SLAP Tears

What is the labrum?

The labrum is a ring of strong fibrous cartilage that surrounds the outer edge of the shoulder socket to deepen the socket and stabilize the shoulder. Many of the shoulder ligaments and tendons also attach to the shoulder labrum, including the biceps tendon. The shoulder labrum is a common site of injury and degeneration which causes both pain and disability.

What is a SLAP tear?

A slap tear is a tear in the labrum of the shoulder joint. SLAP stands for Superior Labrum Anterior and Posterior which indicates the tear is in the top or superior part of the labrum from front to back. When it tears, it can cause the bones to rub together. SLAP tears are common in the middle-aged population and are often asymptomatic.

What causes a SLAP tear?

SLAP tears are usually caused by an injury such as trauma from an auto accident or a fall on an outstretched arm.  However, they can also occur when trying to catch a heavy object, when the arm is forced above the level of the shoulder. They can also result from a shoulder dislocation.

Slap tears are often found in athletes who play overhead sports like tennis, volleyball and are common in throwing athletes. Repetitive shoulder motion can tear the labrum.  Additionally, some SLAP tears are degenerative caused by normal wear and tear over time.

What are the symptoms of a SLAP tear?

  • pain with movement or when holding the shoulder in certain positions

  • pain while lifting objects overhead

  • a feeling the shoulder is unstable

  • a sensation of locking, popping and catching or grinding

  • reduced shoulder strength

  • decreased range of motion 

Diagnosis

Diagnosis of a SLAP tear can be challenging because the symptoms are similar to other tears in the labrum, and because many SLAP tears occur with other shoulder injuries. Dr. Johnston will review your medical history and discuss your symptoms. He will then conduct a thorough examination of your shoulder using specific tests of your shoulder function; and order imaging studies to view your shoulder bones and soft tissues including x-rays and an MRI.

Treatment options

Initial treatment is non-operative treatment because it is often very successful in treating pain especially in young, active patients. Non-operative treatment includes rest, ice, over the counter anti-inflammatory medications (NSAIDS) to reduce swelling and pain, and a structured rehabilitation program.  If your pain doesn’t improve, he may recommend minimally invasive arthroscopic surgery. Surgery to repair a slap tear is often recommended for patients with a traumatic tear that is symptomatic.

Arthroscopic surgery will help Dr. Johnston visualize the damaged labrum, confirm the diagnosis and detect any other shoulder joint damage. Several small incisions or portals are made so that  the arthroscope is inserted into the joint. The scope contains a tiny camera which broadcasts the images of your shoulder on a video monitor. This allows Dr. Johnston to directly see the damage. The arthroscope also has tiny surgical instruments that are inserted into the joint to repair the SLAP tear. The benefits of arthroscopic surgery include less pain, and faster recovery. Recovery typically takes 4-6 months.

Dr. Johnston is a board-certified shoulder and elbow specialist and expert in complex surgeries of the shoulder and elbow. He was also Fellowship trained at the prestigious TJU Rothman Institute in Philadelphia.Contact Dr. Peter Johnston at his offices Leonardtown and White Plains Maryland to schedule a consultation today.