from the bone at which it is attached.
This separation causes a SLAP tear.
The symptoms that most people with SLAP tears complain of are pain with throwing motions or overhead activities, pain at the back of the shoulder and sometimes popping or catching while moving the shoulder. In most cases, an MRI is used to determine whether the labrum is torn or not. In a few cases your doctor may order an MRI Arthrogram, which is an MRI with dye injected into the shoulder. This makes the labrum easier to see. If the MRI shows a positive SLAP tear, surgery is indicated in most instances since the labrum does not repair itself.
Once the diagnosis is determined, non-surgical management is attempted and usually consists of ice, anti-inflammatory medication and rest from activities or sports that cause pain. In some cases, physical therapy would be beneficial. Surgery is the only method of treatment to repair a SLAP tear since a tear does not heal itself, but non- surgical treatment may reduce the symptoms. If surgery is indicated, the patient will be immobilized for 3-4 weeks after surgery. Gentle range of motion exercises may be started at the 2 week point, and formal physical therapy will be started at the 3-4 week point after surgery.
Overall time of recovery before return to full sports is estimated to be 4-6 months. Before the patient is able to return to full competition, he or she must demonstrate full range of motion and full strength without pain. They should also be able to do sport specific drills (i.e. throwing for a baseball player) without pain. Each individual patient is different, even if they have the same diagnosis and the same surgery. This means that each patient heals at their own rate, which is why there is a time range for return to sport.
- SLAP tears occur usually by either falling on a straight arm or by a
forceful biceps contraction.
- An MRI or MRA (arthrogram) is usually necessary to determine if the
labrum is torn.
- SLAP tears do not repair themselves and if non-surgical management does
not help, then surgery is necessary to repair the tear.