A SLAP tear is a specific type of shoulder injury that was first described by Dr. James Andrews in 1985. The moniker stands for Superior Labrum, Anterior and Posterior (SLAP), and the condition develops when you suffer a tear to the cartilage ring in the inner part of your shoulder joint. In today’s blog, we take a closer look at why SLAP tears develop, the symptoms that accompany them and how the injury is diagnosed and treated.
Causes And Symptoms Of SLAP Tears
Your labrum plays a few crucial roles in your shoulder. For starters, your labrum acts as a cushion for the top part of your upper arm bone. This helps to keep the bone cradled in the shoulder socket where it’s supposed to be. Secondly, the labrum acts as a connection point between your shoulder blade and biceps tendon, which also helps to stabilize the area.
There are a number of different ways to tear your labrum, but SLAP tears are common in athletes that perform overhead motions, especially when these motions are quite forceful. Pitchers and other baseball players are prone to these types of injuries, but so too are volleyball players, lacrosse players and golfers. So what specifically causes the labrum to tear? Oftentimes SLAP injuries are caused by one or more of three common underlying issues:
- Chronic stress/injury – Repetitive motion, even if it doesn’t overload the labrum in an instant, can lead to microtears and other damage to the labrum. Over time, the labrum gets weaker as a result of this damage, and eventually it can tear during one of these repetitive motions.
- Acute trauma – The labrum can also tear if an acute moment of stress or trauma overwhelms the area. If you fall off a ladder and try to brace your fall with your arms, the shoulder joint is going to experience a traumatic force as it tries to lessen the impact, which can lead to labral tears. Lifting heavy objects or forceful shoulder movements can also lead to an acute labral tear.
- Aging – Aging itself won’t lead to a labral tear, but the process does lead to additional wear and tear on the labrum. Most people over the age of 40 will have some natural wear and damage on their labrum, which can put them at a higher risk for a full tear if they are exposed to repetitive motions or acute trauma.
Symptoms of a SLAP tear include:
- Dull shoulder pain.
- Sharper shoulder pain with movement, especially when moving the arm above your head.
- A grinding or popping sensation.
- A feeling of shoulder instability.
Diagnosing And Treating SLAP Tears
If you suspect that you’re dealing with a SLAP tear, or you just want to figure out what’s causing your shoulder pain, head to your primary care physician or a shoulder specialist near you. They’ll ask about your symptoms and conduct a physical exam to assess your shoulder strength and range of motion. They’ll also likely order imaging tests, which typically involves an MRI to assess the labrum and other soft tissues in the area.
Treatment will depend on the extent of your tear, your goals and which form of treatment your specialist believes will produce optimal results. For mild fraying or minor tears, conservative treatment may be able to strengthen the shoulder and prevent further damage. Those treatments usually involve a combination of rest and activity avoidance, physical therapy, stretching exercises, anti-inflammatory medications and cortisone shots. These treatments can help patients find enough relief that they can avoid surgery, but if damage is more severe or they’ll need to continue putting heavy stress on the shoulder joint, an operation may be the only option.
Surgery will also depend on your specific needs, but the goal will be to stabilize and strengthen the labrum and/or debride any loose objects that could restrict its normal movement. Following surgery you’ll remain in a shoulder sling for a period of time before eventually progressing to physical therapy, range of motion exercises and activity increases. Although it depends on the activity, sport-specific exercise and return to normal activities generally occurs around the 12-week mark following surgery for a torn labrum.
So if you use your shoulder a lot and you’ve noticed that your shoulder has become uncomfortable, or you’ve recently suffered acute trauma to the area and something just doesn’t feel right, connect with Dr. Holloway and his team today to get back on the path to pain-free shoulder movement.
