What is a SLAP tear?

Shoulder pain caused by injury or overuse occurs in 25 percent of adults sometime in their lives. Labrum tears are also called SLAP tears, Superior Labrum, Anterior to Posterior tears and make up 4% to 8% of all shoulder injuries.

The L in SLAP refers to your glenoid labrum. Your labrum has two important jobs: keeping your pain-free shoulder and working shoulder. Your labrum is a cushion for the top part of your upper arm bone.That cushion helps your upper arm bone to stay precisely where it is meant to: nested in your shoulder socket. Your labrum is a passageway to attach one of your bicep tendons to your shoulder blade socket.

This is actually an abbreviation of Superior Labrum Anterior to Posterior. The S refers to the top of your labrum. So, when that part of your labrum tears, it makes your upper arm bone lose its cushion and it loses contact between the bicep tendon and the socket of the shoulder blade. Consequently, this leads to the shoulder aching and feeling unstable.

You can injure your labrum in several different ways. SLAP tears are common sports injuries. Your labrum may be torn from an injury or degenerate slowly as you age.

Some SLAP tears heal with rest and physical therapy, while others require surgery.

What is the cause of SLAP tears?

There are three causes for SLAP tears.

• This chronic injury occurs in any people who play sports or exercise with repeated overhead motion.Most SLAP tears result from playing baseball, softball, swimming, or weightlifting. The most common cause of a SLAP tear is due to chronic injury.
• Acute injury: SLAP tears may result if you try to break a fall using your stretched arm or use sudden jerking motions to move heavy objects.
• Age: SLAP tears may happen as your labrum degenerates with age. This tear most often occurs in people age 40 or older.

What are SLAP tear symptoms?

Common symptoms of SLAP tears include:

• Shoulder pain may be more of a dull ache or sharp pain within your shoulder.
• You experience pain in your shoulder when you move your arms in certain positions, such as reaching over to the side, lifting your arm up, or stretching back with your arms to reach behind your head.
• Your activities cause significant pain, such as throwing a ball or reaching overhead.
• You hear popping noises or feel a grinding sensation when moving your shoulder.
• You may feel like your shoulder is going to pop out of your shoulder blade.

How are SLAP tears diagnosed?

Your provider uses the following tests to diagnose SLAP tears and plan treatment:

• Physical examination: Your doctor checks your arm and shoulder range of motion and strength.
• Magnetic resonance imaging (MRI) or MRI arthrogram.

How do healthcare providers help me decide on surgery for a SLAP tear?

Healthcare professionals evaluate the following when deciding whether to do surgery for SLAP tears:

The classification of the tear:

Tears are classified based on location and whether the tear may have secondary effects on other parts of your shoulder.

• Your age
• Common activities per day
• Previous non-surgical treatment

Do SLAP tears have various types?

There are many different types and subtypes of SLAP. Of the various types of SLAP tears, the most common is the type 2 tear. Type 2 tears themselves include several subtypes, each describing distinct ways in which a type 2 tear might look:

Type 1: This tear causes your labrum to be frayed or shredded, but it is still functional. Type 1: tears are often noticed among people in their middle and more advanced ages.

Type 2:  This is the most common type of SLAP tears. In Type 2 tears, the labrum and bicep tendon are torn off from the shoulder socket.

Type 3 Labrum tissue is torn and wedged into the shoulder joint.

Type 4: With this type, the tear that starts in your labrum tears your bicep tendon.

What's the treatment for SLAP tears?

SLAP tear treatment depends on the amount, and kind of damage health care providers find when they look at your labrum. They might recommend non-surgical treatments first before determining that surgery is the best way to help you. At any rate, SLAP tears can take months to recover from fully.

Here are some of the common SLAP tear treatments:

• Rest.
• Anti-inflammatory drugs.
• Cortisone shots.
• Physical therapy.
• Debridement.
• Arthroscopic labral surgery to repair your labrum.
• Bicep tenodesis.

What happens if you don't treat your SLAP tear?

The symptoms of SLAP tear may exacerbate if left untreated, and you may experience chronic pain in the shoulder area. However, it limits your ability to use your arm and shoulder.

How long does it take to recover after getting a SLAP tear?

Recovery from a SLAP tear can range from six months to a year.

What can be expected after SLAP tear surgery?

To prevent your damaged shoulder from bearing any weight, you will wear an arm sling. You might have to wear the sling for several weeks up to several months.

• Your shoulder might feel stiff.
• Your shoulder might feel weak.
• You may still have limited motion.
• Your doctor may recommend light exercise or physical therapy to regain strength.
• Some SLAP tears just can't be helped. You may have sustained a SLAP tear if you tried to grab yourself with your outstretched arm to stop your fall.

However, you can also damage your labrum with daily activities such as repeatedly engaging in sports that involve overhead arm movements and lifting heavy objects with jerky movements.

Here's how you can avoid getting a SLAP tear:

• Warm up your shoulder muscles with stretches before playing sports.
• Be mindful of pain or stiffness in your shoulders and notify your provider.

What is the prognosis for a SLAP tear?

Recovery from SLAP tear treatment is a marathon, not a sprint. Nonoperative treatment should take at least three to four months to produce relief of your pain and improvement in your functioning. Recovery may take up to a year from SLAP tear surgical treatment.

Can I re-injure my shoulder and need further SLAP tear treatment?

Recurrent, new, or more substantial SLAP tears are common. When patients return to the activity that caused the labrum tear, they may continue to injure the healed labrum or tear another area of the labrum at the exact location.

Living With

What should I know about living with SLAP tears?

Recovery from SLAP tears and treatment should not translate to any more sports or recreational activities. It's just that you need to protect your shoulder from new and recurrent injuries. Here's how to do it:

• If you're an athlete or sports enthusiast, always stretch before and after the event.
• Avoid doing an activity that makes you repeatedly reach over your head to move or lift something.
• Be constantly aware of persistent shoulder pain.
• You must go to the hospital if you have fallen, or someone or something has jerked your arm hard and you hurt your shoulder.

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